Nursing Elites

1. Which neurotransmitter is primarily implicated in the development of schizophrenia?

• A. Serotonin
• B. Norepinephrine
• C. Dopamine
• D. Acetylcholine

Correct answer: C

Rationale: The correct answer is dopamine. Dopamine dysregulation is a key factor in the development of schizophrenia. Excess dopamine activity in certain brain regions is associated with positive symptoms of schizophrenia, such as hallucinations and delusions. Dopaminergic medications that reduce dopamine levels are often used to manage these symptoms, further supporting the role of dopamine in schizophrenia. Serotonin (Choice A) is more commonly associated with mood regulation and is implicated in depression and anxiety disorders. Norepinephrine (Choice B) is involved in the body's 'fight or flight' response and is linked to conditions like anxiety and PTSD. Acetylcholine (Choice D) plays a role in muscle movement and memory but is not primarily implicated in schizophrenia.

2. A client is under a great deal of stress. Which nursing recommendation would be least helpful in assisting the client in coping with stress? Select one that doesn't apply.

• A. Enjoy a pet.
• B. Spend time with a loved one.
• C. Listen to music.
• D. Focus on the stressors.

Correct answer: D

Rationale: Focusing on the stressors can exacerbate stress levels in the client's life rather than helping to cope with it. Engaging in activities such as enjoying a pet, spending time with loved ones, and listening to music are known to be stress-relieving and can aid in coping with stress. It is essential to encourage strategies that promote relaxation and positive emotions, rather than fixating on the stressors that may worsen the client's condition. Therefore, 'Focus on the stressors' is the least helpful recommendation as it does not contribute to stress management.

3. When a husband accuses his wife of infidelity, which situation would indicate to the nurse the husband's use of the ego defense mechanism of projection?

• A. The husband cries and stamps his feet, demanding that his wife be true to her marriage vows.
• B. The husband ignores the wife's continued absence from the home.
• C. The husband has already admitted to having an affair with a coworker.
• D. The husband takes out his marital frustrations through employee abuse.

Correct answer: C

Rationale: Projection is a defense mechanism where one attributes their unacceptable feelings or impulses to another person. In this scenario, the husband, by admitting to having an affair with a coworker, is projecting his infidelity onto his wife, indicating the use of the projection defense mechanism. Choice A is incorrect as it describes a different behavior, not projection. Choice B does not demonstrate projection but rather avoidance or denial. Choice D shows displacement of aggression, not projection.

4. Substance abuse is often present in individuals diagnosed with bipolar disorder. Laura, a 28-year-old with a bipolar disorder diagnosis, chooses to drink alcohol instead of taking her prescribed medications. The nurse caring for this patient recognizes that:

• A. Anxiety may be present.
• B. Alcohol ingestion is a form of self-medication.
• C. The patient is lacking a sufficient number of neurotransmitters.
• D. The patient is using alcohol as a coping mechanism.

Correct answer: B

Rationale: Individuals with bipolar disorder may turn to alcohol as a form of self-medication to cope with their symptoms. This behavior is often seen as an attempt to manage mood swings and alleviate distress. It is important for healthcare providers to address and manage substance abuse issues in patients with bipolar disorder to ensure proper treatment and overall well-being.

5. A client with post-traumatic stress disorder (PTSD) is experiencing flashbacks. Which of the following interventions should the nurse implement?

• A. Encourage the client to ignore the flashbacks.
• B. Stay with the client and offer reassurance.
• C. Instruct the client to avoid discussing the traumatic event.
• D. Encourage the client to engage in group therapy.

Correct answer: B

Rationale: During a flashback, it is essential for the nurse to stay with the client and offer reassurance. This approach can help the client feel safe and supported during a distressing experience. Encouraging the client to ignore the flashbacks may lead to increased anxiety and distress. Instructing the client to avoid discussing the traumatic event can hinder the therapeutic process of addressing and processing the trauma. While group therapy can be beneficial, it may not be the immediate intervention needed during a flashback.

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