Nursing Elites

1. A client has been diagnosed with borderline personality disorder. Which behavior is characteristic of this disorder?

• A. Excessive need for attention
• B. Instability in relationships
• C. Fear of abandonment
• D. Lack of interest in activities

Correct answer: B

Rationale: The correct answer is B: Instability in relationships. Individuals with borderline personality disorder often exhibit instability in their relationships, characterized by intense and unstable interpersonal connections, oscillating between idealization and devaluation. This pattern can lead to frequent conflicts, dramatic emotional shifts, and difficulties maintaining stable relationships. Choices A, C, and D are incorrect. While individuals with borderline personality disorder may also have an excessive need for attention, fear of abandonment, or lack of interest in activities, the hallmark feature defining this disorder is the instability in relationships.

2. A client is diagnosed with generalized anxiety disorder (GAD). Which of the following interventions should the nurse implement? Select one that does not apply.

• A. Encourage the client to express their feelings
• B. Teach the client relaxation techniques
• C. Promote regular physical activity
• D. Encourage the use of caffeine

Correct answer: D

Rationale: Interventions for a client with GAD should include encouraging the client to express their feelings, teaching relaxation techniques, and promoting regular physical activity. Caffeine should be avoided as it can exacerbate anxiety symptoms. Stimulants like caffeine can increase feelings of restlessness and nervousness, making it counterproductive in managing anxiety. Choices A, B, and C are appropriate interventions for managing generalized anxiety disorder by promoting emotional expression, relaxation, and physical well-being, respectively. Choice D, encouraging the use of caffeine, is incorrect as it can worsen anxiety symptoms rather than alleviate them.

3. A client with borderline personality disorder exhibits self-mutilating behavior. Which nursing intervention should the nurse implement to address this behavior?

• A. Encourage the client to discuss underlying issues.
• B. Set firm limits on the client's behavior.
• C. Provide a safe environment to prevent self-harm.
• D. Discuss the consequences of self-mutilating behavior.

Correct answer: C

Rationale: The correct intervention when dealing with a client exhibiting self-mutilating behavior, especially with borderline personality disorder, is to provide a safe environment to prevent self-harm. This approach is crucial in ensuring the client's physical safety and well-being. Setting firm limits may be appropriate in some situations, but the immediate priority is to prevent self-harm. Encouraging the client to discuss underlying issues and discussing consequences are important aspects of therapy; however, in the case of acute self-mutilating behavior, the primary focus should be on creating a safe environment to prevent harm.

4. During an intake assessment, a healthcare professional asks both physiological and psychosocial questions. The client angrily responds, 'I'm here for my heart, not my head problems.' What is the healthcare professional's best response?

• A. It's just a routine part of our assessment. All clients are asked these same questions.
• B. Why are you concerned about these types of questions?
• C. Psychological factors, like excessive stress, have been found to affect medical conditions.
• D. We can skip these questions, if you like. It isn't imperative that we complete this section.

Correct answer: C

Rationale: The healthcare professional should educate the client on the negative effects of excessive stress on medical conditions. Understanding the interconnectedness of physical and mental health is crucial for providing holistic care. Choice A is incorrect because it doesn't address the importance of psychosocial aspects. Choice B is wrong as it doesn't provide relevant information about the impact of psychological factors on health. Choice D is incorrect because skipping questions would lead to an incomplete assessment, potentially missing crucial information affecting the client's overall health outcomes.

5. Luc's family comes home one evening to find him extremely agitated, and they suspect he is in a full manic episode. The family calls emergency medical services. While one medic is talking with Luc and his family, the other medic is counting something on his desk. What is the medic most likely counting?

• A. Hypodermic needles
• B. Fast food wrappers
• C. Empty soda cans
• D. Energy drink containers

Correct answer: D

Rationale: Energy drink containers are often associated with exacerbating manic episodes due to their high caffeine content, which can worsen symptoms of agitation and restlessness.

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