Nursing Elites

1. In schizophrenia, a patient is experiencing negative symptoms. Which of the following is a negative symptom?

• A. Hallucinations
• B. Delusions
• C. Apathy
• D. Disorganized speech

Correct answer: C

Rationale: In schizophrenia, negative symptoms refer to deficits in normal emotional responses or other thought processes. Apathy is a negative symptom characterized by a lack of interest, enthusiasm, or concern. Hallucinations (seeing or hearing things that aren't there), delusions (false beliefs), and disorganized speech are positive symptoms, which involve the presence of abnormal behaviors or thoughts.

2. A nurse is planning care for several clients attending community-based mental health programs. Which of the following clients should the nurse visit first?

• A. A client who received a burn on the arm while using a hot iron at home
• B. A client who requests a change of antipsychotic medication due to new adverse effects
• C. A client who reports hearing a voice saying that life is not worth living anymore
• D. A client who tells the nurse about experiencing manifestations of severe anxiety before and during a job interview

Correct answer: C

Rationale: The nurse should visit the client who reports hearing a voice saying that life is not worth living anymore first. This statement indicates potential suicidal ideation, which requires immediate intervention to ensure the client's safety. Choices A, B, and D do not present an immediate threat to the client's life. While burns, adverse effects of medication, and severe anxiety are important concerns, they do not pose an immediate risk of self-harm or suicide.

3. A patient is being discharged with a prescription for an antidepressant for their depression. Which instruction is most important?

• A. Take the medication with food to prevent stomach upset.
• B. Refrain from driving until you understand the effects of the medication.
• C. Do not discontinue the medication suddenly.
• D. Avoid alcohol consumption while taking this medication.

Correct answer: C

Rationale: The most critical instruction is to not discontinue the antidepressant medication suddenly. Abrupt discontinuation can lead to withdrawal symptoms and potentially trigger a relapse of depression. Options A, B, and D are important but not as crucial as ensuring the patient follows the prescribed regimen and consults with a healthcare provider before making any changes to the medication routine.

4. What is a primary goal of treatment for a patient with obsessive-compulsive disorder (OCD)?

• A. To eliminate all obsessive thoughts and compulsive behaviors
• B. To reduce the frequency and intensity of obsessive thoughts
• C. To increase the patient’s social interactions
• D. To improve the patient’s sleep quality

Correct answer: B

Rationale: The primary goal of treating obsessive-compulsive disorder (OCD) is to reduce the frequency and intensity of obsessive thoughts and compulsive behaviors. While complete elimination of all obsessive thoughts and compulsive behaviors may be an ideal outcome, it is often unrealistic. Focusing on reducing the impact of these symptoms on the patient's daily life and functioning is more achievable and practical. Choices C and D are incorrect as they are not primary goals in the treatment of OCD. Increasing social interactions and improving sleep quality may be beneficial as part of a comprehensive treatment plan, but they are not the primary focus when managing OCD.

5. A 32-year-old female patient is diagnosed with generalized anxiety disorder (GAD). Which behavior would the nurse expect to observe?

• A. Complains of persistent and excessive worry.
• B. Frequently fidgets and has difficulty sitting still.
• C. Exhibits ritualistic behaviors.
• D. Reports periods of derealization.

Correct answer: A

Rationale: In generalized anxiety disorder (GAD), individuals often experience persistent and excessive worry about various aspects of their life. This worry is difficult to control and is disproportionate to the actual source of concern. The other options describe behaviors more commonly associated with other anxiety disorders like social anxiety disorder (frequent fidgeting and difficulty sitting still), obsessive-compulsive disorder (ritualistic behaviors), and depersonalization/derealization disorder (periods of derealization). Therefore, the correct behavior to expect in a patient with GAD is persistent and excessive worry.

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