Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A charge nurse is preparing an educational session about addictive disorders for the nursing staff. Which of the following should the nurse include as etiological factors of addictive disorders? (Select all that apply).
A. Low self-esteem.
Low self-esteem is considered a risk factor for addictive disorders. Individuals with low self-esteem may use substances as a coping mechanism to deal with negative feelings about themselves.
B. Family history of addiction.
A family history of addiction is a significant risk factor. Genetic predisposition plays a crucial role in the development of addictive behaviors.
C. Asian ethnicity.
Asian ethnicity is not typically considered an etiological factor for addictive disorders. In fact, some studies suggest that certain genetic factors in Asian populations may reduce the risk of alcohol addiction.
D. Personality disorders.
Personality disorders, such as borderline personality disorder or antisocial personality disorder, are associated with a higher risk of substance use disorders. These disorders can lead to behaviors that increase the likelihood of addiction.
E. Being female.
Being female is not a direct etiological factor for addictive disorders. However, gender can influence the patterns and consequences of substance use, with males generally having a higher prevalence of substance use disorders.
This question is an excerpt from Nurse Dive's nursing test bank - ATI Custom NSG 133 Mental Health Final Proctored Exam Summer (2023). Take the full exam now
Full Explanation
The correct answer is choice a. Low self-esteem, b. Family history of addiction, and d. Personality disorders.
Choice A rationale:
Low self-esteem is considered a risk factor for addictive disorders. Individuals with low self-esteem may use substances as a coping mechanism to deal with negative feelings about themselves.
Choice B rationale:
A family history of addiction is a significant risk factor. Genetic predisposition plays a crucial role in the development of addictive behaviors.
Choice C rationale:
Asian ethnicity is not typically considered an etiological factor for addictive disorders. In fact, some studies suggest that certain genetic factors in Asian populations may reduce the risk of alcohol addiction.
Choice D rationale:
Personality disorders, such as borderline personality disorder or antisocial personality disorder, are associated with a higher risk of substance use disorders. These disorders can lead to behaviors that increase the likelihood of addiction.
Choice E rationale:
Being female is not a direct etiological factor for addictive disorders. However, gender can influence the patterns and consequences of substance use, with males generally having a higher prevalence of substance use disorders.
Similar Questions
A school nurse is speaking to the mother of a 16-year-old male adolescent. The mother has concerns about her son. Which of the following statements by the mother should indicate to the nurse that the adolescent is at risk for suicide?
A. "His cousin committed suicide a few weeks ago.”
A). This experience increases the risk due to the potential for social contagion. The other options, including spending time with school friends, sleep patterns, and religious involvement, do not directly suggest an imminent risk of suicide.
B. "He spends much of his time with his two school friends.”
"He spends much of his time with his two school friends." While changes in social behavior might raise concerns, this statement alone does not directly indicate a risk of suicide. Adolescents can experience shifts in their social preferences for various reasons, and it's not a definitive sign of suicidal ideation or intent.
C. "He has slept 9 hours each night for the past 2 years.”
"He has slept 9 hours each night for the past 2 years." Sleeping patterns alone do not strongly correlate with suicide risk. However, drastic changes in sleep patterns, such as insomnia or hypersomnia, might be indicative of underlying mental health issues. In this case, the consistent sleep pattern mentioned does not directly signal a risk of suicide.
D. "He is very religious and attends services twice a week.”
"He is very religious and attends services twice a week." Religious involvement can have protective effects on mental health, and attending religious services can provide a support network. While religion might offer some resilience against suicide, it is not a definitive indicator. Other factors need to be considered in conjunction with religious activities. For , the statement indicating an adolescent's higher risk of suicide is "His cousin committed suicide a few weeks ago" (
Full Explanation
Choice A rationale:
"His cousin committed suicide a few weeks ago." This statement is a significant red flag indicating a higher risk of suicide. When an adolescent is exposed to suicide, especially within their family or close social circle, they become more vulnerable due to the potential for social contagion. This scenario increases the urgency for intervention and support to prevent a similar outcome.
Choice B rationale:
"He spends much of his time with his two school friends." While changes in social behavior might raise concerns, this statement alone does not directly indicate a risk of suicide. Adolescents can experience shifts in their social preferences for various reasons, and it's not a definitive sign of suicidal ideation or intent.
Choice C rationale:
"He has slept 9 hours each night for the past 2 years." Sleeping patterns alone do not strongly correlate with suicide risk. However, drastic changes in sleep patterns, such as insomnia or hypersomnia, might be indicative of underlying mental health issues. In this case, the consistent sleep pattern mentioned does not directly signal a risk of suicide.
Choice D rationale:
"He is very religious and attends services twice a week." Religious involvement can have protective effects on mental health, and attending religious services can provide a support network. While religion might offer some resilience against suicide, it is not a definitive indicator. Other factors need to be considered in conjunction with religious activities. For , the statement indicating an adolescent's higher risk of suicide is "His cousin committed suicide a few weeks ago" (Choice A). This experience increases the risk due to the potential for social contagion. The other options, including spending time with school friends, sleep patterns, and religious involvement, do not directly suggest an imminent risk of suicide.
A nurse is caring for a client diagnosed with schizophrenia and is experiencing hallucinations. Which of the following actions should the nurse take?
A. Ask the client direct questions about the hallucination.
Asking direct questions about the hallucination helps the nurse understand the client’s experience and assess the content and intensity of the hallucinations. This approach also allows the nurse to provide appropriate support and interventions.
B. Act to the client as if the hallucination is real.
Acting as if the hallucination is real can reinforce the client’s distorted perception of reality, which is not therapeutic. The nurse should acknowledge the client’s experience without validating the hallucination as real.
C. Tell the client to go to their room and they should go away.
Telling the client to go to their room and that the hallucinations should go away is dismissive and does not address the client’s immediate needs. It is important to engage with the client and provide support rather than dismiss their experience.
D. Instruct the client to argue with the voices that are a part of the hallucination.
Instructing the client to argue with the voices can increase the client’s distress and is not a recommended therapeutic approach. Instead, the nurse should help the client find ways to cope with and manage the hallucinations.
Full Explanation
The correct answer is choice A. Ask the client direct questions about the hallucination.
Choice A rationale:
Asking direct questions about the hallucination helps the nurse understand the client’s experience and assess the content and intensity of the hallucinations. This approach also allows the nurse to provide appropriate support and interventions.
Choice B rationale:
Acting as if the hallucination is real can reinforce the client’s distorted perception of reality, which is not therapeutic. The nurse should acknowledge the client’s experience without validating the hallucination as real.
Choice C rationale:
Telling the client to go to their room and that the hallucinations should go away is dismissive and does not address the client’s immediate needs. It is important to engage with the client and provide support rather than dismiss their experience.
Choice D rationale:
Instructing the client to argue with the voices can increase the client’s distress and is not a recommended therapeutic approach. Instead, the nurse should help the client find ways to cope with and manage the hallucinations.
A nurse is assessing an adolescent female client who has anorexia nervosa. Which of the following findings should the nurse expect?
A. Metrorrhagia.
Metrorrhagia (Choice A) refers to irregular or excessive uterine bleeding between menstrual periods. While anorexia nervosa can disrupt menstrual cycles, causing amenorrhea, metrorrhagia is not a common associated finding.
B. Tachycardia.
Tachycardia is not expected in anorexia nervosa; bradycardia is more common due to metabolic adaptation and reduced cardiac workload. The body conserves energy by lowering heart rate, often below 60 bpm. Malnutrition leads to decreased thyroid hormone (T3), reduced sympathetic tone, and myocardial atrophy. Electrolyte imbalances and hypovolemia further depress cardiac output. Tachycardia may occur in refeeding syndrome or acute stress, but chronically, the heart rate is typically slow due to adaptive mechanisms.
C. Hyperkalemia.
Hyperkalemia (Choice C), which is elevated levels of potassium in the blood, is not a typical finding in anorexia nervosa. Electrolyte imbalances in anorexia more commonly involve decreased potassium levels (hypokalemia) due to inadequate intake and excessive purging.
D. Constipation.
Constipation is a frequent finding in anorexia nervosa due to decreased caloric intake, slowed gastrointestinal motility, and reduced fiber consumption. Starvation suppresses parasympathetic activity, leading to delayed colonic transit. Electrolyte imbalances, especially hypokalemia, further impair smooth muscle contraction. Normal bowel frequency ranges from three times per week to three times per day; anorexic clients often fall below this due to systemic hypometabolism. Constipation may also be exacerbated by dehydration and laxative dependence.
Full Explanation
The correct answer is Choice D
Choice A rationale: Metrorrhagia, or irregular uterine bleeding, is not typically associated with anorexia nervosa. Instead, amenorrhea is more common due to hypothalamic suppression from low body fat and caloric intake. The hypothalamus reduces gonadotropin-releasing hormone (GnRH), leading to decreased luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which suppresses ovulation and menstruation. Estrogen levels fall below normal (typically 30–400 pg/mL), disrupting endometrial stability. Thus, bleeding is less likely than complete menstrual cessation.
Choice B rationale: Tachycardia is not expected in anorexia nervosa; bradycardia is more common due to metabolic adaptation and reduced cardiac workload. The body conserves energy by lowering heart rate, often below 60 bpm. Malnutrition leads to decreased thyroid hormone (T3), reduced sympathetic tone, and myocardial atrophy. Electrolyte imbalances and hypovolemia further depress cardiac output. Tachycardia may occur in refeeding syndrome or acute stress, but chronically, the heart rate is typically slow due to adaptive mechanisms.
Choice C rationale: Hyperkalemia is rare in anorexia nervosa; hypokalemia is far more common due to purging behaviors, vomiting, and diuretic or laxative abuse. Potassium levels often fall below the normal range of 3.5–5.0 mEq/L. Losses through the gastrointestinal tract and renal excretion lead to muscle weakness, arrhythmias, and fatigue. Intracellular shifts during starvation also contribute to low serum potassium. Hyperkalemia may occur transiently during tissue breakdown or renal failure but is not a hallmark finding.
Choice D rationale: Constipation is a frequent finding in anorexia nervosa due to decreased caloric intake, slowed gastrointestinal motility, and reduced fiber consumption. Starvation suppresses parasympathetic activity, leading to delayed colonic transit. Electrolyte imbalances, especially hypokalemia, further impair smooth muscle contraction. Normal bowel frequency ranges from three times per week to three times per day; anorexic clients often fall below this due to systemic hypometabolism. Constipation may also be exacerbated by dehydration and laxative dependence.