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. Which of the following are common symptoms of schizophrenia? Select one that does not apply.

• A. Delusions
• B. Hallucinations
• C. Organized speech
• D. Catatonia

Correct answer: C

Rationale: Common symptoms of schizophrenia include delusions, hallucinations, disorganized speech, and catatonia. Organized speech is not a typical symptom of schizophrenia. In schizophrenia, individuals often exhibit disorganized or incoherent speech patterns, rather than organized speech. Euphoria is not typically associated with schizophrenia, making it an incorrect choice.

3. Which of the following is identified as a psychoneurotic response to severe anxiety as it appears in the DSM-5?

• A. Somatic symptom disorder
• B. Grief responses
• C. Psychosis
• D. Bipolar disorder

Correct answer: A

Rationale: The correct answer is A: Somatic symptom disorder. Somatic symptom disorder is characterized by preoccupation with physical symptoms for which there is no demonstrable organic pathology. One of the diagnostic criteria is a high level of anxiety about health concerns or illness. In the DSM-5, somatic symptom disorders are classified under the category of somatic symptom and related disorders, which encompass conditions where psychological factors play a significant role in the development, exacerbation, or maintenance of physical symptoms. Choices B, C, and D are incorrect. Grief responses, psychosis, and bipolar disorder are not specifically categorized as psychoneurotic responses to severe anxiety in the DSM-5.

4. A client with generalized anxiety disorder is prescribed buspirone. Which statement by the client indicates a need for further teaching?

• A. I can stop taking this medication once I feel less anxious.
• B. I should avoid drinking alcohol while taking this medication.
• C. It may take several weeks for this medication to take full effect.
• D. This medication can cause dependency.

Correct answer: A

Rationale: The correct answer is A because it indicates a misunderstanding about buspirone. Buspirone should not be abruptly stopped, and patients should follow the prescribed regimen consistently. Stopping the medication without proper guidance can lead to adverse effects or a return of anxiety symptoms. Choices B, C, and D demonstrate an understanding of important aspects of buspirone therapy: avoiding alcohol due to interactions, being patient for the medication to reach full effectiveness, and being aware of the potential for dependency with this medication.

5. A patient with generalized anxiety disorder (GAD) is prescribed buspirone. The nurse understands that buspirone is different from benzodiazepines because it:

• A. Has a high potential for abuse.
• B. Works immediately to relieve anxiety.
• C. Does not cause sedation.
• D. Is used for short-term treatment only.

Correct answer: C

Rationale: Buspirone is different from benzodiazepines because it does not cause sedation. Unlike benzodiazepines, buspirone has a lower potential for abuse and does not cause the sedative effects commonly seen with benzodiazepines. While benzodiazepines may work immediately to relieve anxiety, buspirone may take longer to show its therapeutic effects. Additionally, buspirone is not limited to short-term treatment only, making it a preferred choice in patients where sedation is a concern or in those with a history of substance abuse.

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