Nursing Elites

1. Natasha's husband died suddenly two months ago, and she has been overwhelmed with grief. When Natasha is subsequently diagnosed with major depressive disorder, her daughter, Nadia, makes which true statement?

• A. Depression often begins after a major loss. Losing dad was a major loss.
• B. Bereavement and depression are the same problem.
• C. Mourning is pathological and not normal behavior.
• D. Antidepressant medications will not help this type of depression.

Correct answer: A

Rationale: When individuals experience a significant loss, such as the death of a loved one, it can trigger major depressive disorder. This is because the intense grief and sadness associated with the loss can lead to the development of depressive symptoms. Therefore, Nadia's statement that 'Depression often begins after a major loss' is accurate in this context.

2. Which approach involves surgically implanting electrodes into specific areas of the brain to stimulate regions identified as underactive in depression?

• A. Transcranial magnetic stimulation
• B. Deep brain stimulation
• C. Vagus nerve stimulation
• D. Electroconvulsive therapy

Correct answer: B

Rationale: Deep brain stimulation is a treatment approach that involves the surgical implantation of electrodes into specific areas of the brain to stimulate regions identified as underactive in depression. This method aims to modulate brain activity and has shown effectiveness in treating certain cases of depression.

3. Which of the following is a common side effect of antipsychotic medications?

• A. Hyperactivity
• B. Weight loss
• C. Extrapyramidal symptoms
• D. Insomnia

Correct answer: C

Rationale: Extrapyramidal symptoms, such as tremors and rigidity, are frequently observed as side effects of antipsychotic medications. These symptoms result from the medications' influence on dopamine receptors in the brain. Choice A, hyperactivity, is not a typical side effect of antipsychotic medications. Choice B, weight loss, is less common compared to weight gain. Choice D, insomnia, though possible, is not as prevalent as extrapyramidal symptoms in individuals taking antipsychotic medications.

4. When discussing the main differences between narcolepsy and obstructive sleep apnea syndrome, what should the nurse highlight?

• A. Symptoms of the two diagnoses are essentially the same, making it challenging to differentiate between them
• B. Naps are contraindicated for clients with narcolepsy due to their association with cataplexy
• C. People with narcolepsy awaken from a nap feeling rested and replenished
• D. People with obstructive sleep apnea syndrome may experience temporary paralysis during sleep

Correct answer: C

Rationale: Narcolepsy is characterized by excessive daytime sleepiness and sudden attacks of sleep, while individuals with narcolepsy often feel refreshed after a brief nap. In contrast, obstructive sleep apnea syndrome is marked by pauses in breathing or shallow breathing during sleep, leading to fragmented sleep and excessive daytime sleepiness. Therefore, the correct answer is that individuals with narcolepsy awaken from a nap feeling rested and replenished, which is a key distinguishing feature from obstructive sleep apnea syndrome.

5. Devastated by a divorce from an abusive husband, a wife completes grief counseling. Which statement by the wife should indicate to a nurse that the client is in the acceptance stage of grief?

• A. If only we could have tried again, things might have worked out.
• B. I am so mad that the children and I had to put up with him as long as we did.
• C. Yes, it was a difficult relationship, but I think I have learned from the experience.
• D. I still don't have any appetite and continue to lose weight.

Correct answer: C

Rationale: The nurse should recognize that the client is in the acceptance stage of grief based on the statement 'Yes, it was a difficult relationship, but I think I have learned from the experience.' In this statement, the client is acknowledging the difficulty of the relationship but also expressing personal growth and learning from the experience, indicating acceptance. Choices A, B, and D do not reflect the acceptance stage of grief. Choice A shows a sense of regret and a wish for things to have turned out differently. Choice B demonstrates lingering anger towards the ex-husband. Choice D suggests ongoing physical manifestations of grief like loss of appetite and weight loss, which are more indicative of earlier stages of grief.

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