Nursing Elites

1. A patient is being assessed for generalized anxiety disorder (GAD). Which symptom is the patient most likely to report?

• A. Excessive worrying about various aspects of life.
• B. Extreme mood swings between euphoria and depression.
• C. Persistent thoughts of self-harm.
• D. Hearing voices that others do not hear.

Correct answer: A

Rationale: Patients with generalized anxiety disorder (GAD) commonly present with excessive worrying about various aspects of life. This persistent and uncontrollable worry is a hallmark symptom of GAD and can significantly impact daily functioning and quality of life. Extreme mood swings (choice B), persistent thoughts of self-harm (choice C), and auditory hallucinations (choice D) are more indicative of other mental health conditions like bipolar disorder, depression, and schizophrenia, respectively. These symptoms are not specific to GAD.

2. In planning care for the termination phase of a nurse-client relationship, which of the following actions should the nurse include in the plan of care?

• A. Discussing ways to use new behaviors
• B. Practicing new problem-solving skills
• C. Developing goals
• D. Establishing boundaries

Correct answer: A

Rationale: During the termination phase of a nurse-client relationship, it is crucial to discuss ways to use new behaviors. This helps the client integrate and apply the skills and strategies they have acquired during the therapeutic process into their daily life. By focusing on the application of new behaviors, the client can maintain progress and continue to grow even after the professional relationship has ended. Practicing new problem-solving skills, developing goals, and establishing boundaries are important aspects of the therapeutic process but are more commonly addressed in earlier phases of the nurse-client relationship. Therefore, the correct action to include in the plan of care during the termination phase is discussing ways to use new behaviors.

3. A patient with a diagnosis of panic disorder is prescribed an SSRI. Which side effect should the nurse monitor for when the patient starts this medication?

• A. Increased heart rate
• B. Increased appetite
• C. Gastrointestinal disturbances
• D. Dry mouth

Correct answer: C

Rationale: When a patient with panic disorder is prescribed an SSRI, the nurse should monitor for gastrointestinal disturbances as a common side effect. SSRIs can cause gastrointestinal symptoms such as nausea, diarrhea, or abdominal discomfort, especially at the beginning of treatment. Increased heart rate (Choice A) is not a common side effect of SSRIs; it is more commonly associated with medications like stimulants. Increased appetite (Choice B) is not a typical side effect of SSRIs, as they are more likely to cause weight loss or appetite suppression. Dry mouth (Choice D) is a side effect seen more commonly with medications that have anticholinergic properties, not typically with SSRIs.

4. James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for the day shift and anxiously reports, ‘Last night, demons came to my room and tried to rape me.’ Which response would be most therapeutic?

• A. There are no such things as demons. What you saw were hallucinations.
• B. It is not possible for anyone to enter your room at night. You are safe here.
• C. You seem very upset. Please tell me more about what you experienced last night.
• D. That must have been very frightening, but we’ll check on you at night and you’ll be safe.

Correct answer: C

Rationale: Choice C is the most therapeutic response as it acknowledges the patient’s feelings, shows empathy, and encourages further expression of his experiences. By actively listening and inviting the patient to share more details, the healthcare provider provides a supportive environment that can help the patient feel understood and validated. Option A dismisses the patient's experience and can make him feel unheard. Option B denies the patient's reality and can increase his distress. Option D, while offering reassurance, does not address the patient's emotional state or encourage further communication.

5. A healthcare provider is assessing a patient with generalized anxiety disorder (GAD). Which symptom would be most indicative of this disorder?

• A. Frequent nightmares
• B. Persistent worrying about multiple issues
• C. Excessive sleeping
• D. Loss of interest in daily activities

Correct answer: B

Rationale: Persistent worrying about multiple issues is a hallmark symptom of generalized anxiety disorder (GAD). Individuals with GAD often experience excessive, uncontrollable worry about various aspects of their life, such as work, relationships, and health. This persistent and excessive worrying distinguishes GAD from normal everyday concerns and is a defining feature of the disorder. Frequent nightmares (Choice A) are more commonly associated with conditions like post-traumatic stress disorder (PTSD) rather than GAD. Excessive sleeping (Choice C) is not a typical symptom of GAD, as individuals with GAD often experience difficulty falling or staying asleep due to their anxious thoughts. Loss of interest in daily activities (Choice D) is more characteristic of conditions like depression rather than GAD.

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