Nursing Elites

1. When communicating with a client admitted for treatment of a substance use disorder, which of the following communication techniques should be identified as a barrier to therapeutic communication?

• A. Offering advice
• B. Reflecting
• C. Listening attentively
• D. Giving information

Correct answer: A

Rationale: Offering advice is a barrier to therapeutic communication because it can hinder the client's ability to explore their own solutions and feelings. It may come across as judgmental or dismissive of the client's experience, leading to a breakdown in trust and hindering the therapeutic relationship. Reflecting (choice B) is a helpful technique that involves paraphrasing or restating the client's words to show understanding. Listening attentively (choice C) is crucial for building rapport and demonstrating empathy. Giving information (choice D) is also important but should be done in a way that supports the client's understanding and autonomy, rather than directing their choices.

2. Which intervention is most appropriate to promote the self-esteem of a patient with severe depression?

• A. Encouraging the patient to spend time alone for self-reflection.
• B. Involving the patient in simple, achievable activities to ensure success.
• C. Allowing the patient to rest and avoid responsibilities.
• D. Providing frequent reassurances and compliments.

Correct answer: B

Rationale: Involving the patient in simple, achievable activities is a constructive approach to promote self-esteem by fostering a sense of accomplishment and success. This method encourages positive reinforcement and helps the patient regain confidence and self-worth, which are essential in managing depression. Choice A could potentially lead to rumination and worsen depressive symptoms. Choice C might reinforce avoidance behaviors and hinder progress. Choice D, while supportive, may not address the core need for building self-esteem through personal achievements.

3. A patient with generalized anxiety disorder is being taught about buspirone. Which statement indicates the patient needs further teaching?

• A. I should take this medication consistently rather than 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 avoid drinking alcohol while taking this medication.

Correct answer: A

Rationale: The correct answer is A because buspirone is not meant to be taken on an as-needed basis. It should be taken consistently to achieve optimal effectiveness in managing generalized anxiety disorder. Taking it as needed may lead to inadequate symptom control and reduced therapeutic benefits.

4. Which behavior is most characteristic of agoraphobia?

• A. Avoiding crowded places and public transportation
• B. Excessively washing hands to prevent contamination
• C. Experiencing unexpected panic attacks
• D. Having a fear of gaining weight

Correct answer: A

Rationale: Agoraphobia is characterized by the avoidance of situations where escape might be difficult or help unavailable in the event of a panic attack. Avoiding crowded places and public transportation aligns with this fear of being in situations where escape might be challenging, making choice A the most characteristic behavior of agoraphobia. Choices B, C, and D do not directly relate to the core feature of agoraphobia, which is the avoidance of situations perceived as difficult to escape from.

5. A patient with borderline personality disorder is admitted to the psychiatric unit. Which behavior is most characteristic of this disorder?

• A. Avoiding social interactions due to fear of rejection.
• B. Engaging in impulsive and self-destructive behaviors.
• C. Having a grandiose sense of self-importance.
• D. Exhibiting a pattern of unstable relationships.

Correct answer: B

Rationale: Borderline personality disorder is characterized by impulsivity and self-destructive behaviors, such as substance abuse, reckless driving, and self-harm. These behaviors are often used to cope with intense emotional distress and are a key feature of this disorder. While individuals with borderline personality disorder may also struggle with unstable relationships, the hallmark feature that sets it apart is the impulsivity and self-destructive behaviors. Avoiding social interactions due to fear of rejection is more characteristic of avoidant personality disorder. Having a grandiose sense of self-importance is a feature of narcissistic personality disorder.

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