Nursing Elites

1. In the care plan of a male patient diagnosed with a dissociative disorder, the nursing diagnosis of ineffective coping is included. Which behavior demonstrated by the patient supports this nursing diagnosis?

• A. Has no memory of the physical abuse he endured.
• B. Using both alcohol and marijuana.
• C. Often reports being unaware of surroundings.
• D. Reports feelings of 'not really being here.'

Correct answer: B

Rationale: The correct answer is B because using substances like alcohol and marijuana can be a sign of ineffective coping mechanisms in patients with dissociative disorders. Substance abuse is often used as a maladaptive way to cope with stress, trauma, or other underlying issues. Choices A, C, and D may be related to dissociative symptoms but do not directly reflect ineffective coping behaviors as substance abuse does.

2. A client has been diagnosed with post-traumatic stress disorder (PTSD). Which intervention should the nurse implement to reduce the client's anxiety?

• A. Encourage the client to avoid discussing the traumatic event.
• B. Encourage the client to participate in group therapy sessions.
• C. Encourage the client to engage in relaxation techniques.
• D. Encourage the client to maintain a daily journal.

Correct answer: C

Rationale: Engaging in relaxation techniques, such as deep breathing, mindfulness, or progressive muscle relaxation, can help reduce anxiety for clients with PTSD. These techniques promote relaxation and help manage stress responses, contributing to a sense of calmness and improved coping mechanisms in dealing with anxiety triggers associated with PTSD. Avoiding discussing the traumatic event (Choice A) may hinder the client's progress in processing and coping with the trauma. While group therapy (Choice B) can be beneficial, relaxation techniques are more specific for reducing anxiety in this context. Maintaining a daily journal (Choice D) may be helpful for some clients but might not directly address anxiety reduction as effectively as relaxation techniques.

3. A client with post-traumatic stress disorder (PTSD) is experiencing flashbacks. Which of the following interventions should the nurse implement?

• A. Encourage the client to ignore the flashbacks.
• B. Stay with the client and offer reassurance.
• C. Instruct the client to avoid discussing the traumatic event.
• D. Encourage the client to engage in group therapy.

Correct answer: B

Rationale: During a flashback, it is essential for the nurse to stay with the client and offer reassurance. This approach can help the client feel safe and supported during a distressing experience. Encouraging the client to ignore the flashbacks may lead to increased anxiety and distress. Instructing the client to avoid discussing the traumatic event can hinder the therapeutic process of addressing and processing the trauma. While group therapy can be beneficial, it may not be the immediate intervention needed during a flashback.

4. Which response demonstrates accurate information that should be discussed with the female patient diagnosed with bipolar disorder and her support system? Select the incorrect one.

• A. Remember that alcohol and caffeine can trigger a relapse of your symptoms.
• B. Due to the risk of a manic episode, antidepressant therapy is never used with bipolar disorder.
• C. It's critical to inform your healthcare provider immediately if you are experiencing sleep disturbances.
• D. Is your family prepared to be actively involved in helping manage this disorder?

Correct answer: B

Rationale: In managing bipolar disorder, it is vital to educate the patient and their support system about triggers like alcohol and caffeine, the significance of good sleep, and the need for family involvement. However, the statement in choice B is incorrect. While antidepressants need to be carefully monitored in bipolar disorder, they can be used in conjunction with mood stabilizers to manage depression in some cases.

5. A healthcare professional is assessing a client with major depressive disorder. Which of the following findings should the professional expect? Select one that does not apply.

• A. Anhedonia
• B. Hypersomnia
• C. Fatigue
• D. Flight of ideas

Correct answer: D

Rationale: In major depressive disorder, common findings include anhedonia (loss of interest or pleasure), hypersomnia (excessive sleepiness), fatigue, and feelings of worthlessness. Flight of ideas, characterized by racing thoughts and rapid speech, is more commonly associated with bipolar disorder, particularly during manic episodes. Therefore, 'Flight of ideas' does not apply to the expected findings in major depressive disorder.

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