Nursing Elites

1. Which statement about the concept of psychoses is most accurate?

• A. Individuals experiencing psychoses are aware that their behaviors are maladaptive.
• B. Individuals experiencing psychoses experience little distress.
• C. Individuals experiencing psychoses are aware of experiencing psychological problems.
• D. Individuals experiencing psychoses are based in reality.

Correct answer: B

Rationale: The most accurate statement about psychoses is that individuals experiencing it often exhibit limited distress because they are not fully aware of their altered perception of reality. They may not recognize that their behaviors are maladaptive or acknowledge the presence of psychological issues. Choice A is incorrect because individuals with psychoses may not be aware that their behaviors are maladaptive. Choice C is incorrect because individuals with psychoses may not have insight into their psychological problems. Choice D is incorrect because individuals with psychoses often struggle to differentiate between reality and their altered perceptions.

2. Maggie, a child in protective custody, is found to have an imaginary friend, Holly. Her foster family shares this information with the nurse. The nurse teaches the family members about children who have suffered trauma and knows her teaching was effective when the foster mother states:

• A. I understand that imaginary friends are abnormal.
• B. I understand that imaginary friends are a maladaptive behavior.
• C. I understand that imaginary friends are a coping mechanism.
• D. I understand that we should tell the child that imaginary friends are unacceptable.

Correct answer: C

Rationale: Imaginary friends can serve as a coping mechanism for children, especially those who have experienced trauma. They can provide comfort and a sense of control in challenging situations. Acknowledging and supporting the child's imaginary friend can be beneficial in their emotional healing and development.

3. During a manic episode in bipolar disorder, which intervention is most appropriate for a patient?

• A. Encourage the patient to engage in group activities.
• B. Provide a structured and low-stimulus environment.
• C. Allow the patient to set their schedule.
• D. Engage the patient in high-energy physical activities.

Correct answer: B

Rationale: During a manic episode in bipolar disorder, individuals may experience heightened energy levels, impulsivity, and decreased need for sleep. Providing a structured and low-stimulus environment is crucial in managing manic episodes. This intervention helps reduce overstimulation and provides a calm and predictable setting, which can be beneficial in helping the patient regain control and stability. Group activities and high-energy physical activities may exacerbate the symptoms of mania by increasing stimulation and excitement. Allowing the patient to set their schedule may not provide the necessary structure needed during a manic episode, hence making it less appropriate.

4. When a patient with major depressive disorder is started on fluoxetine, what is the most important side effect for the nurse to monitor?

• A. Weight gain
• B. Suicidal ideation
• C. Hypertension
• D. Hyperglycemia

Correct answer: B

Rationale: When initiating fluoxetine therapy in a patient with major depressive disorder, monitoring for suicidal ideation is crucial due to the increased risk of suicidal thoughts or behaviors that can occur, especially in the initial phase of treatment. This close monitoring is essential to ensure patient safety and intervene promptly if such symptoms arise. Weight gain, hypertension, and hyperglycemia are potential side effects of some medications used to treat depression, but suicidal ideation is the most critical and immediate side effect to monitor for when starting fluoxetine.

5. A healthcare professional is teaching a patient about relaxation techniques to manage anxiety. Which technique is the healthcare professional most likely to recommend?

• A. Deep breathing exercises
• B. Physical exercise
• C. Mindfulness meditation
• D. Journaling

Correct answer: A

Rationale: Deep breathing exercises are a widely recommended technique for managing anxiety and promoting relaxation. By focusing on deep, slow breaths, individuals can activate the body's relaxation response, leading to decreased anxiety levels and an overall sense of calm. This technique is easy to learn, can be practiced anywhere, and is often suggested by healthcare professionals as a first-line approach for anxiety management. Physical exercise, mindfulness meditation, and journaling are also beneficial for mental well-being but may not be the first choice when specifically targeting acute anxiety management.

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