Nursing Elites

1. When interviewing a distressed client who was fired after 15 years of loyal employment, which of the following questions would best assist the nurse in determining the client's appraisal of the situation? Select the one that does not apply.

• A. What coping resources have you used previously in stressful situations?
• B. Have you ever faced a similar stressful situation before?
• C. Who do you think is to blame for this situation?
• D. What do you believe led to your termination from your job?

Correct answer: C

Rationale: In this scenario, it is crucial for the nurse to help the client assess their coping mechanisms and perspective on the situation. Questions A and B focus on exploring the client's coping resources and past experiences to guide them towards effective stress management. Asking who is to blame (choice C) is not conducive to evaluating coping abilities; instead, it might elicit a blame-focused response, which can impede progress. Choice D, inquiring about the reason for being fired, is a nontherapeutic approach that does not promote a constructive appraisal of the situation.

2. Which of the following are common symptoms of major depressive disorder? Select one that doesn't apply.

• A. Insomnia
• B. Feelings of hopelessness
• C. Increased energy
• D. Difficulty concentrating

Correct answer: C

Rationale: Common symptoms of major depressive disorder include insomnia, feelings of hopelessness, difficulty concentrating, and appetite changes. While individuals with major depressive disorder often experience fatigue and low energy levels, increased energy is not typically associated with this condition. Therefore, 'Increased energy' is the correct choice that doesn't apply to major depressive disorder. Choices A, B, and D are all commonly seen in individuals with major depressive disorder, making them incorrect answers.

3. When assessing a client diagnosed with anorexia nervosa, which of the following findings should the nurse expect? Select one that does not apply.

• A. Amenorrhea
• B. Lanugo
• C. Hypotension
• D. Hyperkalemia

Correct answer: D

Rationale: In a client diagnosed with anorexia nervosa, expected findings include amenorrhea, lanugo, hypotension, and bradycardia. Hyperkalemia is not typically associated with anorexia nervosa; instead, hypokalemia, which is low potassium levels, is more common. Hypokalemia can result from decreased intake of potassium-rich foods or excessive purging behaviors commonly seen in individuals with anorexia nervosa.

4. A client prescribed sertraline for depression is receiving discharge instructions. Which statement by the client indicates an accurate understanding of the medication?

• A. I should take this medication at bedtime to avoid nausea.
• B. I should avoid drinking alcohol while taking this medication.
• C. I should take this medication with food to avoid stomach upset.
• D. It may take several weeks for this medication to be effective.

Correct answer: D

Rationale: The correct answer is D because sertraline, used for depression, typically takes several weeks to become effective. It is important for clients to understand this delayed onset of action to manage their expectations and continue taking the medication as prescribed despite not seeing immediate results.

5. A healthcare provider is assessing a client who has been diagnosed with factitious disorder. Which of the following behaviors should the healthcare provider expect?

• A. Intentional production of false symptoms
• B. Lack of concern about symptoms
• C. Fear of gaining weight
• D. Unintentional production of false symptoms

Correct answer: A

Rationale: Individuals with factitious disorder deliberately fabricate or exaggerate symptoms to assume the sick role and garner attention. They may show a lack of concern about their symptoms, a phenomenon known as la belle indifférence. Fear of gaining weight is not typically associated with factitious disorder. Therefore, the correct behavior to expect in a client with factitious disorder is the intentional production of false symptoms. Choices B, C, and D are incorrect as lack of concern about symptoms and fear of gaining weight are not characteristic of factitious disorder. Additionally, factitious disorder involves the intentional, not unintentional, production of false symptoms.

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