Nursing Elites

1. A client has been diagnosed with generalized anxiety disorder and expresses worrying about their job, family, and health, feeling a loss of control. What should the nurse do first?

• A. Administer a prescribed antianxiety medication.
• B. Encourage the client to attend a support group.
• C. Identify triggers of the client's anxiety.
• D. Teach the client deep breathing techniques.

Correct answer: D

Rationale: The initial step for the nurse is to teach the client deep breathing techniques to aid in managing anxiety symptoms. Deep breathing exercises can help the client relax, reduce anxiety levels, and regain a sense of control. This intervention is non-invasive, empowering the client to develop a coping strategy for immediate use when feeling overwhelmed by anxiety. Administering medication (Choice A) should not be the first action unless the client is in severe distress. Encouraging attendance at a support group (Choice B) and identifying triggers of anxiety (Choice C) are important but teaching coping strategies like deep breathing comes first to help the client feel more in control of managing their anxiety.

2. The healthcare provider is preparing to provide medication instruction for a patient. Which of the following understandings about anxiety will be essential to effective instruction?

• A. Learning is best when anxiety is moderate to severe.
• B. Learning is enhanced when anxiety is mild.
• C. Panic-level anxiety helps the provider teach better.
• D. Severe anxiety is characterized by intense concentration and enhances the attention span.

Correct answer: B

Rationale: Mild anxiety sharpens the senses, increases the perceptual field, and results in heightened awareness of the environment, which enhances learning. As anxiety increases, attention span decreases, making learning more difficult. Therefore, mild anxiety is more conducive to effective instruction compared to moderate to severe anxiety, panic-level anxiety, or severe anxiety. Choice A is incorrect because moderate to severe anxiety impairs learning. Choice C is incorrect as panic-level anxiety can be overwhelming and hinder the learning process. Choice D is incorrect because severe anxiety typically leads to impaired attention span rather than enhancing it.

3. A nurse is caring for a client who has been diagnosed with schizoaffective disorder. The client states, 'I am the president of the United States.' Which of the following responses should the nurse make?

• A. You are not the president. You are a client in the hospital.
• B. Tell me more about being the president.
• C. Why do you think you are the president?
• D. Let's talk about something else.

Correct answer: C

Rationale: The nurse should avoid challenging the client's delusions directly. Asking for more information can help the nurse understand the client's experience and build rapport.

4. A client with obsessive-compulsive disorder (OCD) is being cared for by a nurse. Which intervention should the nurse include in the plan of care?

• A. Encourage the client to suppress compulsive behaviors.
• B. Set strict limits on the amount of time the client can engage in compulsive behaviors.
• C. Allow the client to perform compulsive behaviors as needed.
• D. Gradually limit the amount of time allotted for compulsive behaviors.

Correct answer: D

Rationale: In caring for a client with OCD, it is essential to gradually limit the time allotted for compulsive behaviors. This intervention helps the client develop alternative coping mechanisms. Encouraging suppression or setting strict limits on compulsive behaviors can exacerbate the client's anxiety, making it crucial to approach the care plan with a gradual reduction strategy. Allowing the client to perform compulsive behaviors as needed does not promote progress towards managing OCD symptoms and may reinforce maladaptive patterns of behavior.

5. In addition to antianxiety agents, which classification of drugs is commonly prescribed to treat anxiety and anxiety disorders?

• A. Antipsychotics
• B. Mood stabilizers
• C. Antidepressants
• D. Cholinesterase inhibitors

Correct answer: C

Rationale: Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are frequently used in the treatment of anxiety disorders. These medications help alleviate symptoms by affecting neurotransmitters in the brain associated with mood regulation and anxiety.

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