Nursing Elites

1. A patient presents in the Emergency Department immediately following a shooting incident in a school where she has been teaching. There is no evidence of physical injury, but she appears very hyperactive and talkative. Which of these symptoms manifested by the patient are common initial biological responses to stress? Select one that doesn't apply.

• A. Constricted pupils
• B. Watery eyes
• C. Unusual food cravings
• D. Increased heart rate

Correct answer: C

Rationale: When faced with stress, the body can react in various ways. Symptoms such as constricted pupils, increased heart rate, and increased respirations are commonly seen as initial biological responses to stress. In this case, the presence of constricted pupils is not typically associated with stress responses. Dilated pupils are more commonly linked to the Fight or Flight response. Watery eyes and increased heart rate are typical responses to stress. Unusual food cravings are not considered a typical biological response to stress.

2. A healthcare professional is assessing a client diagnosed with narcissistic personality disorder. Which of the following behaviors should the healthcare professional expect?

• A. Grandiose sense of self-importance
• B. Lack of empathy
• C. Need for excessive admiration
• D. Envy of others

Correct answer: A

Rationale: Clients with narcissistic personality disorder often exhibit a grandiose sense of self-importance, believing they are special and unique. This behavior is characterized by an exaggerated sense of achievements and talents, expecting to be recognized as superior without commensurate achievements. While individuals with this disorder may lack empathy and have a need for excessive admiration, the prominent feature of grandiosity is a core aspect of narcissistic personality disorder. Therefore, the correct behavior expected in this case is a grandiose sense of self-importance (Choice A). Lack of empathy (Choice B) and need for excessive admiration (Choice C) are also common traits in narcissistic personality disorder, but they are not the primary behavior associated with the disorder. Envy of others (Choice D) is not a characteristic behavior typically seen in individuals with narcissistic personality disorder.

3. When caring for a client experiencing alcohol withdrawal, which intervention should the nurse implement to prevent complications?

• A. Provide a well-lit environment.
• B. Administer antipsychotic medication as prescribed.
• C. Monitor the client's vital signs closely.
• D. Encourage the client to express their feelings.

Correct answer: D

Rationale: Encouraging the client to express their feelings is essential during alcohol withdrawal as it can help them cope with the emotional and psychological stress associated with the process. This intervention promotes open communication, allows the client to verbalize their emotions, and may prevent escalating anxiety or agitation, ultimately reducing the risk of complications. Providing a well-lit environment (Choice A) is not directly related to preventing complications of alcohol withdrawal. Administering antipsychotic medication (Choice B) is not the standard treatment for alcohol withdrawal; medications such as benzodiazepines are more commonly used. While monitoring vital signs (Choice C) is important, encouraging the client to express their feelings (Choice D) directly addresses emotional well-being, which is crucial during this vulnerable time.

4. A client diagnosed with panic disorder is receiving discharge teaching from a healthcare provider. Which statement by the client indicates an accurate understanding of the teaching?

• A. I should avoid caffeine and other stimulants.
• B. I should take my medication only when I feel anxious.
• C. I should use relaxation techniques to manage anxiety.
• D. I should avoid exercising to prevent triggering anxiety.

Correct answer: A

Rationale: The correct answer is A. Avoiding caffeine and other stimulants is crucial for clients with panic disorder as these substances can exacerbate anxiety symptoms. Caffeine can trigger or worsen anxiety, leading to increased heart rate and restlessness. By eliminating stimulants, the client can better manage their anxiety levels and reduce the risk of panic attacks. Choices B, C, and D are incorrect because taking medication only when feeling anxious may lead to inconsistent treatment, using relaxation techniques alone may not be sufficient for managing panic disorder, and avoiding exercise can actually be counterproductive as regular physical activity can help reduce anxiety and stress levels.

5. How do psychiatrists determine which diagnosis to give a patient?

• A. Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
• B. Hospital policy dictates how psychiatrists diagnose mental disorders.
• C. Psychiatrists assess the patient and identify diagnoses based on the patient's unhealthy responses and contributing factors.
• D. The American Medical Association identifies 10 diagnostic labels that psychiatrists can choose from.

Correct answer: A

Rationale: The correct answer is A. Psychiatrists use the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association (APA) to determine diagnoses. The DSM-5 provides standardized criteria for the classification of mental disorders, ensuring accurate and reliable diagnosis and treatment. Choices B and D are inaccurate as hospital policy does not dictate psychiatric diagnoses, and the American Medical Association is not responsible for psychiatric diagnostic criteria. Choice C describes a more general approach to assessment and does not specifically address the standardized criteria used in psychiatric diagnosis.

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