Nursing Elites

1. A healthcare provider is assessing a client diagnosed with avoidant personality disorder. Which of the following behaviors should the healthcare provider expect?

• A. Social inhibition
• B. Fear of criticism
• C. Desire for close relationships
• D. Fear of abandonment

Correct answer: A

Rationale: Individuals with avoidant personality disorder commonly display social inhibition and a fear of criticism or rejection. While they may have a desire for close relationships, they tend to avoid them due to their fear of disapproval and negative evaluation by others. Fear of criticism (Choice B) is also a characteristic behavior seen in individuals with avoidant personality disorder. However, the primary behavior associated with this disorder is social inhibition (Choice A), where individuals tend to be reserved and avoid social interactions. Desiring close relationships (Choice C) may be present, but the fear of rejection typically prevents individuals from pursuing these relationships. Fear of abandonment (Choice D) is more commonly associated with borderline personality disorder rather than avoidant personality disorder.

2. When interviewing a distressed client who was fired after 15 years of loyal employment, which of the following questions would best assist the nurse in determining the client's appraisal of the situation? Select the one that does not apply.

• A. What coping resources have you used previously in stressful situations?
• B. Have you ever faced a similar stressful situation before?
• C. Who do you think is to blame for this situation?
• D. What do you believe led to your termination from your job?

Correct answer: C

Rationale: In this scenario, it is crucial for the nurse to help the client assess their coping mechanisms and perspective on the situation. Questions A and B focus on exploring the client's coping resources and past experiences to guide them towards effective stress management. Asking who is to blame (choice C) is not conducive to evaluating coping abilities; instead, it might elicit a blame-focused response, which can impede progress. Choice D, inquiring about the reason for being fired, is a nontherapeutic approach that does not promote a constructive appraisal of the situation.

3. The mental health team is determining treatment options for a male patient experiencing psychotic symptoms. Which question shouldn't the team answer to determine whether a community outpatient or inpatient setting is most appropriate?

• A. Is the patient expressing suicidal thoughts?
• B. Does the patient have intact judgment and insight into his situation?
• C. Does the patient have experiences with either community or inpatient mental healthcare facilities?
• D. Does the patient require a therapeutic environment to support the management of psychotic symptoms?

Correct answer: C

Rationale: Assessing suicidal thoughts, judgment, insight, and the need for a therapeutic environment are crucial factors in determining the appropriate treatment setting for a patient experiencing psychotic symptoms. Past experiences with mental healthcare facilities do not play a direct role in deciding between a community outpatient or inpatient setting.

4. During a manic episode, which nursing intervention is most appropriate?

• A. Encourage group activities to increase socialization.
• B. Provide a structured environment with limited stimuli.
• C. Allow the patient to engage in physical activities freely.
• D. Give the patient detailed and complex tasks to complete.

Correct answer: B

Rationale: During a manic episode, individuals may experience heightened energy levels and reduced impulse control. Providing a structured environment with limited stimuli is the most appropriate nursing intervention. This approach helps reduce excessive stimulation and potential triggers for further escalation of manic behavior. It promotes a calming and controlled setting, assisting in managing symptoms and promoting the patient's well-being. Encouraging group activities (Choice A) may lead to overstimulation, allowing the patient to engage in physical activities freely (Choice C) could be risky due to impulsivity, and giving detailed tasks (Choice D) might overwhelm the individual.

5. While auditing care plans for clients with eating disorders, the nurse realizes that a nursing diagnosis appropriate for a client with anorexia nervosa as well as for a client with bulimia nervosa is

• A. Risk for imbalanced body temperature
• B. Ineffective denial
• C. Chronic low self-esteem
• D. Adult failure to thrive

Correct answer: C

Rationale: Chronic low self-esteem is a nursing diagnosis that can be applicable to clients with both anorexia nervosa and bulimia nervosa. These eating disorders are often associated with distorted body image, feelings of inadequacy, and low self-esteem. Clients with these conditions may engage in harmful behaviors related to their self-image, making chronic low self-esteem a relevant nursing diagnosis for them.

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