Nursing Elites

1. A healthcare provider is assessing a client who has been diagnosed with conversion disorder. Which of the following findings should the provider expect?

• A. Paralysis of a limb
• B. Auditory hallucinations
• C. Dissociative amnesia
• D. Compulsive behaviors

Correct answer: A

Rationale: Conversion disorder is characterized by the development of neurological symptoms, such as paralysis of a limb, that cannot be explained by medical evaluation. The paralysis is typically due to a psychological conflict or stress rather than a physical issue. Auditory hallucinations, dissociative amnesia, and compulsive behaviors are not commonly associated with conversion disorder, making them incorrect choices. Therefore, the healthcare provider should expect to find paralysis of a limb in a client with conversion 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. When explaining one of the main differences between narcolepsy and obstructive sleep apnea syndrome, what should the nurse mention?

• A. Symptoms of the two diagnoses are essentially the same, making it difficult to differentiate between them.
• B. People with narcolepsy awaken from a nap feeling rested and replenished.
• C. People with obstructive sleep apnea syndrome can experience temporary paralysis during naps.
• D. Naps are contraindicated for clients with narcolepsy due to their association with catatonia.

Correct answer: B

Rationale: Narcolepsy is a sleep disorder characterized by excessive daytime sleepiness and sudden attacks of sleep, while obstructive sleep apnea syndrome involves the obstruction of the upper airway during sleep. One of the main differences is that people with narcolepsy often experience refreshing naps, feeling rested and replenished upon waking, which is not the case for obstructive sleep apnea syndrome. This distinction is important for healthcare providers to understand as it helps differentiate between these two sleep disorders.

4. In the care plan of a male patient diagnosed with a dissociative disorder, the nursing diagnosis of ineffective coping is included. Which behavior demonstrated by the patient supports this nursing diagnosis?

• A. Has no memory of the physical abuse he endured.
• B. Using both alcohol and marijuana.
• C. Often reports being unaware of surroundings.
• D. Reports feelings of 'not really being here.'

Correct answer: B

Rationale: The correct answer is B because using substances like alcohol and marijuana can be a sign of ineffective coping mechanisms in patients with dissociative disorders. Substance abuse is often used as a maladaptive way to cope with stress, trauma, or other underlying issues. Choices A, C, and D may be related to dissociative symptoms but do not directly reflect ineffective coping behaviors as substance abuse does.

5. A client with schizophrenia is experiencing delusions. Which intervention should the nurse implement to address this symptom?

• A. Encourage the client to ignore the delusions.
• B. Provide reality-based feedback to the client.
• C. Distract the client from the delusions.
• D. Encourage the client to discuss the delusions.

Correct answer: B

Rationale: When a client with schizophrenia is experiencing delusions, providing reality-based feedback is considered an effective intervention to address this symptom. This approach helps the client differentiate between what is real and what is not real, assisting them in managing their delusions and promoting their overall well-being. Choice A is incorrect because ignoring the delusions does not help the client in distinguishing reality from delusions. Choice C is incorrect as distraction may only provide temporary relief but does not address the underlying issue. Choice D is incorrect because encouraging the client to discuss the delusions may reinforce or intensify them rather than help in managing them effectively.

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