Nursing Elites

1. A charge nurse is conducting a class on therapeutic communication with a group of newly licensed nurses. Which of the following aspects of communication should the nurse identify as a component of verbal communication?

• A. Personal space
• B. Posture
• C. Eye contact
• D. Intonation

Correct answer: D

Rationale: Verbal communication involves the use of words, tone, and pitch to convey messages. Intonation refers to the variation of pitch in speech, which can convey emotions, attitudes, and emphasize certain points. Therefore, intonation is a key component of verbal communication, making it the correct choice in this scenario. Choices A, B, and C are aspects of nonverbal communication. Personal space, posture, and eye contact are important nonverbal cues that contribute to effective communication, but they are not components of verbal communication.

2. A patient with obsessive-compulsive disorder (OCD) performs hand washing repeatedly. Which nursing intervention is most appropriate?

• A. Restricting the patient from washing hands
• B. Setting strict limits on the patient's hand washing
• C. Allowing the patient to wash hands at specified times
• D. Ignoring the patient's behavior

Correct answer: C

Rationale: Allowing the patient to wash hands at specified times is the most appropriate nursing intervention for a patient with OCD who repetitively performs hand washing. This intervention provides structure by allowing the patient to engage in the behavior at designated times, helping to reduce the compulsion gradually. Restricting or setting strict limits may increase anxiety and worsen the condition, while ignoring the behavior does not address the underlying issue of OCD.

3. In dissociative identity disorder, a patient exhibits different personalities, each with distinct behaviors and memories. The nurse recognizes that this fragmentation of identity serves as a coping mechanism for:

• A. Current stressors
• B. Developmental issues
• C. Traumatic experiences
• D. Family dynamics

Correct answer: C

Rationale: In dissociative identity disorder, the fragmentation of identity serves as a coping mechanism for traumatic experiences. Individuals may develop different identities to help them manage and cope with overwhelming and traumatic events from their past. These distinct personalities often emerge as a way to protect the individual from the emotional pain associated with their traumatic experiences. Choices A, B, and D are incorrect because dissociative identity disorder is primarily associated with coping mechanisms related to past traumatic experiences, rather than current stressors, developmental issues, or family dynamics.

4. Which symptom is most characteristic of generalized anxiety disorder (GAD)?

• A. Fear of social situations
• B. Excessive worrying about various aspects of life
• C. Hallucinations
• D. Impulsive behaviors

Correct answer: B

Rationale: Excessive worrying about various aspects of life is a hallmark symptom of generalized anxiety disorder (GAD). In GAD, individuals experience excessive and uncontrollable worry about a wide range of everyday problems. This persistent worrying can lead to physical and emotional symptoms, impacting their daily functioning and quality of life. Fear of social situations, hallucinations, and impulsive behaviors are not typically associated with GAD.

5. A nurse is providing discharge teaching to a patient prescribed fluoxetine for panic disorder. Which statement should be included in the teaching?

• A. You should notice the effects of this medication within a few days.
• B. It's important to take this medication only when you feel anxious.
• C. It may take several weeks before you notice the full effects of this medication.
• D. You can stop taking this medication as soon as you feel better.

Correct answer: C

Rationale: The correct statement to include in the teaching is that it may take several weeks before the patient notices the full effects of fluoxetine. This is because fluoxetine, like other SSRIs, requires time to reach its full therapeutic effect. Choice A is incorrect as fluoxetine does not show its effects within a few days. Choice B is incorrect as fluoxetine should be taken regularly as prescribed, not only when feeling anxious. Choice D is incorrect as discontinuing fluoxetine abruptly can lead to withdrawal symptoms and a return of panic disorder symptoms.

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