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. A patient with major depressive disorder is struggling to cope. Which intervention is most appropriate to help the patient develop better coping skills?

• A. Encouraging the patient to express their feelings through art
• B. Providing the patient with information about their diagnosis
• C. Encouraging the patient to keep a journal of their thoughts and feelings
• D. Providing the patient with a structured daily routine

Correct answer: D

Rationale: Providing a patient with major depressive disorder a structured daily routine can help them establish a sense of stability, which is crucial for coping with their condition. Routine provides predictability and helps in organizing activities, promoting a sense of accomplishment and control, which can be especially beneficial for individuals struggling with depression.

3. When developing a care plan for a patient with generalized anxiety disorder (GAD), which long-term goal is most appropriate?

• A. The patient will experience no episodes of anxiety.
• B. The patient will recognize and modify anxiety-provoking thoughts.
• C. The patient will avoid situations that cause anxiety.
• D. The patient will take medication as prescribed.

Correct answer: B

Rationale: The most appropriate long-term goal for managing generalized anxiety disorder is for the patient to recognize and modify anxiety-provoking thoughts. By addressing and modifying these thoughts, the patient can develop coping mechanisms and strategies to manage their anxiety more effectively in the long term. Choices A and C are not ideal long-term goals as complete elimination of anxiety episodes or avoidance of anxiety-provoking situations may not be realistic or sustainable. Choice D focuses solely on medication adherence, which is important but does not address the core cognitive-behavioral aspects of managing anxiety in GAD.

4. What is a common side effect of benzodiazepines prescribed for anxiety?

• A. Weight gain
• B. Insomnia
• C. Drowsiness
• D. Increased appetite

Correct answer: C

Rationale: The correct answer is C: Drowsiness. Benzodiazepines, commonly prescribed for anxiety, often cause drowsiness as a side effect due to their sedative properties. This can lead to impairments in cognitive and motor skills, making it important for individuals on these medications to exercise caution when performing tasks that require alertness, such as driving or operating machinery. Choices A, B, and D are incorrect because weight gain, insomnia, and increased appetite are not typically associated with benzodiazepines; instead, drowsiness and sedation are more commonly reported side effects.

5. Which therapeutic approach is most effective for a patient with generalized anxiety disorder (GAD)?

• A. Psychoanalytic therapy
• B. Cognitive-behavioral therapy (CBT)
• C. Humanistic therapy
• D. Gestalt therapy

Correct answer: B

Rationale: Cognitive-behavioral therapy (CBT) is the most effective therapeutic approach for generalized anxiety disorder (GAD). CBT helps individuals identify and modify negative thought patterns and behaviors that contribute to anxiety. It focuses on changing cognitive distortions and maladaptive behaviors, providing practical strategies to manage anxiety symptoms effectively. Numerous studies have shown the effectiveness of CBT in treating GAD by helping patients develop coping mechanisms and skills to address their anxiety. Choice A, Psychoanalytic therapy, is not the most effective for GAD as it primarily focuses on exploring unconscious conflicts and childhood experiences rather than providing immediate coping strategies. Choice C, Humanistic therapy, emphasizes personal growth and self-improvement, which may not directly target the specific symptoms of GAD. Choice D, Gestalt therapy, focuses on increasing self-awareness and personal responsibility, which might not address the cognitive distortions and behavioral patterns associated with GAD as directly as CBT does.

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