Nursing Elites

1. When developing a care plan for a client with generalized anxiety disorder (GAD), which of the following interventions should not be included?

• A. Encourage the client to avoid anxiety-provoking situations.
• B. Teach the client relaxation techniques.
• C. Encourage the client to express their feelings.
• D. Provide a structured daily routine.

Correct answer: A

Rationale: Avoiding anxiety-provoking situations is not a recommended intervention in caring for a client with generalized anxiety disorder (GAD) as it can reinforce the client's anxiety. Exposing the client gradually to feared situations can help reduce anxiety in the long term through techniques like cognitive-behavioral therapy. Teaching relaxation techniques helps the client manage stress and anxiety effectively. Encouraging the client to express their feelings promotes emotional processing and reduces internal tension. Providing a structured daily routine can offer predictability and stability, which are beneficial for individuals with GAD.

2. A nursing instructor is discussing diseases of adaptation with students and when they are likely to occur. Which student response indicates that learning has occurred?

• A. When an individual has limited experience managing stress
• B. When an individual inherits adaptive genes
• C. When an individual faces pre-existing conditions that worsen stress
• D. When an individual's physiological and psychological resources are depleted

Correct answer: D

Rationale: The correct answer is D. During the stage of exhaustion in the general adaptation syndrome, an individual's physiological and psychological resources become depleted, leading to a reduced capacity to adapt effectively. This depletion of resources is when diseases of adaptation, such as stress-related disorders, are more likely to occur. Choices A, B, and C do not reflect an accurate understanding of diseases of adaptation. Limited experience managing stress, inheriting adaptive genes, and facing pre-existing conditions that worsen stress do not directly relate to the concept of physiological and psychological resource depletion leading to diseases of adaptation.

3. A healthcare professional is planning care for a client with borderline personality disorder. Which of the following interventions should not be included in the plan of care?

• A. Set clear and consistent boundaries
• B. Encourage dependency on the healthcare professional
• C. Avoid discussing the client's feelings
• D. Use a firm, authoritative approach

Correct answer: B

Rationale: In caring for a client with borderline personality disorder, it is essential to set clear and consistent boundaries, use a firm, authoritative approach, and provide opportunities for the client to express feelings. Encouraging dependency can reinforce maladaptive behaviors, while avoiding discussing feelings can hinder therapeutic progress in addressing underlying issues. Building a sense of dependency may exacerbate the client's difficulties in developing autonomy and self-reliance, which are crucial for their progress and recovery. Therefore, encouraging dependency is not a recommended intervention in the plan of care for clients with borderline personality disorder.

4. A healthcare professional is assessing a client diagnosed with paranoid schizophrenia. Which of the following findings should the healthcare professional expect?

• A. Auditory hallucinations
• B. Delusions of grandeur
• C. A flat affect
• D. Disorganized speech

Correct answer: B

Rationale: The correct answer is B: Delusions of grandeur. Clients with paranoid schizophrenia often experience delusions of grandeur or persecution, auditory hallucinations, and a flat affect. However, the most characteristic finding for paranoid schizophrenia is the presence of delusions, which are fixed false beliefs that are not based in reality. Delusions of grandeur, where individuals believe they are exceptionally powerful or important, are commonly seen in paranoid schizophrenia. Choice A, auditory hallucinations, are more commonly associated with other types of schizophrenia such as paranoid or disorganized schizophrenia. Choice C, a flat affect, is a symptom that can be seen across various types of schizophrenia. Choice D, disorganized speech, is more indicative of disorganized schizophrenia.

5. Which statement made by a patient prescribed bupropion (Wellbutrin) demonstrates that the medication education the patient received was effective?

• A. I hope Wellbutrin will help my depression and also help me to finally quit smoking.
• B. I'm happy to hear that I won't need to worry too much about weight gain.
• C. It's okay to take Wellbutrin since I haven't had a seizure in 6 months.
• D. I need to be careful about driving since the medication could make me drowsy.

Correct answer: A

Rationale: Choice A is the correct answer because it shows that the patient understands the dual benefits of bupropion (Wellbutrin) in treating depression and aiding in smoking cessation. Bupropion is commonly prescribed for these reasons as it has a lower risk of weight gain compared to other antidepressants. Choices B, C, and D are not the most appropriate because they do not specifically reflect the benefits or key information related to bupropion therapy.

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