Nursing Elites

1. 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.

2. A nurse is caring for a client who has been diagnosed with schizoaffective disorder. The client states, 'I am the president of the United States.' Which of the following responses should the nurse make?

• A. You are not the president. You are a client in the hospital.
• B. Tell me more about being the president.
• C. Why do you think you are the president?
• D. Let's talk about something else.

Correct answer: C

Rationale: The nurse should avoid challenging the client's delusions directly. Asking for more information can help the nurse understand the client's experience and build rapport.

3. A client diagnosed with schizophrenia is prescribed an antipsychotic medication. Which of the following side effects should the nurse monitor for? Select one that doesn't apply.

• A. Tardive dyskinesia
• B. Muscle tension
• C. Orthostatic hypotension
• D. Hyperglycemia

Correct answer: B

Rationale: Side effects of antipsychotic medications commonly include tardive dyskinesia, orthostatic hypotension, and hyperglycemia. Muscle tension is not typically associated with antipsychotic medication use. Tardive dyskinesia is characterized by involuntary movements, orthostatic hypotension refers to a drop in blood pressure upon standing, and hyperglycemia indicates high blood sugar levels. Monitoring these side effects is crucial for early detection and management, but muscle tension is not a typical side effect of antipsychotic medications.

4. According to Maslow's hierarchy of needs, which situation on an inpatient psychiatric unit would require priority intervention by a nurse?

• A. A client rudely complaining about limited visiting hours
• B. A client exhibiting aggressive behavior toward another client
• C. A client stating that no one cares
• D. A client verbalizing feelings of failure

Correct answer: B

Rationale: The correct answer is B. According to Maslow's hierarchy of needs, safety needs are considered fundamental and must be addressed before higher-level needs. When a client exhibits aggressive behavior toward another client, it poses an immediate threat to safety and requires priority intervention by the nurse to ensure the well-being of all individuals involved. Clients who are rude in their complaints (Choice A), express feelings of failure (Choice D), or state that no one cares (Choice C) are addressing higher-level needs related to social interactions, esteem, and self-actualization, respectively, which can be addressed once safety needs are secured.

5. A healthcare professional is teaching a patient about relaxation techniques to manage anxiety. Which technique is the healthcare professional most likely to recommend?

• A. Deep breathing exercises
• B. Physical exercise
• C. Mindfulness meditation
• D. Journaling

Correct answer: A

Rationale: Deep breathing exercises are a widely recommended technique for managing anxiety and promoting relaxation. By focusing on deep, slow breaths, individuals can activate the body's relaxation response, leading to decreased anxiety levels and an overall sense of calm. This technique is easy to learn, can be practiced anywhere, and is often suggested by healthcare professionals as a first-line approach for anxiety management. Physical exercise, mindfulness meditation, and journaling are also beneficial for mental well-being but may not be the first choice when specifically targeting acute anxiety management.

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