Nursing Elites

1. 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.

2. A patient with generalized anxiety disorder (GAD) is prescribed buspirone. Which statement by the patient indicates a need for further teaching?

• A. I can take this medication on an as-needed basis.
• B. It may take a few weeks to feel the full effect of this medication.
• C. This medication has a lower risk of dependency compared to benzodiazepines.
• D. I should take this medication consistently every day.

Correct answer: A

Rationale: The correct answer is A. Buspirone is not meant to be taken on an as-needed basis. It should be taken consistently every day to achieve the desired therapeutic effect. Choice B is correct as it accurately reflects that buspirone may take a few weeks to reach its full effect. Choice C is also correct as buspirone indeed has a lower risk of dependency compared to benzodiazepines. Choice D is correct because taking buspirone consistently every day is the appropriate way to use this medication.

3. What principle about patient 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 talking to you than listening to what you have to say, so they are not likely to be offended.
• C. Considering the patient's history, there is little chance that the comment will do any actual harm.
• D. Most people with a mental illness have, by necessity, developed a high tolerance for forgiveness.

Correct answer: A

Rationale: Effective patient communication is guided by the principle that patients value genuine acceptance, respect, and concern from their caregivers. This approach helps to build trust and fosters effective communication, enhancing the nurse-patient relationship. Choice B is incorrect because patients value both talking and listening in effective communication. Choice C is incorrect because a nurse should always consider the impact of their words on the patient, regardless of the patient's history. Choice D is incorrect as it generalizes about people with mental illness and forgiveness, which is not directly relevant to patient communication.

4. What is the primary benefit of cognitive-behavioral therapy (CBT) for patients with anxiety disorders?

• A. It focuses on the long-term use of medications.
• B. It helps patients understand and change their thought patterns.
• C. It primarily addresses childhood traumas.
• D. It encourages patients to avoid anxiety-provoking situations.

Correct answer: B

Rationale: The primary benefit of cognitive-behavioral therapy (CBT) for patients with anxiety disorders is that it helps individuals understand and change their thought patterns. By doing so, patients can effectively reduce their anxiety levels by altering their responses to anxious thoughts and situations, leading to improved coping mechanisms and overall well-being. Choice A is incorrect because CBT does not focus on the long-term use of medications but rather on changing cognitive patterns. Choice C is incorrect because while CBT may address past experiences, its primary focus is on current thoughts and behaviors. Choice D is incorrect as CBT aims to help patients confront and manage anxiety-provoking situations rather than avoid them.

5. 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.

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