Nursing Elites

1. A patient with major depressive disorder is prescribed a selective serotonin reuptake inhibitor (SSRI). The nurse should educate the patient about which potential side effect?

• A. Hypertension
• B. Diarrhea
• C. Sexual dysfunction
• D. Weight gain

Correct answer: C

Rationale: Corrected Rationale: Selective serotonin reuptake inhibitors (SSRIs) are commonly associated with sexual dysfunction as a side effect. This adverse effect includes decreased libido, delayed orgasm, and erectile dysfunction. Educating patients about this potential side effect is crucial to manage expectations and consider appropriate interventions. Choices A, B, and D are incorrect as SSRIs are not typically associated with hypertension, diarrhea, or weight gain as common side effects.

2. 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.

3. A client with borderline personality disorder is receiving care. Which of the following interventions should be included in the plan of care?

• A. Set clear and consistent boundaries
• B. Encourage independence
• C. Avoid discussing the client's feelings
• D. Use a firm, authoritative approach

Correct answer: B

Rationale: When caring for a client with borderline personality disorder, it is essential to encourage independence rather than dependency. This helps promote autonomy and self-reliance, which are important aspects of treatment. Setting clear and consistent boundaries is also crucial, as it provides structure and predictability. Avoiding discussing the client's feelings is not recommended, as addressing emotions and promoting emotional awareness is a key part of therapy. Using a firm, authoritative approach may not be the most effective strategy as it can lead to power struggles and conflicts in individuals with borderline personality disorder.

4. A client has been diagnosed with histrionic personality disorder. Which of the following behaviors should the nurse expect?

• A. Attention-seeking behavior
• B. Dramatic expressions of emotion
• C. Seductive behavior
• D. Dependency on others

Correct answer: A

Rationale: Individuals with histrionic personality disorder often display attention-seeking behaviors as a way to draw focus and validation from others. This behavior may manifest as exaggerated emotions and dramatic expressions to maintain the spotlight. While seductive behavior and dependency on others are potential characteristics of histrionic personality disorder, attention-seeking behavior is the hallmark trait. Therefore, the correct answer is attention-seeking behavior (Choice A). Dramatic expressions of emotion (Choice B) can be a feature of histrionic personality disorder, but it is not as characteristic as attention-seeking behavior. Seductive behavior (Choice C) may also be present in individuals with histrionic personality disorder, but it is not the primary behavior to expect. Dependency on others (Choice D) is not a core feature of histrionic personality disorder, although individuals with this disorder may seek attention and validation from others.

5. A bright student confides in the school nurse about conflicts related to attending college or working to add needed financial support to the family. Which coping strategy is most appropriate for the nurse to recommend to the student at this time?

• A. Meditation
• B. Problem-solving training
• C. Relaxation
• D. Journaling

Correct answer: B

Rationale: In this scenario, the student is dealing with conflicting priorities of attending college or working to support the family financially. Problem-solving training is the most appropriate coping strategy to recommend. It can help the student objectively assess the situation, identify potential solutions, and make informed decisions. Problem-solving training provides structure and guidance, empowering the student to navigate the conflicting priorities effectively and choose the best course of action. Meditation, relaxation, and journaling may be beneficial for stress relief but may not directly address the decision-making process required in this situation.

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