Nursing Elites

1. A man who is admitted for a suicide attempt after the death of his child says, 'I hear my son telling me to come over to the other side.' Which psychotic symptom is the client experiencing?

• A. Fixed delusion
• B. Magical thinking
• C. Pathological regression
• D. Command hallucination

Correct answer: D

Rationale: The client is experiencing a command hallucination. Command hallucinations involve auditory messages instructing harm to self or others, and giving an identity to the hallucinated voice increases the risk of compliance. A fixed delusion is a false belief held to be true despite evidence to the contrary. Magical thinking involves believing that thoughts can influence events, commonly seen in young children. Pathological regression refers to reverting to a previous developmental stage, not applicable in this scenario.

2. What feeling is likely to result from withdrawn behavior?

• A. Anger
• B. Paranoia
• C. Loneliness
• D. Boredom

Correct answer: C

Rationale: Withdrawn behavior involves avoiding social interactions and isolating oneself. This isolation can lead to feelings of loneliness as the individual lacks connection and companionship. While anger or paranoia may contribute to withdrawal, loneliness is a common emotional consequence of prolonged social isolation. Boredom may also arise from withdrawal if meaningful activities and social engagements are reduced.

3. Which implemented strategies would not be effective in preventing post-traumatic stress in the nursing staff?

• A. Providing breaks to the staff whenever needed
• B. Encouraging the staff to work for more than 12 hours per day
• C. Encouraging the staff to encourage and support their coworkers
• D. Asking the staff and managers to talk about their feelings with each other

Correct answer: B

Rationale: To prevent post-traumatic stress in the nursing staff, it is crucial to avoid overworking them. Encouraging staff to work for more than 12 hours per day can lead to burnout and increased stress levels, thus exacerbating post-traumatic stress. Providing breaks whenever needed is essential to ensure rest and rejuvenation during demanding shifts. Encouraging staff to support and uplift their coworkers can create a positive work environment, fostering resilience against stress. Additionally, promoting open communication by asking staff and managers to discuss their feelings can facilitate emotional processing and mutual support, ultimately reducing the risk of post-traumatic stress.

4. A client at a local university claims to be the president of the university. Which type of delusion is the client displaying?

• A. Somatic
• B. Grandiose
• C. Erotomanic
• D. Persecutory

Correct answer: B

Rationale: The correct answer is 'Grandiose.' This type of delusion involves an exaggerated sense of self-importance, where the individual believes they are a prominent figure or possess special abilities. In this scenario, the client claiming to be the president of the university is displaying grandiose delusions. Somatic delusions relate to bodily functions or sensations, which are not present in this case. Erotomanic delusions involve the fixed belief that another person is in love with the individual, which is not applicable here. Persecutory delusions involve the belief that one is being targeted or conspired against, which is also not demonstrated in the given situation.

5. Which statement best describes the pathophysiology of dementia of the Alzheimer type?

• A. There is a genetic predisposition and dysregulation of neurotransmitters.
• B. The dementia is transient and secondary to a physical imbalance or disorder.
• C. Hypoxia and decreased perfusion of select areas of the brain cause tissue damage.
• D. The presence of amyloid plaques is associated with brain tissue destruction.

Correct answer: D

Rationale: In Alzheimer's disease, the accumulation of amyloid plaques in the brain is a hallmark feature. These plaques are associated with the destruction of brain tissue, contributing to the cognitive decline seen in dementia. Genetic predisposition and dysregulation of neurotransmitters are factors linked to the development of Alzheimer's disease, but the primary pathology lies in the amyloid plaques. Transient dementia is not characteristic of Alzheimer's disease, which is a progressive neurodegenerative disorder. Hypoxia and decreased perfusion are more typical of vascular dementia, where blood flow to the brain is compromised.

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