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. Tammy, a 28-year-old with major depressive disorder and bulimia nervosa, is ready for discharge from the county hospital after 2 weeks of inpatient therapy. Tammy is taking citalopram (Celexa) and reports that it has made her feel more hopeful. With a secondary diagnosis of bulimia nervosa, what is an alternative antidepressant to consider?

• A. Fluoxetine (Prozac)
• B. Isocarboxazid (Marplan)
• C. Amitriptyline
• D. Duloxetine (Cymbalta)

Correct answer: A

Rationale: Fluoxetine (Prozac) is a suitable alternative antidepressant for Tammy due to its approval for the treatment of bulimia nervosa. It belongs to the selective serotonin reuptake inhibitor (SSRI) class of antidepressants, similar to citalopram, which Tammy is already taking. Fluoxetine has shown efficacy in treating bulimia nervosa and can be a beneficial choice for individuals with this condition.

3. A client diagnosed with schizophrenia is receiving discharge teaching. Which of the following instructions should the nurse exclude?

• A. Continue taking medications as prescribed
• B. Avoid all social interactions
• C. Report any side effects of medications to the healthcare provider
• D. Develop a daily routine

Correct answer: B

Rationale: The nurse should exclude the instruction to 'Avoid all social interactions' when providing discharge teaching to a client with schizophrenia. It's important for individuals with schizophrenia to continue taking medications as prescribed, report any medication side effects to the healthcare provider, and develop a daily routine to promote stability. Social interactions, albeit with appropriate boundaries, can be beneficial for the client's well-being and integration into the community.

4. A client with depression is experiencing anhedonia. Which statement by the client reflects this symptom?

• A. I feel so anxious all the time.
• B. I don't enjoy the things I used to love.
• C. I can't concentrate on anything.
• D. I have trouble sleeping through the night.

Correct answer: B

Rationale: Anhedonia is the inability to experience pleasure from activities usually found enjoyable. The statement 'I don't enjoy the things I used to love' directly reflects this symptom as the client is expressing a lack of pleasure from previously enjoyable activities. Choices A, C, and D do not specifically relate to anhedonia but rather indicate symptoms of anxiety, concentration difficulties, and sleep disturbances, respectively.

5. Which characteristic identified during an assessment serves to support a diagnosis of disruptive mood dysregulation disorder? Select one that doesn't apply.

• A. Female
• B. 7 years old
• C. Comorbid autism diagnosis
• D. Outbursts occur at least once a week

Correct answer: C

Rationale: Characteristics such as age, frequency of outbursts, and occurrence in multiple settings support a diagnosis of disruptive mood dysregulation disorder. While comorbid conditions like autism can coexist with disruptive mood dysregulation disorder, it is not a characteristic that serves to support a diagnosis of this specific disorder.

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