Nursing Elites

1. While assessing a distraught female high school student who is overly concerned because her parents can't afford horseback riding lessons, how should the nurse interpret the student's reaction to her perceived problem?

• A. The problem is endangering her well-being.
• B. The problem is personally relevant to her.
• C. The problem is based on immaturity.
• D. The problem is exceeding her capacity to cope.

Correct answer: B

Rationale: In this scenario, the student being overly concerned about not being able to afford horseback riding lessons indicates that the problem is personally relevant to her. Psychological stressors related to self-esteem and self-image are influenced by how an individual perceives a situation or event. Adolescents, in particular, place significance on self-image and feeling entitled to experiences that other adolescents have, which can lead to distress when such desires are not met. Choice A is incorrect because there is no indication that the student's physical well-being is at risk. Choice C is incorrect as it simplifies the issue by attributing it solely to immaturity. Choice D is incorrect as there is no evidence provided that the problem is beyond the student's coping abilities.

2. A healthcare provider is providing care for a patient with major depressive disorder who is prescribed a tricyclic antidepressant (TCA). Which common side effect should the healthcare provider educate the patient about?

• A. Hypertension
• B. Diarrhea
• C. Dry mouth
• D. Weight loss

Correct answer: C

Rationale: Dry mouth is a common side effect associated with tricyclic antidepressants (TCAs). TCAs can cause anticholinergic side effects, such as dry mouth, due to their mechanism of action. Educating the patient about dry mouth can help them stay informed and manage this common side effect effectively during treatment. Hypertension (Choice A) is not a common side effect of TCAs. Diarrhea (Choice B) is more commonly associated with selective serotonin reuptake inhibitors (SSRIs) than with TCAs. Weight loss (Choice D) is not a common side effect of TCAs; in fact, TCAs are more likely to cause weight gain.

3. A client with borderline personality disorder exhibits self-mutilating behavior. Which nursing intervention should the nurse implement to address this behavior?

• A. Encourage the client to discuss underlying issues.
• B. Set firm limits on the client's behavior.
• C. Provide a safe environment to prevent self-harm.
• D. Discuss the consequences of self-mutilating behavior.

Correct answer: C

Rationale: The correct intervention when dealing with a client exhibiting self-mutilating behavior, especially with borderline personality disorder, is to provide a safe environment to prevent self-harm. This approach is crucial in ensuring the client's physical safety and well-being. Setting firm limits may be appropriate in some situations, but the immediate priority is to prevent self-harm. Encouraging the client to discuss underlying issues and discussing consequences are important aspects of therapy; however, in the case of acute self-mutilating behavior, the primary focus should be on creating a safe environment to prevent harm.

4. A healthcare professional is conducting education on anxiety and stress management. Which of the following should be identified as the most important initial step in learning how to manage anxiety?

• A. Diagnostic blood tests
• B. Awareness of factors creating stress
• C. Relaxation exercises
• D. Identifying support systems

Correct answer: B

Rationale: The correct answer is B: Awareness of factors creating stress. In managing anxiety, the first crucial step is recognizing and being aware of the factors that contribute to stress. Without this awareness, it becomes challenging to effectively address and manage anxiety. Diagnostic blood tests are not typically the initial step in managing anxiety; they may be used to rule out other medical conditions but are not the primary focus. While relaxation exercises can be helpful in managing anxiety, understanding the root causes of stress takes precedence. Identifying support systems is important but comes after recognizing the stress factors to develop a comprehensive management plan.

5. Based on what criteria do most cultures label behavior as mental illness?

• A. Incomprehensibility and cultural relativity
• B. Strength of character and ethics
• C. Goal directedness and high energy
• D. Creativity and good coping skills

Correct answer: A

Rationale: The correct answer is A: Incomprehensibility and cultural relativity. Incomprehensibility and cultural relativity are the main criteria used across cultures to define behavior as mental illness. When behavior is incomprehensible and significantly deviates from cultural norms, it is more likely to be classified as a mental illness. Choices B, C, and D are incorrect. Strength of character, ethics, goal directedness, high energy, creativity, and good coping skills are typically associated with positive mental health rather than mental illness.

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