Nursing Elites

1. To provide effective care for a patient diagnosed with schizophrenia, what associated condition should the nurse frequently assess for? Select all that apply.

• A. Alcohol use disorder
• B. Major depressive disorder
• C. Stomach cancer
• D. Polydipsia

Correct answer: A

Rationale: Alcohol use disorder is commonly associated with schizophrenia, leading to a dual diagnosis. Assessing for alcohol use disorder is crucial in managing the patient's overall well-being and treatment plan. Major depressive disorder can co-occur with schizophrenia but is not the most commonly associated condition. Stomach cancer is not typically associated with schizophrenia. Polydipsia, excessive thirst, can be a symptom in some individuals with schizophrenia due to medication side effects, but it is not an associated condition that requires frequent assessment compared to alcohol use disorder.

2. A client with alcohol use disorder is being treated in a rehabilitation facility. Which behavior indicates that the client is making progress in recovery?

• A. Attends all scheduled therapy sessions regularly.
• B. Is participating in group therapy and sharing experiences.
• C. Completes a work-study program.
• D. Has a decreased need for psychiatric medication.

Correct answer: B

Rationale: The correct answer is B. Participation in group therapy and sharing experiences is a positive sign of progress in recovery for a client with alcohol use disorder. It fosters peer support, allows for personal insight, and encourages social interaction, which are essential aspects of the recovery process. Attending all scheduled therapy sessions regularly (Choice A) is important but may not necessarily indicate the same level of progress as active participation in group therapy. Completing a work-study program (Choice C) is not directly related to the client's recovery from alcohol use disorder. Having a decreased need for psychiatric medication (Choice D) is not necessarily a reliable indicator of progress in recovery from alcohol use disorder, as medication management is a separate aspect of treatment.

3. A client who is admitted to the mental health unit reports shortness of breath and dizziness. The client tells the nurse, “I feel like I’m going to die.” Which nursing problem should the nurse include in this client’s plan of care?

• A. Mood disturbance
• B. Moderate anxiety
• C. Altered thoughts
• D. Social isolation

Correct answer: B

Rationale: The correct answer is B: Moderate anxiety. When a client presents with symptoms such as shortness of breath, dizziness, and a fear of dying, it indicates moderate anxiety. Anxiety can manifest physically with symptoms like these. Mood disturbance (choice A) refers to a change in mood, while altered thoughts (choice C) relate to cognitive changes. Social isolation (choice D) involves a lack of social interaction, which is not the primary concern in this scenario where the client is experiencing acute anxiety symptoms.

4. Which client statement suggests to the nurse that the client is using the defense mechanism of projection to deal with anxiety related to admission to a psychiatric unit?

• A. I am here because the police thought I was doing something wrong
• B. At least I hit the wall instead of hitting the psychiatric aide
• C. I want to be here because I know it is the best psychiatric facility
• D. Don’t believe everything my family tells you, I am not crazy

Correct answer: B

Rationale: The correct answer is B because the client is projecting their aggressive impulses onto an inanimate object, the wall, instead of accepting their own feelings. This statement reflects the defense mechanism of projection. Choice A is not projection; it is an explanation of why the client is there. Choice C indicates acceptance of the facility and does not involve projection. Choice D is a denial statement rather than projection.

5. 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: Resilience is the ability to adapt and cope with adverse situations. In this case, Christopher's positive outlook, love for school, and good academic performance despite experiencing neglect demonstrate resilience. Choice A, 'Temperament,' refers to an individual's natural behavioral style and would not fully explain Christopher's response. Genetic factors (Choice B) are not directly related to his ability to cope with neglect. Choice D, 'Paradoxical effects of neglect,' does not fit the situation as Christopher's positive response is more indicative of resilience than paradoxical effects.

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