Nursing Elites

1. Which of the following is a positive symptom of schizophrenia?

• A. Apathy
• B. Social withdrawal
• C. Delusions
• D. Flat affect

Correct answer: C

Rationale: The correct answer is 'C: Delusions.' Positive symptoms of schizophrenia involve an excess or distortion of normal functions. Delusions are fixed false beliefs that are not based in reality and are considered positive symptoms because they represent an addition of abnormal behavior or thoughts.

2. Which symptom is most indicative of posttraumatic stress disorder (PTSD)?

• A. Persistent low mood
• B. Frequent nightmares
• C. Hallucinations
• D. Compulsive behaviors

Correct answer: B

Rationale: Frequent nightmares are a hallmark symptom of posttraumatic stress disorder (PTSD). Individuals with PTSD often experience intrusive and distressing nightmares related to the traumatic event they have experienced. These nightmares can contribute to sleep disturbances and further exacerbate the individual's overall psychological distress. Persistent low mood, hallucinations, and compulsive behaviors are not specific symptoms of PTSD and are more commonly associated with other mental health conditions such as depression, psychotic disorders, and obsessive-compulsive disorder respectively.

3. A patient with obsessive-compulsive disorder (OCD) is under the care of a nurse. Which intervention is most appropriate?

• A. Encourage the patient to suppress their compulsive behaviors.
• B. Allow the patient to perform their rituals, then gradually limit the time spent on these rituals.
• C. Discourage the patient from discussing their obsessions.
• D. Avoid setting limits on the patient’s compulsive behaviors.

Correct answer: B

Rationale: In managing a patient with OCD, it is crucial to allow them to perform their rituals while gradually limiting the time spent on these rituals. This approach helps the patient feel supported while working towards reducing the compulsive behaviors. Choice A is incorrect because suppressing compulsive behaviors can increase anxiety and distress. Choice C is inappropriate as discussing obsessions is part of therapy. Choice D is not recommended as setting limits on compulsive behaviors is essential for treatment.

4. James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for the day shift and anxiously reports, ‘Last night, demons came to my room and tried to rape me.’ Which response would be most therapeutic?

• A. There are no such things as demons. What you saw were hallucinations.
• B. It is not possible for anyone to enter your room at night. You are safe here.
• C. You seem very upset. Please tell me more about what you experienced last night.
• D. That must have been very frightening, but we’ll check on you at night and you’ll be safe.

Correct answer: C

Rationale: Choice C is the most therapeutic response as it acknowledges the patient’s feelings, shows empathy, and encourages further expression of his experiences. By actively listening and inviting the patient to share more details, the healthcare provider provides a supportive environment that can help the patient feel understood and validated. Option A dismisses the patient's experience and can make him feel unheard. Option B denies the patient's reality and can increase his distress. Option D, while offering reassurance, does not address the patient's emotional state or encourage further communication.

5. In an emergency mental health facility, a nurse is caring for a group of clients. The nurse should identify that which of the following clients requires a temporary emergency admission?

• A. A client with schizophrenia who has delusions of grandeur
• B. A client with manifestations of depression who attempted suicide a year ago
• C. A client with borderline personality disorder who assaulted a homeless man with a metal rod
• D. A client with bipolar disorder who paces quickly around the room while talking to themselves

Correct answer: C

Rationale: The correct answer is C. A client with borderline personality disorder who has committed an assault poses a risk to others and themselves, necessitating temporary emergency admission for safety and further assessment. Choices A, B, and D do not indicate an immediate risk to self or others that would require temporary emergency admission.

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