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When told that he is scheduled to interview a patient with narcissistic personality disorder, the nurse can anticipate the assessment findings will include the following:

  • A. charm, drama, seductiveness, and admiration seeking.
  • B. preoccupation with minute details and perfectionism.
  • C. difficulty being alone, indecisiveness, and submissiveness.
  • D. grandiosity, self-importance, and a sense of entitlement.
Correct Answer: D

Rationale: The correct answer is D. In narcissistic personality disorder, individuals exhibit grandiosity, self-importance, and a sense of entitlement. This is a key feature of the disorder where individuals have an inflated sense of their own importance and require excessive admiration. This behavior is often accompanied by a lack of empathy and exploitation of others.

Choice A (charm, drama, seductiveness, and admiration seeking) is more characteristic of histrionic personality disorder.

Choice B (preoccupation with minute details and perfectionism) is more characteristic of obsessive-compulsive personality disorder.

Choice C (difficulty being alone, indecisiveness, and submissiveness) does not align with the typical presentation of narcissistic personality disorder.

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Retreat from reality by hallucinations and delusions and by social withdrawal typically characterizes

  • A. somatoform disorders
  • B. anxiety disorders
  • C. psychotic disorders
  • D. personality disorders
Correct Answer: C

Rationale: Psychotic disorders, like schizophrenia, involve hallucinations, delusions, and withdrawal, distinguishing them from other categories.

A patient admitted to the eating disorders unit has yellow skin, the extremities are cold, and the heart rate is 42 bpm. The patient weighs 70 pounds; height is 5 feet 4 inches. The patient is quiet during the assessment saying only, "I will not eat until I lose enough weight to look thin." Select the best initial nursing diagnosis.

  • A. Anxiety related to fear of weight gain
  • B. Disturbed body image related to weight loss
  • C. Ineffective coping related to lack of conflict resolution skills
  • D. Imbalanced nutrition: less than body requirements related to self-starvation
Correct Answer: D

Rationale: The correct initial nursing diagnosis is D: Imbalanced nutrition: less than body requirements related to self-starvation. The patient's presentation of yellow skin, cold extremities, bradycardia, low weight, and refusal to eat indicate severe malnutrition due to self-starvation. The key indicators are the physical signs of malnutrition and the patient's statement about not eating until they lose enough weight. Options A and B do not address the primary issue of malnutrition and self-starvation. Option C focuses on coping skills, which is not the priority in this case. Therefore, option D is the best initial nursing diagnosis to address the patient's life-threatening condition of malnutrition.

When making a distinction as to whether an elderly patient has confusion related to delirium or another problem, what information would be of particular value?

  • A. Evidence of spasticity or flaccidity
  • B. The patients level of motor activity
  • C. Medications the patient has recently taken
  • D. Level of preoccupation with somatic symptoms
Correct Answer: C

Rationale: Delirium in the elderly produces symptoms of confusion. Medication interactions or adverse reactions are often a cause. The distracters do not give information important for delirium.

The nurse is administering donepezil (Aricept) to a client with stage 1 Alzheimer's disease. Based on this drug's mechanism of action, the nurse will seek evidence of improvement in the client's:

  • A. Ability to remember
  • B. Ability to tolerate stress
  • C. Social behaviors
  • D. Delusions and hallucinations
Correct Answer: A

Rationale: The correct answer is A: Ability to remember. Donepezil is a cholinesterase inhibitor that works by increasing levels of acetylcholine in the brain, which helps improve cognitive function, particularly memory. Therefore, the nurse should seek evidence of improvement in the client's ability to remember.

Choice B: Ability to tolerate stress is incorrect because donepezil does not directly impact stress tolerance.

Choice C: Social behaviors is incorrect as donepezil primarily targets memory and cognitive function, not social behaviors.

Choice D: Delusions and hallucinations is incorrect because donepezil does not specifically address these symptoms, which are more commonly associated with psychosis rather than Alzheimer's disease.

Suzanne is a 10-year-old girl who has been diagnosed as experiencing depression. What is likely to be the most effective way to help Suzanne express her feelings?

  • A. Have her participate in a group therapy session with other young children who are depressed
  • B. Ask her to draw some pictures about things that shes been thinking about
  • C. Arrange for individual psychotherapy sessions with a psychiatrist
  • D. Observe her actions but dont seek to draw her out into conversation
Correct Answer: B

Rationale: Younger children who may have more difficulty verbally expressing feelings may be able to draw them.

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