Nursing Elites

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

• A. Difficulty making decisions
• B. Preoccupation with orderliness
• C. Attention-seeking behavior
• D. Aggression

Correct answer: A

Rationale: Individuals with dependent personality disorder typically struggle with making decisions independently and rely heavily on others for guidance and reassurance. This can manifest as difficulty in initiating or making choices without the input of others. Clients with this disorder often display clingy, submissive behaviors and fear being alone, which aligns with the characteristic of difficulty making decisions seen in option A. Choices B, C, and D are not typically associated with dependent personality disorder. Preoccupation with orderliness may be seen in obsessive-compulsive personality disorder, attention-seeking behavior in histrionic personality disorder, and aggression in other disorders such as antisocial personality disorder.

2. Natasha's husband died suddenly two months ago, and she has been overwhelmed with grief. When Natasha is subsequently diagnosed with major depressive disorder, her daughter, Nadia, makes which true statement?

• A. Depression often begins after a major loss. Losing dad was a major loss.
• B. Bereavement and depression are the same problem.
• C. Mourning is pathological and not normal behavior.
• D. Antidepressant medications will not help this type of depression.

Correct answer: A

Rationale: When individuals experience a significant loss, such as the death of a loved one, it can trigger major depressive disorder. This is because the intense grief and sadness associated with the loss can lead to the development of depressive symptoms. Therefore, Nadia's statement that 'Depression often begins after a major loss' is accurate in this context.

3. Which response by a 15-year-old demonstrates a common symptom observed in patients diagnosed with major depressive disorder?

• A. I'm so restless. I can't seem to sit still.
• B. I spend most of my time studying. I have to get into a good college.
• C. I'm not trying to diet, but I've lost about 5 pounds in the past 5 months.
• D. I go to sleep around 11 p.m. but I'm always up by 3 a.m. and can't go back to sleep.

Correct answer: D

Rationale: Sleep disturbances, such as early morning awakening, are common symptoms of major depressive disorder.

4. A client with obsessive-compulsive disorder (OCD) is being cared for by a nurse. Which intervention should the nurse include in the plan of care?

• A. Encourage the client to suppress compulsive behaviors.
• B. Set strict limits on the amount of time the client can engage in compulsive behaviors.
• C. Allow the client to perform compulsive behaviors as needed.
• D. Gradually limit the amount of time allotted for compulsive behaviors.

Correct answer: D

Rationale: In caring for a client with OCD, it is essential to gradually limit the time allotted for compulsive behaviors. This intervention helps the client develop alternative coping mechanisms. Encouraging suppression or setting strict limits on compulsive behaviors can exacerbate the client's anxiety, making it crucial to approach the care plan with a gradual reduction strategy. Allowing the client to perform compulsive behaviors as needed does not promote progress towards managing OCD symptoms and may reinforce maladaptive patterns of behavior.

5. Which statement made by the nurse demonstrates the best understanding of nonverbal communication?

• A. The patient's verbal and nonverbal communication is often different.
• B. When my patient responds to my question, I check for congruence between verbal and nonverbal communication to help validate the response.
• C. If a patient is slumped in the chair, I can be sure he's angry or depressed.
• D. It's easier to understand verbal communication than nonverbal communication.

Correct answer: B

Rationale: Checking for congruence between verbal and nonverbal communication helps validate the patient's response.

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