Nursing Elites

1. When caring for a client with major depressive disorder, what is the most appropriate short-term goal for the client?

• A. The client will report a decrease in depressive symptoms.
• B. The client will establish a sleep routine.
• C. The client will improve social interactions.
• D. The client will set realistic goals for the future.

Correct answer: A

Rationale: The most appropriate short-term goal for a client with major depressive disorder is for them to report a decrease in depressive symptoms. This goal is specific, measurable, and achievable, focusing on the primary symptoms of the disorder. By monitoring and assessing the client's self-reported improvement in depressive symptoms, the healthcare team can track progress and adjust interventions accordingly.

2. During pregnancy, a woman is in a relationship with a male who routinely abuses her. Her unborn child may engage in high-risk behavior as a teen as a result of:

• A. Maternal stress
• B. Parental nurturing
• C. Appropriate stress responses in the brain
• D. Memories of the abuse

Correct answer: A

Rationale: Maternal stress during pregnancy can have long-term effects on the child's behavior and stress responses. Research shows that exposure to high levels of stress hormones in the womb can influence the developing fetal brain and the child's future behavior, potentially leading to high-risk behaviors during adolescence.

3. A distraught, single, first-time mother cries and asks a nurse, 'How can I go to work if I can't afford childcare?' What is the nurse's initial action in assisting the client with the problem-solving process?

• A. Determine the risks and benefits for each alternative.
• B. Formulate goals for resolution of the problem.
• C. Evaluate the outcome of the implemented alternative.
• D. Assess the facts of the situation.

Correct answer: D

Rationale: In this scenario, the nurse's initial step should be to assess the facts of the situation. By gathering accurate information about the client's circumstances, the nurse can better understand the problem and make informed decisions moving forward. This foundational assessment is crucial before proceeding to formulate goals, evaluate outcomes, or consider risks and benefits. Options A, B, and C involve steps that should follow the initial assessment of the situation, making them less suitable as the initial action in this context.

4. During an acute panic attack, which intervention should the nurse implement?

• A. Encourage the client to discuss their feelings
• B. Provide a calm environment
• C. Teach the client deep breathing exercises
• D. Leave the client alone to calm down

Correct answer: C

Rationale: During an acute panic attack, the priority intervention is to create a calm and safe environment. Teaching the client deep breathing exercises is crucial as it promotes relaxation and reduces hyperventilation, helping to manage the panic attack effectively. Encouraging the client to discuss their feelings may exacerbate the panic by increasing emotional distress. Providing a busy environment can escalate stress levels rather than alleviate them. Leaving the client alone may lead to feelings of abandonment or worsen the panic attack. Therefore, the most appropriate intervention is to teach deep breathing exercises to help the client regain control and manage the panic attack.

5. Which of the following symptoms shouldn't one expect to assess in a client diagnosed with major depressive disorder?

• A. Loss of interest or pleasure
• B. Decreased ability to concentrate
• C. Significant weight loss or gain
• D. Increased energy

Correct answer: D

Rationale: Symptoms commonly associated with major depressive disorder include a loss of interest or pleasure, decreased ability to concentrate, significant weight loss or gain, and feelings of worthlessness or excessive guilt. Increased energy is not a typical symptom of major depressive disorder; individuals with this condition often experience fatigue rather than increased energy.

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