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. For a patient diagnosed with borderline personality disorder exhibiting self-harming behavior, which therapeutic approach is most appropriate?

• A. Dialectical behavior therapy
• B. Psychoanalysis
• C. Supportive therapy
• D. Pharmacotherapy

Correct answer: A

Rationale: The most appropriate therapeutic approach for a patient diagnosed with borderline personality disorder exhibiting self-harming behavior is dialectical behavior therapy (DBT). DBT is specifically designed to address the core symptoms of borderline personality disorder, including self-harming behaviors. It focuses on teaching patients skills to manage emotions, improve interpersonal relationships, and enhance distress tolerance. Psychoanalysis (Choice B) is not the most appropriate for immediate symptom management in this case. Supportive therapy (Choice C) may not provide the structured approach needed to address self-harming behaviors effectively. Pharmacotherapy (Choice D) may be used as an adjunct in some cases, but DBT is the frontline therapy for managing self-harming behaviors in borderline personality disorder.

3. A school nurse is assessing a female high school student who is overly concerned about her appearance. The client's mother states, 'That's not something to be stressed about!' Which is the most appropriate nursing response?

• A. Teenagers! They don't know a thing about real stress.
• B. Stress occurs only when there is a loss.
• C. When you are in poor physical condition, you can't experience psychological well-being.
• D. Stress can be psychological. A threat to self-esteem may result in high stress levels.

Correct answer: D

Rationale: The most appropriate response is D: 'Stress can be psychological. A threat to self-esteem may result in high stress levels.' This response acknowledges the psychological aspect of stress and how a perceived threat to self-esteem can be just as stressful as a physiological change. Choices A, B, and C are incorrect because they do not address the client's concerns or provide a therapeutic response to the situation.

4. A client with borderline personality disorder is receiving care. Which of the following interventions should be included in the plan of care?

• A. Set clear and consistent boundaries
• B. Encourage independence
• C. Avoid discussing the client's feelings
• D. Use a firm, authoritative approach

Correct answer: B

Rationale: When caring for a client with borderline personality disorder, it is essential to encourage independence rather than dependency. This helps promote autonomy and self-reliance, which are important aspects of treatment. Setting clear and consistent boundaries is also crucial, as it provides structure and predictability. Avoiding discussing the client's feelings is not recommended, as addressing emotions and promoting emotional awareness is a key part of therapy. Using a firm, authoritative approach may not be the most effective strategy as it can lead to power struggles and conflicts in individuals with borderline personality disorder.

5. Which drug group requires nursing assessment for the development of abnormal movement disorders in individuals taking therapeutic dosages?

• A. SSRIs
• B. Antipsychotics
• C. Benzodiazepines
• D. Tricyclic antidepressants

Correct answer: B

Rationale: Antipsychotics are known to cause extrapyramidal symptoms, which manifest as abnormal movement disorders. Nursing assessments are crucial in monitoring patients taking antipsychotics to promptly identify and manage these potential side effects.

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