Nursing Elites

1. While auditing care plans for clients with eating disorders, the nurse realizes that a nursing diagnosis appropriate for a client with anorexia nervosa as well as for a client with bulimia nervosa is

• A. Risk for imbalanced body temperature
• B. Ineffective denial
• C. Chronic low self-esteem
• D. Adult failure to thrive

Correct answer: C

Rationale: Chronic low self-esteem is a nursing diagnosis that can be applicable to clients with both anorexia nervosa and bulimia nervosa. These eating disorders are often associated with distorted body image, feelings of inadequacy, and low self-esteem. Clients with these conditions may engage in harmful behaviors related to their self-image, making chronic low self-esteem a relevant nursing diagnosis for them.

2. Research conducted by Miller and Rahe in 1997 demonstrated a correlation between the effects of life changes and illness, leading to the development of the Recent Life Changes Questionnaire (RLCQ). Which principle most limits the effectiveness of this tool?

• A. Specific illnesses are not identified.
• B. The numerical values associated with specific life events are randomly assigned.
• C. Stress is viewed as only a physiological response.
• D. Personal perception of the event is excluded.

Correct answer: D

Rationale: The main limitation of the Recent Life Changes Questionnaire (RLCQ) is that it does not consider an individual's personal perception of a life event. As people may interpret events differently, their subjective perspective plays a crucial role in how they experience stress and its potential impact on their health. Ignoring personal perception limits the effectiveness of the tool as it fails to capture the variations in how people respond to life changes. Choices A, B, and C are not the main limitations of the RLCQ. Specific illnesses not being identified or numerical values being randomly assigned do not directly impact the personal perception of life events. Additionally, viewing stress as only a physiological response is not the primary limitation, as stress encompasses psychological and emotional components as well.

3. A patient with obsessive-compulsive disorder (OCD) is undergoing treatment with an SSRI. Which SSRI is commonly utilized for this condition?

• A. Fluoxetine
• B. Citalopram
• C. Paroxetine
• D. Escitalopram

Correct answer: C

Rationale: Paroxetine is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed for obsessive-compulsive disorder due to its efficacy in managing OCD symptoms. While different SSRIs may be used based on individual patient response and tolerability, Paroxetine stands out as a well-established option for treating OCD. Fluoxetine (Choice A) is another SSRI commonly used for OCD, but Paroxetine is more commonly associated with this indication. Citalopram (Choice B) and Escitalopram (Choice D) are also SSRIs but are not typically the first choice for treating OCD.

4. Which of the following is identified as a psychoneurotic response to severe anxiety as it appears in the DSM-5?

• A. Somatic symptom disorder
• B. Grief responses
• C. Psychosis
• D. Bipolar disorder

Correct answer: A

Rationale: The correct answer is A: Somatic symptom disorder. Somatic symptom disorder is characterized by preoccupation with physical symptoms for which there is no demonstrable organic pathology. One of the diagnostic criteria is a high level of anxiety about health concerns or illness. In the DSM-5, somatic symptom disorders are classified under the category of somatic symptom and related disorders, which encompass conditions where psychological factors play a significant role in the development, exacerbation, or maintenance of physical symptoms. Choices B, C, and D are incorrect. Grief responses, psychosis, and bipolar disorder are not specifically categorized as psychoneurotic responses to severe anxiety in the DSM-5.

5. When an individual's stress response is sustained over a long period of time, which physiological effect of the endocrine system should one anticipate?

• A. Decreased resistance to disease
• B. Increased libido
• C. Decreased blood pressure
• D. Increased inflammatory response

Correct answer: A

Rationale: When stress is prolonged, the body reaches the stage of exhaustion in the general adaptation syndrome, where compensatory mechanisms fail, and diseases of adaptation may occur. One physiological effect includes a decreased immune response, leading to decreased resistance to disease. Therefore, the correct answer is A. Increased libido (choice B) is not a typical physiological effect related to prolonged stress. Decreased blood pressure (choice C) is not commonly associated with sustained stress. Increased inflammatory response (choice D) may occur in the short term due to stress, but over a prolonged period, the immune system's function weakens, leading to decreased resistance to disease.

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