Nursing Elites

1. A family member of a client with a diagnosis of Schizophrenia asks about the prognosis. The nurse's response is based on the knowledge that schizophrenia:

• A. affects both genders equally.
• B. is a chronic, deteriorating disease with periods of remission.
• C. is usually diagnosed in early adulthood.
• D. does not have a clear protective hormone effect delaying diagnosis.

Correct answer: B

Rationale: The correct answer is B: 'is a chronic, deteriorating disease with periods of remission.' While choices A, C, and D contain some truths about schizophrenia, they do not directly address the prognosis aspect of the question. Schizophrenia can affect both men and women equally, is typically diagnosed in early adulthood, and does not have a known protective hormone effect that delays diagnosis. Choice B accurately reflects the chronic and fluctuating nature of the disease, which is essential for understanding its long-term course.

2. How does the ANA define the psychiatric nursing role?

• A. a specialized area of nursing practice that employs theories of human behavior as its science and the powerful use of self as its art
• B. assisting the therapist to relieve the symptoms of clients
• C. to solve clients' problems and give them the answers
• D. having a client committed to long-term therapy with the nurse

Correct answer: A

Rationale: The correct answer aligns with the ANA's definition of the psychiatric nursing role. According to the ANA, psychiatric nursing is a specialized area of nursing practice that incorporates theories of human behavior as its foundational science and utilizes the self as its essential art. This definition emphasizes the importance of understanding human behavior and leveraging therapeutic communication and relationships to provide effective care for individuals with mental health concerns. Choices B, C, and D are incorrect because they do not accurately represent the ANA-defined role of psychiatric nursing. Psychiatric nurses primarily focus on delivering holistic care, promoting mental health, and supporting individuals with mental health challenges using evidence-based practices and therapeutic interventions.

3. The client is scheduled for a pericentesis. Which instruction should be given to the client before the exam?

• A. "You will need to lie flat during the exam."?
• B. "You need to empty your bladder before the procedure."?
• C. "You will be asleep during the procedure."?
• D. "The doctor will inject a medication to treat your illness during the procedure."?

Correct answer: B

Rationale: The client scheduled for a pericentesis should be instructed to empty the bladder to prevent the risk of bladder puncture when the needle is inserted. A pericentesis involves removing fluid from the peritoneal cavity. The client is typically positioned sitting up or leaning over a table, making answer A incorrect. During a pericentesis, the client is usually awake, so answer C is incorrect. Medications are not commonly injected into the peritoneal cavity during this procedure, making answer D incorrect. However, it's important to note that the administration of medications during the procedure could vary based on specific circumstances.

4. Which of the following describes the stages of domestic violence in an intimate relationship?

• A. happiness, crisis, angry outburst, intervention
• B. honeymoon period, escalation of stress, outburst, reconciliation
• C. acting out and making up
• D. peace and calm, angry outburst, peace and calm, denial

Correct answer: B

Rationale: The correct answer is B: 'honeymoon period, escalation of stress, outburst, reconciliation.' A pattern of behavior known as the cycle of abuse involves these stages. It starts with a honeymoon phase, followed by a buildup of stress, an outburst which may involve violence, and then reconciliation. This cycle is commonly observed in domestic violence situations. Choices A, C, and D do not accurately represent the stages of domestic violence in intimate relationships. Choice A mixes positive and negative elements, while choice C simplifies the complex dynamics of domestic violence. Choice D repeats 'peace and calm' inappropriately and includes 'denial,' which is not typically a stage in the cycle of abuse.

5. When the nurse who was not promoted first read the memo and learned that the other nurse had received the promotion, she left the room in tears. This behavior is an example of:

• A. conversion.
• B. regression
• C. introjection.
• D. rationalization

Correct answer: B

Rationale: Crying is a regressive behavior. The ego returned to an earlier, comforting, and less-mature way of behaving in the face of disappointment. Regression involves reverting to an earlier stage of development to cope with stress or conflict. In this scenario, the nurse regressed to a childlike state by crying when faced with the disappointment of not getting the promotion, demonstrating regression as a defense mechanism. Conversion involves transforming anxiety into a physical symptom. Introjection involves unconsciously identifying intensely with another person. Rationalization involves unconsciously creating acceptable explanations to justify unacceptable ideas, actions, or feelings. Therefore, the correct answer is regression as it aligns with the nurse's behavior of regressing to a childlike state by crying due to the disappointment of not receiving the promotion.

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