Nursing Elites

1. A client is experiencing severe anxiety. Which of the following is an appropriate intervention?

• A. Encourage the client to participate in group therapy sessions.
• B. Encourage the client to verbalize feelings of anxiety.
• C. Encourage the client to limit caffeine intake.
• D. Encourage the client to avoid stressful situations.

Correct answer: B

Rationale: Encouraging the client to verbalize feelings of anxiety is an appropriate intervention for severe anxiety. Verbalizing emotions can help the client process their feelings and reduce the intensity of anxiety. It promotes emotional expression and may lead to a better understanding of the underlying causes of anxiety, paving the way for effective coping strategies. Choices A, C, and D are not the most appropriate interventions for severe anxiety. While group therapy can be beneficial, it may not be suitable for someone experiencing severe anxiety. Limiting caffeine intake and avoiding stressful situations are helpful strategies but may not address the root of the severe anxiety or provide immediate relief.

2. In the treatment of a patient with bipolar disorder experiencing a depressive episode, which medication is commonly prescribed?

• A. Valproic acid
• B. Risperidone
• C. Fluoxetine
• D. Lithium

Correct answer: C

Rationale: The correct answer is C, Fluoxetine. Fluoxetine, a commonly prescribed antidepressant, is used to manage depressive episodes in bipolar disorder. It helps alleviate symptoms of depression by increasing the levels of serotonin in the brain, which can improve mood and reduce feelings of sadness and hopelessness. While mood stabilizers like lithium are often used in bipolar disorder, for depressive episodes, antidepressants like fluoxetine are preferred to address the specific symptoms associated with depression. Valproic acid is a mood stabilizer often used in bipolar disorder to manage manic episodes. Risperidone is an atypical antipsychotic that may be used in bipolar disorder to help control manic episodes or as an adjunctive treatment, but it is not a first-line medication for depressive episodes.

3. A 10-year-old boy breaks his mother's vase while playing. When the mother asks who broke the vase, the little boy says that his sister did it. The little boy is exhibiting which defense mechanism?

• A. Projection
• B. Displacement
• C. Dissociation
• D. Sublimation

Correct answer: A

Rationale: Projection is a defense mechanism where one attributes their own unacceptable thoughts, feelings, or impulses onto another person. In this scenario, the little boy is projecting his actions onto his sister by falsely claiming she broke the vase. Displacement involves transferring emotions from the original source to a substitute target. Dissociation is a disconnection between thoughts, identity, consciousness, and memory. Sublimation is the redirection of unacceptable impulses into socially acceptable activities.

4. A client with bipolar disorder is experiencing a manic episode. Which of the following interventions should the nurse avoid implementing?

• A. Provide a structured environment
• B. Encourage rest periods
• C. Limit setting on inappropriate behaviors
• D. Allow the client to engage in stimulating activities

Correct answer: D

Rationale: During a manic episode in bipolar disorder, interventions should focus on providing a structured environment, encouraging rest periods, and setting limits on inappropriate behaviors. Allowing the client to engage in stimulating activities may exacerbate the symptoms of mania, such as increased energy, impulsivity, and risk-taking behaviors. Therefore, it is important to avoid encouraging such activities to prevent worsening of manic symptoms.

5. A client with generalized anxiety disorder is prescribed buspirone (Buspar). Which statement by the client indicates an accurate understanding of the medication?

• A. I should take this medication as needed for anxiety.
• B. I need to avoid eating aged cheeses.
• C. It may take several weeks for this medication to take effect.
• D. I can stop taking this medication abruptly if I feel better.

Correct answer: C

Rationale: Buspirone (Buspar) may take several weeks to take effect, so clients should continue taking it as prescribed.

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