Nursing Elites

1. When educating the family of a client diagnosed with dissociative identity disorder, which of the following instructions should the nurse include?

• A. Encourage the client to avoid stressful situations.
• B. Encourage the client to participate in daily activities.
• C. Encourage the client to express their feelings.
• D. Encourage the client to develop a daily routine.

Correct answer: D

Rationale: In cases of dissociative identity disorder, it is beneficial for the client to establish a daily routine. This structure can enhance symptom management and provide a sense of stability, which is particularly important for individuals with this condition. Encouraging the client to avoid stressful situations (Choice A) may not always be possible and does not address the need for structure. While encouraging the client to participate in daily activities (Choice B) is important, having a routine is more crucial for managing dissociative identity disorder. Expressing feelings (Choice C) is valuable but establishing a routine takes precedence in this situation.

2. Which should the healthcare provider recognize as a DSM-5 disorder?

• A. Obesity
• B. Generalized anxiety disorder
• C. Hypertension
• D. Grief

Correct answer: B

Rationale: The DSM-5 categorizes mental health disorders for diagnostic purposes. Generalized anxiety disorder is one of the disorders listed in the DSM-5, characterized by persistent and excessive worry about various events or activities. This disorder falls under the category of anxiety disorders, which also include panic disorder, phobias, and others. Choices A, C, and D are not DSM-5 disorders. Obesity and hypertension are medical conditions, while grief, though a significant emotional response, is not classified as a mental health disorder in the DSM-5.

3. A nursing instructor is teaching a group of students about intimate partner violence. Which response by the students indicates no further teaching is needed?

• A. Alaska Native women report the highest rate of intimate partner violence.
• B. Caucasian women report the lowest rate of intimate partner violence.
• C. African American women report the highest rate of intimate partner violence.
• D. Asian women report the lowest rate of intimate partner violence.

Correct answer: A

Rationale: The correct answer is A. Alaska Native women do report the highest rate of intimate partner violence. This statistic is important for healthcare professionals to be aware of to provide culturally sensitive care and interventions. Choices B, C, and D are incorrect statements. While it is essential to understand disparities in intimate partner violence rates among different populations, in this context, the focus is on recognizing the accurate information provided about Alaska Native women.

4. During a treatment team meeting, the point is made that a client with schizophrenia has recovered from the acute psychosis but continues to demonstrate apathy, avolition, and blunted affect. The nurse who relates these symptoms to serotonin excess will suggest that the client receive?

• A. Chlorpromazine
• B. Phenelzine
• C. Haloperidol
• D. Olanzapine

Correct answer: D

Rationale: In this scenario, the symptoms of apathy, avolition, and blunted affect are indicative of negative symptoms commonly seen in schizophrenia. These symptoms are often associated with dopamine and serotonin imbalances in the brain. Olanzapine, an atypical antipsychotic, is known for its efficacy in treating both positive and negative symptoms of schizophrenia. It acts by blocking serotonin and dopamine receptors, helping to alleviate the symptoms mentioned. Chlorpromazine and Haloperidol are typical antipsychotics that primarily target dopamine receptors, while Phenelzine is an MAOI used to treat depression and anxiety disorders, not schizophrenia. Therefore, the most appropriate choice for this client displaying these symptoms related to serotonin excess would be Olanzapine.

5. In treating social anxiety disorder, which medication is commonly prescribed to patients with this condition?

• A. Methylphenidate
• B. Sertraline
• C. Lithium
• D. Haloperidol

Correct answer: B

Rationale: Sertraline is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat social anxiety disorder. SSRIs are a first-line pharmacological treatment for social anxiety disorder due to their effectiveness in reducing anxiety symptoms by increasing serotonin levels in the brain, which helps regulate mood and emotions. Methylphenidate is a stimulant primarily used in attention deficit hyperactivity disorder (ADHD) but not in social anxiety disorder. Lithium is typically used in bipolar disorder, while haloperidol is an antipsychotic medication more commonly used in conditions like schizophrenia. Therefore, the correct choice for treating social anxiety disorder is Sertraline (B).

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