Nursing Elites

1. A healthcare professional is assessing a patient with bipolar disorder. Which finding suggests the patient is experiencing a manic episode?

• A. Decreased need for sleep
• B. Feelings of worthlessness
• C. Increased need for sleep
• D. Avoidance of social interactions

Correct answer: A

Rationale: During a manic episode in patients with bipolar disorder, they often experience a decreased need for sleep. This symptom is characterized by feeling rested after only a few hours of sleep, or even feeling like they can go without sleep for extended periods without feeling tired. The increased energy levels and racing thoughts during a manic episode contribute to the decreased need for sleep.

2. While being treated in an inpatient facility, what is the most appropriate intervention for a patient with anorexia nervosa?

• A. Allowing the patient to eat alone to reduce stress
• B. Monitoring the patient's weight daily
• C. Encouraging the patient to exercise daily
• D. Providing the patient with a high-calorie diet

Correct answer: B

Rationale: Monitoring the patient's weight daily is the most appropriate intervention for a patient with anorexia nervosa being treated in an inpatient facility. This approach helps healthcare providers track the patient's progress, assess nutritional status, and promptly identify any concerning changes or trends that may require intervention.

3. James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for the day shift and anxiously reports, “Last night, demons came to my room and tried to rape me.” Which response would be most therapeutic?

• A. There are no such things as demons. What you saw were hallucinations.
• B. It is not possible for anyone to enter your room at night. You are safe here.
• C. You seem very upset. Please tell me more about what you experienced last night.
• D. That must have been very frightening, but we’ll check on you at night and you’ll be safe.

Correct answer: C

Rationale: The most therapeutic response acknowledges the patient's emotional state and invites further discussion about their experience. By saying, 'You seem very upset. Please tell me more about what you experienced last night,' the nurse shows empathy and openness, providing a supportive environment for the patient to express their feelings and perceptions.

4. A client is discussing free associations as a therapeutic tool with a nurse. Which of the following client statements indicates an understanding of this technique?

• A. “I will write down my dreams as soon as I wake up.”
• B. “I might begin to associate my therapist with important people in my life.”
• C. “I can learn to express myself in a nonaggressive manner.”
• D. “I should say the first thing that comes to my mind.”

Correct answer: D

Rationale: Free association is a psychoanalytic technique where the client is encouraged to say the first thing that comes to their mind without censoring or filtering. This technique helps uncover unconscious thoughts and emotions. Choice D, “I should say the first thing that comes to my mind,” indicates an understanding of free association as it aligns with the principle of allowing thoughts to flow freely without inhibition. Choices A, B, and C do not reflect an understanding of free association and its purpose, making them incorrect. A, focusing on writing down dreams, does not relate to the immediate expression of thoughts. B, associating the therapist with important people, and C, learning to express oneself nonaggressively, do not capture the essence of free association as a technique for exploring unconscious processes.

5. What is a common side effect of benzodiazepines prescribed for anxiety?

• A. Weight gain
• B. Insomnia
• C. Drowsiness
• D. Increased appetite

Correct answer: C

Rationale: The correct answer is C: Drowsiness. Benzodiazepines, commonly prescribed for anxiety, often cause drowsiness as a side effect due to their sedative properties. This can lead to impairments in cognitive and motor skills, making it important for individuals on these medications to exercise caution when performing tasks that require alertness, such as driving or operating machinery. Choices A, B, and D are incorrect because weight gain, insomnia, and increased appetite are not typically associated with benzodiazepines; instead, drowsiness and sedation are more commonly reported side effects.

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