Nursing Elites

1. What is the priority intervention for a patient admitted for an overdose of sedatives and diagnosed with dissociative identity disorder?

• A. Conducting a suicide assessment
• B. Arranging for placement in a group home
• C. Providing a low-stimulation environment
• D. Establishing trust and rapport

Correct answer: A

Rationale: Conducting a suicide assessment is the priority intervention for a patient admitted for an overdose of sedatives and diagnosed with dissociative identity disorder. In this scenario, the immediate concern is to assess the risk of harm to the patient's life. It is crucial to determine if the overdose was intentional and if the patient has suicidal ideation or intent. Arranging for placement in a group home (choice B) may be necessary at a later stage depending on the patient's needs, but it is not the priority in this urgent situation. Providing a low-stimulation environment (choice C) and establishing trust and rapport (choice D) are important aspects of care but addressing the immediate risk of suicide takes precedence in this case.

2. A healthcare provider decides to put a client who has a psychotic disorder in seclusion overnight because the unit is very short-staffed, and the client frequently fights with other clients. The healthcare provider’s actions are an example of which of the following torts?

• A. Invasion of privacy
• B. False imprisonment
• C. Assault
• D. Battery

Correct answer: B

Rationale: The correct answer is B: False imprisonment. False imprisonment occurs when an individual is intentionally restricted in their freedom of movement without consent and without lawful justification. In this scenario, placing the client in seclusion overnight due to staffing shortages and behavioral issues constitutes false imprisonment as the client is confined against their will. Choice A, invasion of privacy, does not apply as the situation is about physical confinement, not privacy violation. Assault (choice C) involves the threat of harm, which is not the case here. Battery (choice D) refers to the intentional harmful or offensive touching of another person, which is not happening in this scenario.

3. A patient with generalized anxiety disorder (GAD) is prescribed buspirone. Which statement by the patient indicates effective understanding of the medication?

• A. I will take this medication only when I feel anxious.
• B. I should start feeling less anxious within a few days.
• C. This medication can be addictive if taken for a long time.
• D. It may take a few weeks for this medication to become effective.

Correct answer: D

Rationale: The correct answer is D because buspirone may take a few weeks to become effective in treating generalized anxiety disorder (GAD). Patients should be aware of this delay and not expect immediate relief from their symptoms. Choice A is incorrect because buspirone is typically taken regularly, not just when feeling anxious. Choice B is incorrect because the onset of action for buspirone is gradual, and patients should not expect immediate relief within a few days. Choice C is incorrect because buspirone is not considered addictive, unlike some other medications used for anxiety disorders.

4. What principle about patient communication should guide a nurse's fear of 'saying the wrong thing' to a patient?

• A. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation.
• B. Patients are more interested in talking to you than listening to what you have to say, so they are not likely to be offended.
• C. Considering the patient's history, there is little chance that the comment will do any actual harm.
• D. Most people with a mental illness have, by necessity, developed a high tolerance for forgiveness.

Correct answer: A

Rationale: Effective patient communication is guided by the principle that patients value genuine acceptance, respect, and concern from their caregivers. This approach helps to build trust and fosters effective communication, enhancing the nurse-patient relationship. Choice B is incorrect because patients value both talking and listening in effective communication. Choice C is incorrect because a nurse should always consider the impact of their words on the patient, regardless of the patient's history. Choice D is incorrect as it generalizes about people with mental illness and forgiveness, which is not directly relevant to patient communication.

5. A patient is receiving education about taking clozapine. Which statement indicates the patient understands the side effects?

• A. I should report any signs of infection to my healthcare provider immediately.
• B. I can stop taking this medication once I feel better.
• C. I should take this medication on an empty stomach.
• D. I should avoid drinking alcohol while taking this medication.

Correct answer: A

Rationale: The correct answer is A because patients taking clozapine should report signs of infection immediately due to the risk of agranulocytosis. Agranulocytosis is a potentially life-threatening side effect of clozapine characterized by a significant decrease in white blood cell count, which can leave the patient vulnerable to infections. Reporting signs of infection promptly is crucial to prevent serious complications.

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