Nursing Elites

1. A client has been diagnosed with paranoid personality disorder. Which of the following behaviors should the nurse expect?

• A. Distrust of others
• B. Reluctance to confide in others
• C. Suspiciousness of others
• D. Jealousy of others

Correct answer: A

Rationale: Individuals with paranoid personality disorder commonly display a pervasive distrust of others. They often interpret benign actions of others as hostile or malicious, leading to suspicion and a belief that others have malevolent intentions. While choices B, C, and D may be present in individuals with different personality disorders or issues, distrust of others is a hallmark feature of paranoid personality disorder, making it the correct behavior to expect in these clients.

2. A client diagnosed with generalized anxiety disorder (GAD) states, 'I just can't stop worrying about everything.' Which nursing diagnosis is most appropriate for this client?

• A. Ineffective coping
• B. Disturbed thought processes
• C. Chronic low self-esteem
• D. Social isolation

Correct answer: A

Rationale: The most appropriate nursing diagnosis for a client with generalized anxiety disorder (GAD) who expresses an inability to stop worrying about everything is 'Ineffective coping.' This diagnosis indicates the client's struggle to manage anxiety and worry effectively, which aligns with the client's statement. 'Disturbed thought processes' (Choice B) would involve disorganized or irrational thinking patterns, which are not directly related to the client's statement about excessive worry. 'Chronic low self-esteem' (Choice C) refers to a long-standing negative self-evaluation and is not the most fitting diagnosis for the client's current concern. 'Social isolation' (Choice D) pertains to a lack of social interactions and support, which is not the primary issue highlighted by the client's statement.

3. A nurse is providing discharge instructions to a client who has been prescribed fluoxetine (Prozac). Which information should the nurse include?

• A. Take the medication with food to avoid stomach upset.
• B. Avoid drinking alcohol while taking this medication.
• C. Report any unusual side effects to the healthcare provider.
• D. It may take several weeks for this medication to take effect.

Correct answer: B

Rationale: Clients taking fluoxetine (Prozac) should avoid alcohol to prevent adverse interactions.

4. Which therapeutic communication statement might a psychiatric-mental health registered nurse use when a patient's nursing diagnosis is altered thought processes?

• A. I know you say you hear voices, but I cannot hear them.
• B. Stop listening to the voices, they are NOT real.
• C. You say you hear voices, what are they telling you?
• D. Please tell the voices to leave you alone for now.

Correct answer: C

Rationale: Asking about the content of the voices helps understand the patient's experience and assess risk.

5. A healthcare professional is planning care for a client with borderline personality disorder. Which of the following interventions should not be included in the plan of care?

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

Correct answer: B

Rationale: In caring for a client with borderline personality disorder, it is essential to set clear and consistent boundaries, use a firm, authoritative approach, and provide opportunities for the client to express feelings. Encouraging dependency can reinforce maladaptive behaviors, while avoiding discussing feelings can hinder therapeutic progress in addressing underlying issues. Building a sense of dependency may exacerbate the client's difficulties in developing autonomy and self-reliance, which are crucial for their progress and recovery. Therefore, encouraging dependency is not a recommended intervention in the plan of care for clients with borderline personality disorder.

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