Nursing Elites

1. A nurse hears a newly licensed nurse discussing a client’s hallucinations in the hallway with another nurse. Which of the following actions should the nurse take first?

• A. Notify the nurse manager
• B. Tell the nurse to stop discussing the behavior
• C. Provide an in-service program about confidentiality
• D. Complete an incident report

Correct answer: B

Rationale: The correct action the nurse should take first in this situation is to tell the newly licensed nurse to stop discussing the client's hallucinations with another nurse. Maintaining client confidentiality is a critical aspect of nursing practice. By addressing the behavior immediately, the nurse helps prevent the inappropriate sharing of sensitive information about a client. Choice A is not the first action to take because addressing the behavior directly is more immediate and can prevent further breaches of confidentiality. Choice C is not the priority at this moment as immediate action is required to address the current situation. Choice D, completing an incident report, should come after addressing the immediate issue and ensuring that the inappropriate behavior ceases.

2. Which symptom is most commonly associated with generalized anxiety disorder (GAD)?

• A. Frequent panic attacks
• B. Persistent and excessive worry
• C. Recurrent, intrusive thoughts
• D. Compulsive behaviors

Correct answer: B

Rationale: The correct answer is B: Persistent and excessive worry. Generalized anxiety disorder (GAD) is characterized by persistent and excessive worry about a variety of things, even when there is little or no reason to worry. This worry is difficult to control and can significantly impact daily life. While panic attacks, recurrent intrusive thoughts, and compulsive behaviors can occur in other anxiety disorders, persistent and excessive worry is the hallmark symptom of GAD. Therefore, choices A, C, and D are incorrect as they do not represent the primary symptom associated with GAD.

3. When caring for a client with anorexia nervosa, which of the following examples demonstrates the nurse’s use of interpersonal communication?

• A. The nurse discusses the client’s weight loss during a health care team meeting
• B. The nurse examines their own personal feelings about clients with anorexia nervosa
• C. The nurse asks the client about their personal body image perception
• D. The nurse presents an educational session about anorexia nervosa to a large group of adolescents

Correct answer: C

Rationale: Interpersonal communication involves engaging in a conversation where the nurse asks the client about their personal body image perception. This demonstrates a direct interaction aimed at understanding the client's feelings and thoughts, which is essential in providing holistic care to individuals with anorexia nervosa. Choices A, B, and D do not directly involve the nurse-client interaction that characterizes interpersonal communication. A is more related to team communication, B focuses on the nurse's personal reflection, and D pertains to delivering educational content to a group rather than engaging in a one-on-one conversation with a client.

4. What intervention should the nurse implement when caring for a patient demonstrating manic behavior?

• A. Monitor the patient’s vital signs frequently.
• B. Engage the patient in calming activities.
• C. Offer the patient a quiet environment for relaxation.
• D. Reduce environmental stimuli and create a calm atmosphere.

Correct answer: D

Rationale: When caring for a patient demonstrating manic behavior, the nurse should implement the intervention of reducing environmental stimuli and creating a calm atmosphere. This approach is crucial in managing manic behavior as it helps decrease triggers that may worsen the patient's symptoms. Engaging the patient in calming activities (Choice B) may not be effective during a manic episode as the patient may have difficulty focusing. While offering a quiet environment for relaxation (Choice C) is beneficial, it may not be sufficient to address the heightened stimulation experienced during mania. Monitoring the patient’s vital signs frequently (Choice A) is important in general patient care but may not directly address the specific needs of a patient exhibiting manic behavior.

5. A patient with major depressive disorder has been prescribed sertraline (Zoloft). Which statement by the patient indicates a need for further teaching?

• A. I should take my medication with food to avoid stomach upset.
• B. I should avoid alcohol while taking this medication.
• C. I can stop taking my medication once I feel better.
• D. I might experience some improvement in mood within a few weeks.

Correct answer: C

Rationale: Choice C is the correct answer. It is crucial for patients to understand that they should not stop taking their medication once they feel better. Discontinuing antidepressants abruptly can lead to a relapse of depressive symptoms. Patients should continue taking their medication as prescribed by their healthcare provider, even if they start feeling better, to ensure the best outcomes in managing major depressive disorder. Choices A, B, and D are all accurate statements. Taking medication with food can help reduce stomach upset, avoiding alcohol is essential while on sertraline to prevent interactions, and experiencing some improvement in mood within a few weeks is a common expectation when starting an antidepressant like sertraline.

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