Nursing Elites

1. A healthcare professional is caring for a group of clients. Which of the following clients should the healthcare professional consider for referral to an assertive community treatment (ACT) group?

• A. A client in an acute care mental health facility who has fallen several times while running down the hallway
• B. A client who lives at home and keeps forgetting to come in for a scheduled monthly antipsychotic injection for schizophrenia
• C. A client in a day treatment program who reports increasing anxiety during group therapy
• D. A client in a weekly grief support group who reports still missing a deceased partner who has been dead for 3 months

Correct answer: B

Rationale: The client who lives at home and repeatedly forgets to come in for a scheduled monthly antipsychotic injection for schizophrenia should be considered for referral to an assertive community treatment (ACT) group. ACT teams provide intensive community-based treatment and support for individuals with severe mental illness who may have difficulty adhering to treatment on their own. Choices A, C, and D do not describe individuals with severe mental illness who have difficulty adhering to treatment or need intensive community-based support, which are the typical candidates for referral to an ACT group.

2. Which of the following interventions is most effective in managing a patient with obsessive-compulsive disorder (OCD)?

• A. Encouraging the patient to engage in repetitive behaviors.
• B. Helping the patient to understand that their thoughts are irrational.
• C. Providing the patient with a structured daily routine.
• D. Allowing the patient to avoid situations that trigger their obsessions.

Correct answer: B

Rationale: The most effective intervention in managing a patient with obsessive-compulsive disorder (OCD) is helping the patient to understand that their thoughts are irrational. This cognitive-behavioral approach can assist in reducing the frequency and intensity of obsessive thoughts and compulsive behaviors by challenging and reframing maladaptive beliefs and thought patterns associated with OCD. Encouraging the patient to engage in repetitive behaviors (choice A) reinforces the compulsive behavior rather than addressing the underlying issue. Providing a structured daily routine (choice C) may help in some cases but does not directly target the irrational thoughts and beliefs. Allowing the patient to avoid trigger situations (choice D) can provide temporary relief but does not address the core problem of irrational thoughts and behaviors.

3. A patient with obsessive-compulsive disorder (OCD) performs hand washing repeatedly. Which nursing intervention is most appropriate?

• A. Restricting the patient from washing hands
• B. Setting strict limits on the patient's hand washing
• C. Allowing the patient to wash hands at specified times
• D. Ignoring the patient's behavior

Correct answer: C

Rationale: Allowing the patient to wash hands at specified times is the most appropriate nursing intervention for a patient with OCD who repetitively performs hand washing. This intervention provides structure by allowing the patient to engage in the behavior at designated times, helping to reduce the compulsion gradually. Restricting or setting strict limits may increase anxiety and worsen the condition, while ignoring the behavior does not address the underlying issue of OCD.

4. A patient with posttraumatic stress disorder (PTSD) is experiencing nightmares. Which intervention should the nurse include in the care plan?

• A. Encouraging the patient to journal before bedtime
• B. Teaching relaxation techniques
• C. Avoiding discussing the nightmares directly
• D. Developing a safety plan

Correct answer: B

Rationale: Teaching relaxation techniques is an appropriate intervention for a patient with PTSD experiencing nightmares. Relaxation techniques can help the patient manage anxiety and improve sleep quality, potentially decreasing the frequency and intensity of nightmares. By teaching relaxation techniques, the nurse empowers the patient to actively cope with and reduce the distressing symptoms of PTSD, contributing to overall therapeutic outcomes.

5. A patient with anorexia nervosa is being treated in an inpatient facility. Which intervention should be included in the care plan?

• A. Allowing the patient to eat alone to reduce stress
• B. Monitoring the patient's weight weekly
• C. Encouraging the patient to exercise daily
• D. Providing the patient with a high-calorie diet

Correct answer: B

Rationale: Monitoring the patient's weight weekly is crucial in the care of individuals with anorexia nervosa as it allows healthcare providers to track changes in weight, which is a key indicator of nutritional status. Regular weight monitoring helps in identifying any significant weight loss or gain, enabling prompt intervention and adjustment of the treatment plan to address the patient's nutritional needs effectively.

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