Nursing Elites

1. Luc's family comes home one evening to find him extremely agitated, and they suspect he is in a full manic episode. The family calls emergency medical services. While one medic is talking with Luc and his family, the other medic is counting something on his desk. What is the medic most likely counting?

• A. Hypodermic needles
• B. Fast food wrappers
• C. Empty soda cans
• D. Energy drink containers

Correct answer: D

Rationale: Energy drink containers are often associated with exacerbating manic episodes due to their high caffeine content, which can worsen symptoms of agitation and restlessness.

2. Child protective services have removed 10-year-old Christopher from his parents' home due to neglect. Christopher reveals to the nurse that he considers the woman next door his 'nice' mom, that he loves school, and gets above-average grades. The strongest explanation of this response is:

• A. Temperament
• B. Genetic factors
• C. Resilience
• D. Paradoxical effects of neglect

Correct answer: C

Rationale: Christopher's positive outlook, strong school performance, and forming a bond with the neighbor indicate resilience. Resilience refers to the ability to adapt and thrive despite facing adversity, such as being removed from his parents' home due to neglect. His ability to maintain a positive attitude and excel in school despite the challenging circumstances highlights his resilience.

3. In treating social anxiety disorder, which medication is commonly prescribed to patients with this condition?

• A. Methylphenidate
• B. Sertraline
• C. Lithium
• D. Haloperidol

Correct answer: B

Rationale: Sertraline is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat social anxiety disorder. SSRIs are a first-line pharmacological treatment for social anxiety disorder due to their effectiveness in reducing anxiety symptoms by increasing serotonin levels in the brain, which helps regulate mood and emotions. Methylphenidate is a stimulant primarily used in attention deficit hyperactivity disorder (ADHD) but not in social anxiety disorder. Lithium is typically used in bipolar disorder, while haloperidol is an antipsychotic medication more commonly used in conditions like schizophrenia. Therefore, the correct choice for treating social anxiety disorder is Sertraline (B).

4. A client diagnosed with borderline personality disorder has been admitted to the psychiatric unit after a suicide attempt. Which of the following actions should the nurse take first?

• A. Encourage the client to express feelings about the suicide attempt.
• B. Place the client on one-to-one observation.
• C. Discuss the client's feelings about the suicide attempt.
• D. Encourage the client to participate in group therapy.

Correct answer: B

Rationale: The initial priority for the nurse is to ensure the safety of the client. Placing the client on one-to-one observation allows for constant monitoring and intervention if there are any signs of self-harm or a worsening condition. This immediate intervention is crucial to prevent further harm. Options A, C, and D involve therapeutic communication and interventions, which are important but should come after ensuring the client's safety.

5. 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.

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