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. When educating the family of a client diagnosed with dissociative identity disorder, which of the following instructions should the nurse include?

• A. Encourage the client to avoid stressful situations.
• B. Encourage the client to participate in daily activities.
• C. Encourage the client to express their feelings.
• D. Encourage the client to develop a daily routine.

Correct answer: D

Rationale: In cases of dissociative identity disorder, it is beneficial for the client to establish a daily routine. This structure can enhance symptom management and provide a sense of stability, which is particularly important for individuals with this condition. Encouraging the client to avoid stressful situations (Choice A) may not always be possible and does not address the need for structure. While encouraging the client to participate in daily activities (Choice B) is important, having a routine is more crucial for managing dissociative identity disorder. Expressing feelings (Choice C) is valuable but establishing a routine takes precedence in this situation.

3. Before discharge from the chemical dependency unit, clients are introduced to different community resources. Which of the following resources would be best for a teenage client, who has been abusing over-the-counter sedatives and is ready for discharge in two days?

• A. Detoxification center
• B. Home care
• C. Assertive community team
• D. Twelve-step recovery group

Correct answer: A

Rationale: For a teenage client who has been abusing over-the-counter sedatives and is ready for discharge in two days, the best resource would be a detoxification center. This specialized facility can provide the necessary medical and psychological support to safely manage the withdrawal symptoms associated with substance abuse. It is crucial to ensure a safe and supervised detox process for the client's well-being and successful recovery.

4. A nurse is providing education to the family of a client who has been diagnosed with major depressive disorder. Which of the following instructions should the nurse include?

• A. Encourage the client to avoid caffeine.
• B. Encourage the client to participate in physical activity.
• C. Encourage the client to express their feelings.
• D. Encourage the client to avoid isolation.

Correct answer: D

Rationale: The nurse should instruct the family to encourage the client to avoid isolation. Social support and interaction are crucial for individuals with major depressive disorder as it can help in improving mood, reducing feelings of loneliness, and providing a sense of belonging and support. Choices A, B, and C are not the most appropriate instructions for a client with major depressive disorder. While avoiding caffeine can be beneficial for some individuals with anxiety or sleep issues, it is not a primary intervention for major depressive disorder. Encouraging physical activity and expressing feelings are important aspects of managing depression, but avoiding isolation is more critical to address first.

5. In evaluating a client's response to stress, what would indicate a secondary appraisal of the stressful event?

• A. When the individual judges the event to be benign
• B. When the individual judges the event to be irrelevant
• C. When the individual judges the resources and skills needed to deal with the event
• D. When the individual judges the event to be pleasurable

Correct answer: C

Rationale: A secondary appraisal occurs when an individual evaluates the resources and skills required to cope with a stressful event. This type of appraisal focuses on the person's perceived ability to manage the situation. In contrast, choices A, B, and D do not involve the assessment of resources and skills. Choice A relates to a benign judgment of the event, choice B to an irrelevant judgment, and choice D to a pleasurable judgment, which are aspects of primary rather than secondary appraisals.

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