Nursing Elites

1. Which symptom should a healthcare provider identify as typical of the fight-or-flight response?

• A. Pupil dilation
• B. Increased heart rate
• C. Decreased salivation
• D. Decreased peristalsis

Correct answer: B

Rationale: The correct answer is B: Increased heart rate. During the fight-or-flight response, the sympathetic nervous system is activated, causing the release of epinephrine. This hormone triggers an increase in heart rate to supply more blood to the muscles for a rapid response. Pupil dilation occurs to enhance vision in preparation for quick reactions. On the other hand, salivation and peristalsis decrease as the body prioritizes functions necessary for immediate action rather than digestion-related activities. Therefore, choices A, C, and D are incorrect as they do not align with the typical physiological changes associated with the fight-or-flight response.

2. Which client action is an example of the defense mechanism of sublimation?

• A. A woman channels her energy into a new hobby after a breakup.
• B. A man redirects his anger from work into a workout routine.
• C. A student focuses on studying to avoid thinking about a recent argument.
• D. An athlete channels competitive impulses into a successful sports career.

Correct answer: B

Rationale: Sublimation is a defense mechanism where unacceptable impulses are redirected into socially acceptable activities. In this scenario, the man redirects his anger from work into a workout routine, which is a positive and constructive way of managing his emotions. Choices A, C, and D do not fully align with sublimation as they do not involve redirecting unacceptable impulses into socially acceptable outlets, unlike the man's action in choice B.

3. Which intervention is most appropriate for a patient with a phobia of flying?

• A. Exposure therapy
• B. Cognitive restructuring
• C. Medication management
• D. Psychoeducation

Correct answer: A

Rationale: Exposure therapy is considered the most appropriate intervention for a patient with a phobia of flying. This therapeutic approach involves gradually exposing the individual to the feared stimulus, in this case, flying, in a controlled and supportive environment. By facing the fear in a structured manner, the patient can learn to manage their anxiety response and eventually reduce their phobia-related symptoms. While cognitive restructuring may help change negative thought patterns and medication management can alleviate symptoms, exposure therapy is specifically designed to address phobias through systematic desensitization, making it the most suitable intervention in this scenario. Psychoeducation aims to provide information and support but may not directly target the phobia itself.

4. A client has been diagnosed with depersonalization/derealization disorder. Which of the following behaviors should the nurse expect?

• A. Feelings of detachment from one's body
• B. Fear of gaining weight
• C. Paralysis of a limb
• D. Episodes of hypomania

Correct answer: A

Rationale: Depersonalization/derealization disorder is characterized by feelings of detachment from one's body or surroundings. Individuals with this disorder may feel like they are observing themselves from outside their body or that the world around them is unreal. Therefore, the nurse should expect behaviors such as feelings of detachment from one's body (A). Fear of gaining weight (B) is more indicative of an eating disorder, paralysis of a limb (C) could be related to neurological issues, and episodes of hypomania (D) are associated with mood disorders like bipolar disorder, but not specifically with depersonalization/derealization disorder.

5. 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.

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