Nursing Elites

1. When should healthcare professionals be most alert to the possibility of communication errors resulting in harm to the patient?

• A. Change of shift reports
• B. Admission interviews
• C. One-to-one conversations with patients
• D. Conversations with patient families

Correct answer: A

Rationale: Healthcare professionals should be most alert to the possibility of communication errors resulting in harm to the patient during change of shift reports. This is a critical time when information is transferred between healthcare providers, and any errors in communication during this handover can lead to adverse outcomes for the patient.

2. According to Maslow's hierarchy of needs, which situation on an inpatient psychiatric unit would require priority intervention by a nurse?

• A. A client rudely complaining about limited visiting hours
• B. A client exhibiting aggressive behavior toward another client
• C. A client stating that no one cares
• D. A client verbalizing feelings of failure

Correct answer: B

Rationale: The correct answer is B. According to Maslow's hierarchy of needs, safety needs are considered fundamental and must be addressed before higher-level needs. When a client exhibits aggressive behavior toward another client, it poses an immediate threat to safety and requires priority intervention by the nurse to ensure the well-being of all individuals involved. Clients who are rude in their complaints (Choice A), express feelings of failure (Choice D), or state that no one cares (Choice C) are addressing higher-level needs related to social interactions, esteem, and self-actualization, respectively, which can be addressed once safety needs are secured.

3. A healthcare provider is providing care for a patient with schizophrenia. Which symptom would be considered a positive symptom of this disorder?

• A. Alogia
• B. Anhedonia
• C. Delusions
• D. Flat affect

Correct answer: C

Rationale: Delusions are considered a positive symptom of schizophrenia. Positive symptoms represent an excess or distortion of normal functions, such as hallucinations, delusions, or disorganized speech or behavior. In contrast, negative symptoms involve a decrease or absence of normal functions, like alogia (poverty of speech), anhedonia (inability to experience pleasure), and flat affect (reduced expression of emotions). Therefore, in the context of schizophrenia, delusions fall under the category of positive symptoms.

4. A patient with generalized anxiety disorder (GAD) is prescribed venlafaxine. The nurse should educate the patient about which potential side effect?

• A. Hypertension
• B. Hypotension
• C. Bradycardia
• D. Hyperglycemia

Correct answer: A

Rationale: The correct answer is A: Hypertension. Venlafaxine, an SNRI, can lead to hypertension as a side effect. This medication can cause an increase in blood pressure, particularly at higher doses. Educating the patient about this potential adverse effect is crucial to enhance awareness and monitoring for any signs or symptoms of elevated blood pressure. Choices B, C, and D are incorrect because venlafaxine is more likely to cause hypertension rather than hypotension, bradycardia, or hyperglycemia.

5. For a patient diagnosed with borderline personality disorder exhibiting self-harming behavior, which therapeutic approach is most appropriate?

• A. Dialectical behavior therapy
• B. Psychoanalysis
• C. Supportive therapy
• D. Pharmacotherapy

Correct answer: A

Rationale: The most appropriate therapeutic approach for a patient diagnosed with borderline personality disorder exhibiting self-harming behavior is dialectical behavior therapy (DBT). DBT is specifically designed to address the core symptoms of borderline personality disorder, including self-harming behaviors. It focuses on teaching patients skills to manage emotions, improve interpersonal relationships, and enhance distress tolerance. Psychoanalysis (Choice B) is not the most appropriate for immediate symptom management in this case. Supportive therapy (Choice C) may not provide the structured approach needed to address self-harming behaviors effectively. Pharmacotherapy (Choice D) may be used as an adjunct in some cases, but DBT is the frontline therapy for managing self-harming behaviors in borderline personality disorder.

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