Nursing Elites

1. A client with generalized anxiety disorder (GAD) is being discharged. Which of the following instructions should the nurse not include in the discharge teaching?

• A. Practice relaxation techniques daily
• B. Avoid caffeine and alcohol
• C. Engage in regular physical activity
• D. Use benzodiazepines as the first-line treatment

Correct answer: D

Rationale: Discharge instructions for a client with GAD should include practicing relaxation techniques daily, avoiding caffeine and alcohol, engaging in regular physical activity, and seeking support from friends and family. Benzodiazepines are not recommended as the first-line treatment due to their potential for dependence and should not be included in the discharge teaching.

2. During a mental health assessment on an adult client, which client action would demonstrate the highest achievement in terms of mental health according to Maslow's hierarchy of needs?

• A. Maintaining a long-term, faithful, intimate relationship
• B. Achieving a sense of self-confidence
• C. Possessing a feeling of self-fulfillment and realizing full potential
• D. Developing a sense of purpose and the ability to direct activities

Correct answer: C

Rationale: In Maslow's hierarchy of needs, self-actualization is the highest level. Possessing a feeling of self-fulfillment and realizing full potential reflects self-actualization. This level represents achieving personal growth, self-improvement, and reaching one's full potential, indicating optimal mental health. Choices A, B, and D represent lower levels of needs according to Maslow's hierarchy. Maintaining a long-term relationship indicates belongingness and love needs, achieving self-confidence pertains to esteem needs, and developing a sense of purpose relates to self-esteem and self-actualization needs, but they are not at the pinnacle of self-actualization as in choice C.

3. Which medication is commonly prescribed for the treatment of attention-deficit/hyperactivity disorder (ADHD)?

• A. Haloperidol
• B. Fluoxetine
• C. Methylphenidate
• D. Clozapine

Correct answer: C

Rationale: Methylphenidate is a stimulant medication commonly prescribed to manage symptoms of attention-deficit/hyperactivity disorder (ADHD). It works by affecting certain chemicals in the brain to improve focus, attention span, and impulse control. Haloperidol, fluoxetine, and clozapine are not typically used as first-line treatments for ADHD. Haloperidol is an antipsychotic, fluoxetine is an antidepressant, and clozapine is an atypical antipsychotic, each with different mechanisms of action and primary indications.

4. A client is diagnosed with generalized anxiety disorder (GAD). Which of the following interventions should the nurse implement? Select one that does not apply.

• A. Encourage the client to express their feelings
• B. Teach the client relaxation techniques
• C. Promote regular physical activity
• D. Encourage the use of caffeine

Correct answer: D

Rationale: Interventions for a client with GAD should include encouraging the client to express their feelings, teaching relaxation techniques, and promoting regular physical activity. Caffeine should be avoided as it can exacerbate anxiety symptoms. Stimulants like caffeine can increase feelings of restlessness and nervousness, making it counterproductive in managing anxiety. Choices A, B, and C are appropriate interventions for managing generalized anxiety disorder by promoting emotional expression, relaxation, and physical well-being, respectively. Choice D, encouraging the use of caffeine, is incorrect as it can worsen anxiety symptoms rather than alleviate them.

5. Which therapeutic approach is considered most effective for treating posttraumatic stress disorder (PTSD)?

• A. Cognitive processing therapy
• B. Psychoanalysis
• C. Medication management
• D. Group therapy

Correct answer: A

Rationale: Cognitive processing therapy is a specialized form of cognitive-behavioral therapy that has been shown to be highly effective in treating posttraumatic stress disorder (PTSD). This therapy focuses on helping individuals process and make sense of their traumatic experiences, leading to symptom reduction and improved coping mechanisms. Psychoanalysis, medication management, and group therapy can be beneficial in some cases, but cognitive processing therapy is specifically tailored for addressing the symptoms and underlying causes of PTSD. Psychoanalysis may not be as effective for PTSD due to its focus on unconscious conflicts rather than trauma processing. Medication management can be useful as an adjunct to therapy but does not address the core issues of PTSD. Group therapy can provide support but may not offer the individualized approach that cognitive processing therapy provides.

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