Nursing Elites

1. When assessing a patient with schizophrenia who exhibits disorganized speech and behavior, these symptoms are classified as:

• A. Positive symptoms
• B. Negative symptoms
• C. Cognitive symptoms
• D. Mood symptoms

Correct answer: A

Rationale: Positive symptoms in schizophrenia refer to excesses or distortions in normal behavior and include symptoms like hallucinations, delusions, and disorganized speech and behavior. Disorganized speech and behavior are considered positive symptoms because they represent an excess or distortion of normal functions. Negative symptoms involve deficits in normal behavior, cognitive symptoms affect thinking processes, and mood symptoms relate to emotional experiences. Therefore, in this scenario, the disorganized speech and behavior exhibited by the patient are classified as positive symptoms.

2. A female patient diagnosed with schizophrenia has been prescribed a first-generation antipsychotic medication. What information should the nurse provide to the patient regarding her signs and symptoms?

• A. Her memory problems will likely decrease.
• B. Depressive episodes should be less severe.
• C. She will probably enjoy social interactions more.
• D. She should experience a reduction in hallucinations.

Correct answer: D

Rationale: First-generation antipsychotic medications are effective in reducing hallucinations in patients with schizophrenia. These medications primarily target positive symptoms such as hallucinations and delusions. Therefore, the nurse should inform the patient that she should experience a reduction in hallucinations with the prescribed first-generation antipsychotic medication.

3. A client with bipolar disorder is experiencing a depressive episode. Which of the following interventions should the nurse avoid implementing?

• A. Encourage participation in activities
• B. Promote adequate nutrition and hydration
• C. Monitor for suicidal ideation
• D. Discourage verbalization of feelings

Correct answer: D

Rationale: In caring for a client with bipolar disorder in a depressive episode, the nurse should implement interventions that promote mental well-being. Encouraging participation in activities, promoting adequate nutrition and hydration, and monitoring for suicidal ideation are all essential components of care. Discouraging verbalization of feelings is counterproductive as it hinders the therapeutic process and communication, which are crucial for the client's emotional expression and recovery.

4. When assessing a patient with generalized anxiety disorder (GAD), which symptom would a nurse most likely observe?

• A. Flashbacks
• B. Excessive worry
• C. Hallucinations
• D. Compulsive behaviors

Correct answer: B

Rationale: Excessive worry is a primary characteristic of generalized anxiety disorder (GAD). Patients with GAD experience persistent and excessive worry about various aspects of their lives, often anticipating disaster or catastrophic outcomes. This worry is difficult to control and can be accompanied by physical symptoms like restlessness, fatigue, irritability, muscle tension, and difficulty concentrating. Flashbacks are more commonly associated with post-traumatic stress disorder (PTSD), hallucinations are more typical of psychotic disorders, and compulsive behaviors are characteristic of obsessive-compulsive disorder (OCD). Therefore, when assessing a patient with GAD, a nurse would most likely observe excessive worry.

5. 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.

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