Nursing Elites

1. During an acute panic attack, which intervention should the nurse implement?

• A. Encourage the client to discuss their feelings
• B. Provide a calm environment
• C. Teach the client deep breathing exercises
• D. Leave the client alone to calm down

Correct answer: C

Rationale: During an acute panic attack, the priority intervention is to create a calm and safe environment. Teaching the client deep breathing exercises is crucial as it promotes relaxation and reduces hyperventilation, helping to manage the panic attack effectively. Encouraging the client to discuss their feelings may exacerbate the panic by increasing emotional distress. Providing a busy environment can escalate stress levels rather than alleviate them. Leaving the client alone may lead to feelings of abandonment or worsen the panic attack. Therefore, the most appropriate intervention is to teach deep breathing exercises to help the client regain control and manage the panic attack.

2. Which of the following statements should a healthcare professional recognize as true about defense mechanisms? Select the one that doesn't apply.

• A. They are employed when there is a threat to biological or psychological integrity.
• B. They are controlled by the id and deal with primal urges.
• C. They are used in an effort to relieve mild to moderate anxiety.
• D. They are protective devices for the superego.

Correct answer: B

Rationale: Defense mechanisms are employed by the ego in the face of threats to biological and psychological integrity to relieve mild to moderate anxiety. They act as protective devices for the ego, not the id or superego. The id represents primal instincts, while the superego is associated with moral standards. Defense mechanisms help individuals cope with stressors by redirecting focus and are often unconscious and self-deceptive.

3. A client diagnosed with major depressive disorder is receiving cognitive-behavioral therapy (CBT). Which outcome indicates that the therapy is effective?

• A. The client identifies and challenges negative thoughts.
• B. The client reports an increase in suicidal thoughts.
• C. The client experiences an increase in anxiety.
• D. The client shows no change in behavior.

Correct answer: A

Rationale: In cognitive-behavioral therapy (CBT), one of the primary objectives is to help clients identify and challenge their negative thoughts. This process allows the individual to reframe their thinking patterns and develop more adaptive coping strategies. Reporting an increase in suicidal thoughts (Choice B) or experiencing an increase in anxiety (Choice C) are not desired outcomes and may indicate a need for further intervention. Showing no change in behavior (Choice D) suggests that the therapy has not been effective. Therefore, the correct indicator of effective therapy in this context is the client's ability to identify and challenge negative thoughts (Choice A).

4. A client with bipolar disorder is experiencing a depressive episode. Which intervention should the nurse implement to support the client's recovery?

• A. Encourage the client to engage in physical activity.
• B. Encourage the client to maintain a regular sleep schedule.
• C. Encourage the client to set realistic goals for daily activities.
• D. Encourage the client to express feelings of sadness.

Correct answer: C

Rationale: During a depressive episode in bipolar disorder, encouraging the client to set realistic goals for daily activities can be beneficial. Setting achievable goals can provide structure, a sense of accomplishment, and help in breaking tasks into manageable steps, which can support the client's recovery process. Options A and B, while important in managing bipolar disorder, may not directly address the client's depressive symptoms during this episode. Option D, encouraging the client to express feelings of sadness, is not as effective as setting achievable goals in providing structure and a sense of accomplishment during a depressive episode.

5. During a manic episode in bipolar disorder, which intervention is most appropriate for a patient?

• A. Encourage the patient to engage in group activities.
• B. Provide a structured and low-stimulus environment.
• C. Allow the patient to set their schedule.
• D. Engage the patient in high-energy physical activities.

Correct answer: B

Rationale: During a manic episode in bipolar disorder, individuals may experience heightened energy levels, impulsivity, and decreased need for sleep. Providing a structured and low-stimulus environment is crucial in managing manic episodes. This intervention helps reduce overstimulation and provides a calm and predictable setting, which can be beneficial in helping the patient regain control and stability. Group activities and high-energy physical activities may exacerbate the symptoms of mania by increasing stimulation and excitement. Allowing the patient to set their schedule may not provide the necessary structure needed during a manic episode, hence making it less appropriate.

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