Nursing Elites

1. When patients diagnosed with schizophrenia suffer from anosognosia, they often refuse medication, believing that:

• A. Medications provided are ineffective.
• B. Nurses are trying to control their minds.
• C. The medications will make them sick.
• D. They are not actually ill.

Correct answer: D

Rationale: Anosognosia is a lack of insight that affects patients with schizophrenia, leading them to deny or lack awareness of their illness. This lack of awareness often results in patients refusing medication because they genuinely believe they are not ill and do not need treatment. It is crucial for healthcare providers to approach such situations with understanding and empathy, recognizing the impact of anosognosia on treatment adherence.

2. A client with borderline personality disorder is admitted to the psychiatric unit. Which intervention should the nurse implement to promote the client's safety?

• A. Implement a no-harm contract with the client.
• B. Monitor the client closely for signs of self-harm.
• C. Encourage the client to participate in recreational activities.
• D. Encourage the client to maintain a structured daily routine.

Correct answer: A

Rationale: When a client with borderline personality disorder is admitted to a psychiatric unit, implementing a no-harm contract is a crucial intervention to promote the client's safety. A no-harm contract is a formal agreement between the client and the healthcare provider stating that the client commits to not harm themselves or others. This intervention helps in establishing boundaries and promoting safety by enhancing communication and accountability between the client and the healthcare team. Monitoring the client closely for signs of self-harm (Choice B) is important but does not directly address promoting safety through a formal agreement. Encouraging participation in recreational activities (Choice C) and maintaining a structured daily routine (Choice D) are beneficial interventions but may not directly address the immediate safety concerns of a client with borderline personality disorder.

3. A client diagnosed with panic disorder is receiving discharge teaching from a healthcare provider. Which statement by the client indicates an accurate understanding of the teaching?

• A. I should avoid caffeine and other stimulants.
• B. I should take my medication only when I feel anxious.
• C. I should use relaxation techniques to manage anxiety.
• D. I should avoid exercising to prevent triggering anxiety.

Correct answer: A

Rationale: The correct answer is A. Avoiding caffeine and other stimulants is crucial for clients with panic disorder as these substances can exacerbate anxiety symptoms. Caffeine can trigger or worsen anxiety, leading to increased heart rate and restlessness. By eliminating stimulants, the client can better manage their anxiety levels and reduce the risk of panic attacks. Choices B, C, and D are incorrect because taking medication only when feeling anxious may lead to inconsistent treatment, using relaxation techniques alone may not be sufficient for managing panic disorder, and avoiding exercise can actually be counterproductive as regular physical activity can help reduce anxiety and stress levels.

4. Which therapeutic approach is considered most effective for treating posttraumatic stress disorder (PTSD)?

• A. Cognitive processing therapy
• B. Psychoanalysis
• C. Medication management
• D. Group therapy

Correct answer: A

Rationale: Cognitive processing therapy is a specialized form of cognitive-behavioral therapy that has been shown to be highly effective in treating posttraumatic stress disorder (PTSD). This therapy focuses on helping individuals process and make sense of their traumatic experiences, leading to symptom reduction and improved coping mechanisms. Psychoanalysis, medication management, and group therapy can be beneficial in some cases, but cognitive processing therapy is specifically tailored for addressing the symptoms and underlying causes of PTSD. Psychoanalysis may not be as effective for PTSD due to its focus on unconscious conflicts rather than trauma processing. Medication management can be useful as an adjunct to therapy but does not address the core issues of PTSD. Group therapy can provide support but may not offer the individualized approach that cognitive processing therapy provides.

5. A client with generalized anxiety disorder is prescribed buspirone (Buspar). Which statement by the client indicates an accurate understanding of the medication?

• A. I should take this medication as needed for anxiety.
• B. I need to avoid eating aged cheeses.
• C. It may take several weeks for this medication to take effect.
• D. I can stop taking this medication abruptly if I feel better.

Correct answer: C

Rationale: Buspirone (Buspar) may take several weeks to take effect, so clients should continue taking it as prescribed.

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