Nursing Elites

1. Which characteristic is associated with anorexia nervosa?

• A. Manic
• B. Rebellious
• C. Hypoactive
• D. Perfectionistic

Correct answer: D

Rationale: Individuals with anorexia nervosa often exhibit perfectionistic traits, characterized by rigid standards and extreme self-discipline as a way to maintain control and fulfill personal and societal expectations. The focus on achieving an ideal body image through strict dietary habits and excessive exercise is a common manifestation of this perfectionism. The incorrect choices are: A) 'Manic' is not typically associated with anorexia nervosa; individuals with this disorder are more likely to experience anxiety and depression. B) 'Rebellious' does not align with the usual behavior seen in individuals with anorexia nervosa, who tend to comply with societal expectations rather than rebel against them. C) 'Hypoactive' does not describe the characteristic behavior of individuals with anorexia nervosa, who often engage in excessive physical activity as a means of weight loss.

2. A 20-year-old young adult has been recently admitted to the hospital. According to Erikson, which of the following stages is the adult in?

• A. Trust vs. mistrust
• B. Initiative vs. guilt
• C. Autonomy vs. shame
• D. Intimacy vs. isolation

Correct answer: D

Rationale: The young adult, at 20 years old, is in the stage of Intimacy vs. Isolation according to Erikson's psychosocial theory. This stage typically occurs during young adulthood, between the ages of approximately 19 and 40. The primary conflict in this stage revolves around the development of intimate, loving relationships with others. This stage focuses on establishing close bonds and connections with others, seeking emotional closeness and commitment. Choices A, B, and C are incorrect. Trust vs. mistrust is the stage that occurs in infancy, Initiative vs. guilt is in early childhood, and Autonomy vs. shame is in toddlerhood. These stages each represent different developmental challenges and conflicts that individuals face at various points in their lives.

3. A client with generalized anxiety disorder presents with restlessness and fatigue. Which additional clinical manifestation would the nurse monitor for?

• A. Hoarding
• B. Panic attacks
• C. Excessive worry
• D. Fear of leaving the house

Correct answer: C

Rationale: The nurse would monitor for excessive worry. Generalized anxiety disorder is characterized by physical and cognitive symptoms of chronic or excessive anxiety and worry. Excessive worry is a core feature of generalized anxiety disorder. Hoarding is a symptom of hoarding disorder, not generalized anxiety disorder. Panic attacks are typical of panic disorder, not generalized anxiety disorder. Fear of leaving the house is a characteristic of agoraphobia, which is distinct from generalized anxiety disorder.

4. A client who is newly diagnosed with multiple sclerosis is obviously upset and asks, 'Am I going to die?' Which response would the nurse make?

• A. Most individuals with your disease live a normal life span.
• B. Is your family here? I would like to explain your disease to all of you.
• C. The prognosis varies, as most individuals have remissions and exacerbations.
• D. Why don't you speak with your health care provider to get more details?

Correct answer: C

Rationale: The most appropriate response to the client's question regarding their prognosis is to acknowledge the variable nature of multiple sclerosis by stating that 'The prognosis varies, as most individuals have remissions and exacerbations.' This response provides realistic information while offering some hope. Choice A ('Most individuals with your disease live a normal life span.') gives false reassurance as repeated exacerbations may affect life span. Choice B ('Is your family here? I would like to explain your disease to all of you.') does not directly address the client's question and involves the family unnecessarily. Choice D ('Why don't you speak with your health care provider to get more details?') deflects the responsibility and does not address the client's immediate concerns about their prognosis.

5. Which type of environment would be most suitable for a confused client?

• A. Familiar
• B. Variable
• C. Challenging
• D. Stimulating

Correct answer: A

Rationale: The most appropriate environment for a confused client is a familiar one. A familiar environment provides security and safety, reducing stress for the confused client. Confused individuals struggle to adapt to constant changes, making a variable environment unsuitable. A challenging environment would likely increase anxiety and frustration in a confused client. Similarly, a stimulating environment could overwhelm the confused client, exacerbating their confusion.

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