Nursing Elites

1. Research conducted by Miller and Rahe in 1997 demonstrated a correlation between the effects of life changes and illness, leading to the development of the Recent Life Changes Questionnaire (RLCQ). Which principle most limits the effectiveness of this tool?

• A. Specific illnesses are not identified.
• B. The numerical values associated with specific life events are randomly assigned.
• C. Stress is viewed as only a physiological response.
• D. Personal perception of the event is excluded.

Correct answer: D

Rationale: The main limitation of the Recent Life Changes Questionnaire (RLCQ) is that it does not consider an individual's personal perception of a life event. As people may interpret events differently, their subjective perspective plays a crucial role in how they experience stress and its potential impact on their health. Ignoring personal perception limits the effectiveness of the tool as it fails to capture the variations in how people respond to life changes. Choices A, B, and C are not the main limitations of the RLCQ. Specific illnesses not being identified or numerical values being randomly assigned do not directly impact the personal perception of life events. Additionally, viewing stress as only a physiological response is not the primary limitation, as stress encompasses psychological and emotional components as well.

2. Which of the following are characteristics of borderline personality disorder? Select one that does not apply.

• A. Intense fear of abandonment
• B. Unstable relationships
• C. Impulsivity
• D. Grandiosity

Correct answer: D

Rationale: Borderline personality disorder is characterized by an intense fear of abandonment, unstable relationships, impulsivity, and chronic feelings of emptiness. Grandiosity, which involves an exaggerated sense of self-importance and superiority, is more commonly associated with narcissistic personality disorder rather than borderline personality disorder. Therefore, the correct answer is D.

3. A patient with bipolar disorder has been prescribed lithium. Which dietary advice is important for the nurse to include?

• A. Avoid foods high in tyramine.
• B. Maintain a consistent salt intake.
• C. Increase protein intake.
• D. Avoid foods high in fat.

Correct answer: B

Rationale: Patients prescribed lithium should maintain a consistent salt intake to prevent fluctuations in lithium levels. Salt intake can impact lithium levels, and sudden changes in salt intake can affect how the body absorbs and excretes lithium. Therefore, advising the patient to maintain a stable salt intake is crucial for the effectiveness and safety of lithium therapy. Choices A, C, and D are incorrect. Avoiding foods high in tyramine is more relevant for patients taking MAOIs, not lithium. Increasing protein intake or avoiding foods high in fat are not specific dietary recommendations for patients on lithium therapy.

4. A patient with posttraumatic stress disorder (PTSD) is experiencing flashbacks. The most appropriate intervention is to:

• A. Encourage the patient to talk about the trauma.
• B. Help the patient reorient to the present.
• C. Leave the patient alone to process the flashback.
• D. Remind the patient that the flashback is not real.

Correct answer: B

Rationale: When a patient with PTSD is experiencing flashbacks, the most appropriate intervention is to help them reorient to the present. This intervention can assist in reducing the intensity of the flashback and providing a sense of safety for the patient. Choice A is incorrect because encouraging the patient to talk about the trauma during a flashback may exacerbate their distress. Choice C is incorrect as leaving the patient alone can increase their feelings of isolation and fear. Choice D is incorrect because reminding the patient that the flashback is not real may invalidate their experience and increase their sense of disconnection.

5. A client with generalized anxiety disorder is prescribed buspirone (Buspar). Which statement by the client indicates an accurate understanding of the medication?

• A. I should take this medication as needed for anxiety.
• B. I need to avoid eating aged cheeses.
• C. It may take several weeks for this medication to take effect.
• D. I can stop taking this medication abruptly if I feel better.

Correct answer: C

Rationale: Buspirone (Buspar) may take several weeks to take effect, so clients should continue taking it as prescribed.

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