Nursing Elites

1. Which of the following are cultural aspects of mental illness? Select one that doesn't apply.

• A. Local or cultural norms define pathological behavior.
• B. The higher the social class the greater the recognition of mental illness behaviors.
• C. Psychiatrists typically see patients when the family can no longer deny the illness.
• D. The greater the cultural distance from the mainstream of society, the greater the likelihood that the illness will be treated with sensitivity and compassion.

Correct answer: D

Rationale: The fewer ties that a group has with mainstream society, the greater the likelihood of a negative response by society to mental illness. Coercive treatments and involuntary hospitalizations are more common in this population.

2. A client who experiences stress on a regular basis asks a nurse what causes these feelings. Which is the most appropriate nursing response?

• A. Genetics have no influence on your temperament.
• B. How you reacted to past experiences influences how you feel now.
• C. Maintaining good physical health always keeps stress levels low.
• D. Stress can be avoided by using appropriate coping mechanisms.

Correct answer: B

Rationale: The correct answer is B: 'How you reacted to past experiences influences how you feel now.' This response is appropriate because past experiences can shape an individual's current response to stress. It acknowledges the impact of learned patterns and coping mechanisms on one's current adaptation to stressors. Choice A is incorrect because genetics can play a role in temperament to some extent. Choice C is incorrect because while physical health can contribute to stress management, it is not the sole determinant of stress levels. Choice D is incorrect as stress is not always avoidable, but coping mechanisms can help manage and reduce its impact.

3. The client recently survived a plane crash and is assessed by the nurse. Which client statement would cause the nurse to suspect that the client may be experiencing PTSD?

• A. I believe that I was meant to survive this accident so that I can focus on the important things in life
• B. Although I have nightmares sometimes, I have started going to church to show gratitude for surviving the crash
• C. I am so afraid that I will never be able to fly again, but I know that it will take a while
• D. I keep having these thoughts about the crash that just pop into my mind at random times

Correct answer: D

Rationale: Experiencing intrusive thoughts about a traumatic event, such as a plane crash, that occur unexpectedly and repeatedly is a common symptom of Post-Traumatic Stress Disorder (PTSD). These thoughts can be distressing and are often a key indicator of PTSD. Options A, B, and C demonstrate coping mechanisms and fears related to the traumatic event but do not specifically address the hallmark symptom of intrusive thoughts. Therefore, option D is the correct choice as it aligns with a potential symptom of PTSD.

4. In the treatment of generalized anxiety disorder (GAD), what medication is frequently prescribed as a first-line treatment?

• A. Clonazepam
• B. Buspirone
• C. Propranolol
• D. Hydroxyzine

Correct answer: B

Rationale: Buspirone is often chosen as a first-line treatment for generalized anxiety disorder (GAD) due to its efficacy and favorable side effect profile. Unlike benzodiazepines such as clonazepam (A), buspirone does not carry the risk of tolerance, dependence, or withdrawal symptoms, making it a preferred choice. While propranolol (C) and hydroxyzine (D) are sometimes used for anxiety, they are not typically considered first-line treatments for GAD.

5. A patient with agoraphobia is unable to leave home. Which intervention should the nurse prioritize?

• A. Teach the patient relaxation techniques.
• B. Gradual exposure to feared situations.
• C. Encourage the patient to attend social gatherings.
• D. Provide education about the disorder.

Correct answer: B

Rationale: For a patient with agoraphobia, the priority intervention should be gradual exposure to feared situations. This approach helps the patient confront and gradually overcome their fear of leaving home, a common challenge in agoraphobia. By exposing the patient to feared situations in a step-by-step manner, they can learn to manage their anxiety and increase their confidence in leaving home. Teaching relaxation techniques (Choice A) can be beneficial but may not address the core issue of avoidance behavior. Encouraging the patient to attend social gatherings (Choice C) can be overwhelming and counterproductive at the initial stage of treatment. Providing education about the disorder (Choice D) is important but should come after addressing the immediate need for exposure therapy.

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