Nursing Elites

1. A client is diagnosed with generalized anxiety disorder (GAD). Which of the following interventions should the nurse implement? Select one that does not apply.

• A. Encourage the client to express their feelings
• B. Teach the client relaxation techniques
• C. Promote regular physical activity
• D. Encourage the use of caffeine

Correct answer: D

Rationale: Interventions for a client with GAD should include encouraging the client to express their feelings, teaching relaxation techniques, and promoting regular physical activity. Caffeine should be avoided as it can exacerbate anxiety symptoms. Stimulants like caffeine can increase feelings of restlessness and nervousness, making it counterproductive in managing anxiety. Choices A, B, and C are appropriate interventions for managing generalized anxiety disorder by promoting emotional expression, relaxation, and physical well-being, respectively. Choice D, encouraging the use of caffeine, is incorrect as it can worsen anxiety symptoms rather than alleviate them.

2. A healthcare professional is assessing a client who has been diagnosed with schizoid personality disorder. Which of the following behaviors should the healthcare professional expect?

• A. Preference for solitary activities
• B. Detachment from social relationships
• C. Indifference to praise or criticism
• D. Anxiety in social situations

Correct answer: C

Rationale: The correct behavior that the healthcare professional should expect in an individual with schizoid personality disorder is indifference to praise or criticism. While it is true that individuals with this disorder often exhibit a preference for solitary activities and detachment from social relationships, the key defining characteristic is their emotional detachment and lack of response to external feedback, which includes being indifferent to praise or criticism. Anxiety in social situations is not a typical feature of schizoid personality disorder.

3. A client has generalized anxiety disorder (GAD), and a nurse is providing care. Which of the following interventions should the nurse avoid implementing?

• A. Encourage the client to express their feelings
• B. Monitor daily caloric intake and weight
• C. Promote regular physical activity
• D. Discourage the use of caffeine

Correct answer: B

Rationale: In caring for a client with generalized anxiety disorder (GAD), it is important to encourage the client to express their feelings, promote regular physical activity, and discourage the use of caffeine. Addressing weight and caloric intake monitoring may exacerbate anxiety related to body image, and focusing on these aspects can be distressing for the client. Therefore, monitoring daily caloric intake and weight should be avoided in this scenario.

4. What principle about patient-nurse communication should guide a nurse's fear of saying the wrong thing to a patient?

• A. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation.
• B. Patients are more interested in conversing with you than in hearing your perspective, making offense unlikely.
• C. Considering the patient's background, the likelihood of the comment causing harm is minimal.
• D. Individuals with mental illness often possess a heightened capacity for forgiveness.

Correct answer: A

Rationale: The correct answer is A. Patients value interactions with healthcare providers who express genuine acceptance, respect, and concern for their well-being. By focusing on conveying these qualities, a nurse can help alleviate fears of saying the wrong thing as patients appreciate the sincerity and empathy in the communication. This approach fosters trust and a positive therapeutic relationship, enhancing the effectiveness of patient-nurse communication.

5. In evaluating a client's response to stress, what would indicate a secondary appraisal of the stressful event?

• A. When the individual judges the event to be benign
• B. When the individual judges the event to be irrelevant
• C. When the individual judges the resources and skills needed to deal with the event
• D. When the individual judges the event to be pleasurable

Correct answer: C

Rationale: A secondary appraisal occurs when an individual evaluates the resources and skills required to cope with a stressful event. This type of appraisal focuses on the person's perceived ability to manage the situation. In contrast, choices A, B, and D do not involve the assessment of resources and skills. Choice A relates to a benign judgment of the event, choice B to an irrelevant judgment, and choice D to a pleasurable judgment, which are aspects of primary rather than secondary appraisals.

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