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. A client with obsessive-compulsive disorder (OCD) spends several hours each day washing her hands. Which intervention should the nurse implement?

• A. Encourage the client to wash her hands less frequently.
• B. Set a time limit for hand washing.
• C. Teach the client relaxation techniques.
• D. Discourage the client from washing her hands.

Correct answer: B

Rationale: Setting a time limit for hand washing is an appropriate intervention for a client with OCD who spends excessive time on this compulsive behavior. By setting a time limit, the nurse can help the client gradually reduce the compulsive behavior, promoting a more manageable approach to hand washing without completely discouraging it. Encouraging the client to wash her hands less frequently (Choice A) may not address the root of the issue and could lead to increased anxiety. Teaching relaxation techniques (Choice C) may be helpful for overall anxiety management but may not directly address the excessive hand washing behavior. Discouraging the client from washing her hands (Choice D) may increase anxiety and resistance, making it a less effective intervention.

3. A client has been diagnosed with histrionic personality disorder. Which of the following behaviors should the nurse expect?

• A. Attention-seeking behavior
• B. Dramatic expressions of emotion
• C. Seductive behavior
• D. Dependency on others

Correct answer: A

Rationale: Individuals with histrionic personality disorder often display attention-seeking behaviors as a way to draw focus and validation from others. This behavior may manifest as exaggerated emotions and dramatic expressions to maintain the spotlight. While seductive behavior and dependency on others are potential characteristics of histrionic personality disorder, attention-seeking behavior is the hallmark trait. Therefore, the correct answer is attention-seeking behavior (Choice A). Dramatic expressions of emotion (Choice B) can be a feature of histrionic personality disorder, but it is not as characteristic as attention-seeking behavior. Seductive behavior (Choice C) may also be present in individuals with histrionic personality disorder, but it is not the primary behavior to expect. Dependency on others (Choice D) is not a core feature of histrionic personality disorder, although individuals with this disorder may seek attention and validation from others.

4. A healthcare provider is assessing a client diagnosed with avoidant personality disorder. Which of the following behaviors should the healthcare provider expect?

• A. Social inhibition
• B. Fear of criticism
• C. Desire for close relationships
• D. Fear of abandonment

Correct answer: A

Rationale: Individuals with avoidant personality disorder commonly display social inhibition and a fear of criticism or rejection. While they may have a desire for close relationships, they tend to avoid them due to their fear of disapproval and negative evaluation by others. Fear of criticism (Choice B) is also a characteristic behavior seen in individuals with avoidant personality disorder. However, the primary behavior associated with this disorder is social inhibition (Choice A), where individuals tend to be reserved and avoid social interactions. Desiring close relationships (Choice C) may be present, but the fear of rejection typically prevents individuals from pursuing these relationships. Fear of abandonment (Choice D) is more commonly associated with borderline personality disorder rather than avoidant personality disorder.

5. A client with schizophrenia is prescribed an antipsychotic medication. Which of the following side effects shouldn't the nurse monitor for?

• A. Tardive dyskinesia
• B. Decreased need for sleep
• C. Orthostatic hypotension
• D. Hyperglycemia

Correct answer: B

Rationale: The correct answer is B, 'Decreased need for sleep.' While antipsychotic medications can cause side effects like tardive dyskinesia, orthostatic hypotension, and hyperglycemia, a decreased need for sleep is not a common side effect. It is important for the nurse to monitor the client for the known side effects of antipsychotic medications to ensure early detection and appropriate management.

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