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: When caring for a client with generalized anxiety disorder (GAD), it is essential to consider therapeutic interventions. Encouraging the client to avoid anxiety-provoking situations is not recommended as it can reinforce their anxiety. Teaching relaxation techniques, encouraging the expression of feelings, and providing a structured daily routine are beneficial strategies in managing generalized anxiety disorder by promoting coping skills and emotional expression while fostering stability and predictability.

2. Cabot has multiple symptoms of depression including mood reactivity, social phobia, anxiety, and overeating. With a history of mild hypertension, which classification of antidepressants dispensed as a transdermal patch would be a safe medication?

• A. Tricyclic antidepressants
• B. Selective serotonin reuptake inhibitors
• C. Serotonin and norepinephrine reuptake inhibitors
• D. Monoamine oxidase inhibitors

Correct answer: D

Rationale: Monoamine oxidase inhibitors dispensed as transdermal patches can be a safer option for patients with mild hypertension due to reduced systemic absorption compared to other forms of antidepressants, potentially minimizing cardiovascular effects associated with hypertension.

3. A distraught, single, first-time mother cries and asks a nurse, 'How can I go to work if I can't afford childcare?' What is the nurse's initial action in assisting the client with the problem-solving process?

• A. Determine the risks and benefits of each alternative.
• B. Formulate goals for resolving the problem.
• C. Evaluate the outcome of the implemented solution.
• D. Assess the facts of the situation.

Correct answer: D

Rationale: In this scenario, the nurse's first step should be to assess the facts of the situation. By gathering accurate information about the client's circumstances related to childcare and work, the nurse can better understand the client's needs and concerns, which is essential before proceeding with any problem-solving process. Choice A is incorrect because assessing risks and benefits comes later in the problem-solving process. Choice B is incorrect as formulating goals should follow a thorough assessment. Choice C is incorrect since evaluating outcomes happens after implementing a solution, which is premature at this stage.

4. A client with generalized anxiety disorder is prescribed buspirone. Which statement by the client indicates a need for further teaching?

• A. I can stop taking this medication once I feel less anxious.
• B. I should avoid drinking alcohol while taking this medication.
• C. It may take several weeks for this medication to take full effect.
• D. This medication can cause dependency.

Correct answer: A

Rationale: The correct answer is A because it indicates a misunderstanding about buspirone. Buspirone should not be abruptly stopped, and patients should follow the prescribed regimen consistently. Stopping the medication without proper guidance can lead to adverse effects or a return of anxiety symptoms. Choices B, C, and D demonstrate an understanding of important aspects of buspirone therapy: avoiding alcohol due to interactions, being patient for the medication to reach full effectiveness, and being aware of the potential for dependency with this medication.

5. Which of the following interventions should a nurse include in the care plan for a client with major depressive disorder? Select one that is not appropriate.

• A. Encourage participation in activities
• B. Promote adequate nutrition and hydration
• C. Discourage verbalization of feelings
• D. Monitor for suicidal ideation

Correct answer: C

Rationale: Interventions for a client with major depressive disorder should focus on encouraging participation in activities, promoting adequate nutrition and hydration, monitoring for suicidal ideation, and providing a structured daily schedule. Discouraging verbalization of feelings goes against the therapeutic approach as expressing and discussing feelings is crucial in the treatment of major depressive disorder. Clients with major depressive disorder often benefit from talking about their emotions and experiences, as it can help in processing their feelings and promoting recovery. Therefore, discouraging verbalization of feelings would hinder the client's progress and is not an appropriate intervention.

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