Nursing Elites

1. During a routine health screening, a grieving widow whose husband died 15 months ago reports emptiness, a loss of self, difficulty thinking of the future, and anger at her dead husband. The nurse suggests bereavement counseling. The widow is most likely suffering from:

• A. Major depression
• B. Normal grieving
• C. Adjustment disorder
• D. Posttraumatic stress disorder

Correct answer: C

Rationale: The widow's symptoms align more closely with an adjustment disorder rather than major depression, normal grieving, or posttraumatic stress disorder. The widow's prolonged struggle in coping with the loss, characterized by emptiness, loss of self, difficulty envisioning the future, and anger towards her deceased husband, indicates an inability to adapt to the loss. These symptoms are indicative of an adjustment disorder, which typically arises in response to a significant life stressor and persists beyond what is considered a normal grieving process. Bereavement counseling can help the widow navigate her emotions and coping strategies during this challenging period.

2. A client diagnosed with schizophrenia is prescribed an antipsychotic medication. Which of the following side effects should the nurse monitor for? Select one that doesn't apply.

• A. Tardive dyskinesia
• B. Muscle tension
• C. Orthostatic hypotension
• D. Hyperglycemia

Correct answer: B

Rationale: Side effects of antipsychotic medications commonly include tardive dyskinesia, orthostatic hypotension, and hyperglycemia. Muscle tension is not typically associated with antipsychotic medication use. Tardive dyskinesia is characterized by involuntary movements, orthostatic hypotension refers to a drop in blood pressure upon standing, and hyperglycemia indicates high blood sugar levels. Monitoring these side effects is crucial for early detection and management, but muscle tension is not a typical side effect of antipsychotic medications.

3. During a community education session on mental health, which statement about stigma and mental illness is correct?

• A. Stigma has no impact on treatment outcomes.
• B. Stigma can prevent individuals from seeking treatment.
• C. Stigma is only a problem in developing countries.
• D. Stigma related to mental illness is decreasing significantly worldwide.

Correct answer: B

Rationale: The correct answer is B: 'Stigma can prevent individuals from seeking treatment.' Stigma surrounding mental illness can create barriers for individuals seeking treatment. It can lead to feelings of shame, fear of judgment, and discrimination, which may deter individuals from accessing the necessary support and care they need. Choices A, C, and D are incorrect. Stigma does have a significant impact on treatment outcomes by discouraging individuals from seeking help, it is not limited to developing countries but is a global issue, and unfortunately, stigma related to mental illness is still prevalent worldwide, although efforts are being made to reduce it.

4. A healthcare provider is assessing a client with suspected bipolar disorder. Which of the following findings should the healthcare provider expect? Select one that does not apply.

• A. Periods of elevated mood
• B. Decreased need for sleep
• C. Flight of ideas
• D. Anhedonia

Correct answer: D

Rationale: Findings in a client with bipolar disorder typically include periods of elevated mood, decreased need for sleep, and flight of ideas. Anhedonia, characterized by the inability to experience pleasure, is more commonly associated with major depressive disorder. Therefore, the healthcare provider should not expect anhedonia in a client with suspected bipolar disorder. The other choices are characteristic features of bipolar disorder, such as mania or hypomania.

5. A client who experiences stress on a regular basis asks a nurse what causes these feelings. Which is the most appropriate nursing response?

• A. Genetics have no influence on your temperament.
• B. How you reacted to past experiences influences how you feel now.
• C. Maintaining good physical health always keeps stress levels low.
• D. Stress can be avoided by using appropriate coping mechanisms.

Correct answer: B

Rationale: The correct answer is B: 'How you reacted to past experiences influences how you feel now.' This response is appropriate because past experiences can shape an individual's current response to stress. It acknowledges the impact of learned patterns and coping mechanisms on one's current adaptation to stressors. Choice A is incorrect because genetics can play a role in temperament to some extent. Choice C is incorrect because while physical health can contribute to stress management, it is not the sole determinant of stress levels. Choice D is incorrect as stress is not always avoidable, but coping mechanisms can help manage and reduce its impact.

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