Nursing Elites

1. Why is it important to establish a contract with a client with an eating disorder at the beginning of treatment?

• A. The client and healthcare provider form a partnership that is challenging for the family to disrupt.
• B. A collaborative approach to treatment planning ensures that both physical and emotional needs will be addressed.
• C. Involving the client in decision-making enhances the feeling of control and fosters cooperation.
• D. Permission for refeeding is crucial as it can have adverse effects.

Correct answer: C

Rationale: Establishing a contract with a client with an eating disorder at the start of treatment is crucial to involve the client in decision-making processes. By engaging the client in decision-making, it enhances their sense of control over their treatment, which can lead to increased cooperation and better treatment outcomes. This collaborative approach empowers the client and fosters a therapeutic alliance between the client and the healthcare provider, rather than excluding the family or causing disruptions. It focuses on addressing both the physical and emotional needs of the client, ensuring a comprehensive treatment plan.

2. A client has been diagnosed with depersonalization/derealization disorder. Which of the following behaviors should the nurse expect?

• A. Feelings of detachment from one's body
• B. Fear of gaining weight
• C. Paralysis of a limb
• D. Episodes of hypomania

Correct answer: A

Rationale: Depersonalization/derealization disorder is characterized by feelings of detachment from one's body or surroundings. Individuals with this disorder may feel like they are observing themselves from outside their body or that the world around them is unreal. Therefore, the nurse should expect behaviors such as feelings of detachment from one's body (A). Fear of gaining weight (B) is more indicative of an eating disorder, paralysis of a limb (C) could be related to neurological issues, and episodes of hypomania (D) are associated with mood disorders like bipolar disorder, but not specifically with depersonalization/derealization disorder.

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. A client diagnosed with post-traumatic stress disorder (PTSD) is being assessed by a healthcare professional. Which symptom would the healthcare professional expect the client to exhibit?

• A. Delusions of grandeur
• B. Hypervigilance
• C. Obsessive-compulsive behaviors
• D. Periods of excessive sleeping

Correct answer: B

Rationale: In individuals with post-traumatic stress disorder (PTSD), hypervigilance is a common symptom. Hypervigilance refers to a state of increased alertness, awareness, and sensitivity to potential threats or danger. This heightened state of vigilance can manifest as being easily startled, having difficulty relaxing or sleeping, and constantly scanning the environment for signs of danger. It is an adaptive response to the trauma experienced and can significantly impact the individual's daily functioning. The other options are not typically associated with PTSD. Delusions of grandeur are more commonly seen in certain psychiatric disorders like bipolar disorder or schizophrenia. Obsessive-compulsive behaviors are characteristic of obsessive-compulsive disorder (OCD), not PTSD. Periods of excessive sleeping may be seen in conditions like depression, but they are not a hallmark symptom of PTSD.

5. A nurse is assessing a client who has been diagnosed with persistent depressive disorder (dysthymia). Which of the following findings should the nurse expect?

• A. Episodes of hypomania
• B. Periods of elevated mood
• C. Lack of interest in activities
• D. Feelings of detachment from one's body

Correct answer: C

Rationale: The correct finding the nurse should expect in a client diagnosed with persistent depressive disorder (dysthymia) is a lack of interest in activities. This disorder is characterized by a chronic depressive mood lasting for at least two years, alongside symptoms such as changes in appetite, fatigue, low self-esteem, and difficulty concentrating. Clients with dysthymia do not typically experience hypomania, periods of elevated mood, or feelings of detachment from one's body, which are more commonly associated with other mood disorders. Therefore, options A, B, and D are incorrect findings for a client with persistent depressive disorder.

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