Nursing Elites

1. Which chronic medical condition commonly triggers major depressive disorder?

• A. Pain
• B. Hypertension
• C. Hypothyroidism
• D. Crohn's disease

Correct answer: A

Rationale: Chronic pain is a common trigger for major depressive disorder. The persistent and distressing nature of chronic pain can lead to feelings of hopelessness, helplessness, and contribute to the development of major depressive disorder in individuals experiencing it.

2. A healthcare professional is assessing a client's use of defense mechanisms. Which statement would indicate to the healthcare professional that the client is using the defense mechanism of projection?

• A. The client accuses others of being angry when it is the client who is angry.
• B. The client refuses to acknowledge a problem despite evidence to the contrary.
• C. The client attributes his own feelings of hostility to others.
• D. The client avoids dealing with painful feelings by focusing on something else.

Correct answer: C

Rationale: Projection is a defense mechanism where individuals attribute their own unacceptable feelings, thoughts, or impulses onto others. In this case, the client is projecting his own feelings of hostility onto others by assuming they possess these feelings instead.

3. During a routine health screening, a grieving widow whose husband died 15 months ago reports emptiness, a loss of self, difficulty thinking of the future, and anger at her dead husband. The nurse suggests bereavement counseling. The widow is most likely suffering from:

• A. Major depression
• B. Normal grieving
• C. Adjustment disorder
• D. Posttraumatic stress disorder

Correct answer: C

Rationale: The widow's symptoms align more closely with an adjustment disorder rather than major depression, normal grieving, or posttraumatic stress disorder. The widow's prolonged struggle in coping with the loss, characterized by emptiness, loss of self, difficulty envisioning the future, and anger towards her deceased husband, indicates an inability to adapt to the loss. These symptoms are indicative of an adjustment disorder, which typically arises in response to a significant life stressor and persists beyond what is considered a normal grieving process. Bereavement counseling can help the widow navigate her emotions and coping strategies during this challenging period.

4. A client is diagnosed with somatic symptom disorder. Which question will help the nurse develop nursing diagnoses for this client’s plan of care?

• A. Are you satisfied with your appearance?
• B. Do you take medication for anxiety as prescribed?
• C. When did you last feel detached from your environment?
• D. How long have you had these memory problems?

Correct answer: B

Rationale: In clients with somatic symptom disorder, it is crucial to assess their adherence to medication for anxiety as prescribed. This question helps the nurse understand the client's treatment compliance, which can impact the development of nursing diagnoses and the overall plan of care. Monitoring medication adherence is essential in managing the client's symptoms and improving outcomes.

5. During an admission assessment and interview, which channels of information communication should the nurse be monitoring? Select one that doesn't apply.

• A. Auditory
• B. Visual
• C. Written
• D. Tactile

Correct answer: C

Rationale: During an admission assessment and interview, nurses should monitor auditory, visual, and tactile channels of communication. Written communication is not typically monitored during a face-to-face interview or assessment, making it the correct choice that doesn't apply in this scenario.

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