Nursing Elites

1. Which of the following is not a cultural aspect related to mental illness?

• 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 statement in option D is incorrect. The greater the cultural distance from the mainstream of society, the more likely there will be negative responses to mental illness. In such cases, coercive treatments and involuntary hospitalizations are more common, rather than sensitivity and compassion.

2. A patient with posttraumatic stress disorder (PTSD) is experiencing flashbacks. The most appropriate intervention is to:

• A. Encourage the patient to talk about the trauma.
• B. Help the patient reorient to the present.
• C. Leave the patient alone to process the flashback.
• D. Remind the patient that the flashback is not real.

Correct answer: B

Rationale: When a patient with PTSD is experiencing flashbacks, the most appropriate intervention is to help them reorient to the present. This intervention can assist in reducing the intensity of the flashback and providing a sense of safety for the patient. Choice A is incorrect because encouraging the patient to talk about the trauma during a flashback may exacerbate their distress. Choice C is incorrect as leaving the patient alone can increase their feelings of isolation and fear. Choice D is incorrect because reminding the patient that the flashback is not real may invalidate their experience and increase their sense of disconnection.

3. A client diagnosed with borderline personality disorder has been admitted to the psychiatric unit after a suicide attempt. Which of the following actions should the nurse take first?

• A. Encourage the client to express feelings about the suicide attempt.
• B. Place the client on one-to-one observation.
• C. Discuss the client's feelings about the suicide attempt.
• D. Encourage the client to participate in group therapy.

Correct answer: B

Rationale: The initial priority for the nurse is to ensure the safety of the client. Placing the client on one-to-one observation allows for constant monitoring and intervention if there are any signs of self-harm or a worsening condition. This immediate intervention is crucial to prevent further harm. Options A, C, and D involve therapeutic communication and interventions, which are important but should come after ensuring the client's safety.

4. A client has been prescribed lorazepam (Ativan) for the treatment of anxiety. Which of the following instructions should the nurse include?

• A. Take the medication with food to avoid stomach upset.
• B. Avoid driving until you know how the medication affects you.
• C. Take the medication on an empty stomach.
• D. Double the dose if you miss a dose.

Correct answer: B

Rationale: The correct answer is B because lorazepam (Ativan) can cause dizziness and drowsiness, so the client should avoid driving until they know how the medication affects them. This instruction is crucial for ensuring the client's safety and preventing any potential accidents or harm. Choice A is incorrect because lorazepam does not necessarily need to be taken with food. Choice C is incorrect as it contradicts the usual recommendation of taking lorazepam with or without food. Choice D is incorrect and dangerous advice as doubling the dose of lorazepam can lead to overdose and serious complications.

5. What is the most appropriate intervention for a patient experiencing a panic attack?

• A. Encourage deep, slow breathing.
• B. Encourage the patient to talk about their feelings.
• C. Leave the patient alone to calm down.
• D. Engage the patient in a physical activity.

Correct answer: A

Rationale: Encouraging deep, slow breathing is the most appropriate intervention for a patient experiencing a panic attack. This technique can help the patient regulate their breathing, reduce hyperventilation, and promote relaxation, which are essential in managing the symptoms of a panic attack. Choice B, encouraging the patient to talk about their feelings, may not be effective during an acute panic attack as the focus should be on calming the patient down. Choice C, leaving the patient alone, can lead to increased feelings of fear and isolation during a panic attack. Choice D, engaging the patient in physical activity, may exacerbate symptoms as it can increase the feeling of being out of control.

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