Nursing Elites

1. 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.

2. Child protective services have removed 10-year-old Christopher from his parents’ home due to neglect. Christopher reveals to the nurse that he considers the woman next door his ‘nice’ mom, that he loves school, and gets above-average grades. The strongest explanation for this response is:

• A. Temperament
• B. Genetic factors
• C. Resilience
• D. Paradoxical effects of neglect

Correct answer: C

Rationale: Resilience is the ability to adapt positively in the face of adversity. Christopher's positive outlook and academic success despite experiencing neglect demonstrate his resilience in coping with challenging circumstances. Choice A, Temperament, refers to inherent traits and is not the most fitting explanation for Christopher's response. Genetic factors (Choice B) play a role in development but do not directly explain Christopher's ability to cope. The paradoxical effects of neglect (Choice D) typically refer to unexpected positive outcomes, which do not fully capture Christopher's situation.

3. What is a primary goal of treatment for a patient with obsessive-compulsive disorder (OCD)?

• A. To eliminate all obsessive thoughts and compulsive behaviors
• B. To reduce the frequency and intensity of obsessive thoughts
• C. To increase the patient’s social interactions
• D. To improve the patient’s sleep quality

Correct answer: B

Rationale: The primary goal of treating obsessive-compulsive disorder (OCD) is to reduce the frequency and intensity of obsessive thoughts and compulsive behaviors. While complete elimination of all obsessive thoughts and compulsive behaviors may be an ideal outcome, it is often unrealistic. Focusing on reducing the impact of these symptoms on the patient's daily life and functioning is more achievable and practical. Choices C and D are incorrect as they are not primary goals in the treatment of OCD. Increasing social interactions and improving sleep quality may be beneficial as part of a comprehensive treatment plan, but they are not the primary focus when managing OCD.

4. Which intervention is most appropriate for a patient experiencing a severe manic episode?

• A. Providing a structured and low-stimulation environment
• B. Encouraging the patient to engage in group activities
• C. Providing detailed information about the patient's condition
• D. Allowing the patient to have unsupervised time

Correct answer: A

Rationale: During a severe manic episode, it is crucial to provide a structured and low-stimulation environment to help manage the symptoms effectively. This environment aims to reduce stimuli that can exacerbate manic behavior and provide a sense of predictability and safety for the individual. Group activities, detailed information provision, or unsupervised time may not be suitable during a severe manic episode as they can potentially worsen the condition or pose safety risks.

5. When the caregiver of a child asks the nurse for reassurance about their child’s condition, which of the following responses should the nurse make?

• A. “I think your child is getting better. What have you noticed?”
• B. “I’m sure everything will be okay. It just takes time to heal.”
• C. “I’m not sure what’s wrong. Have you asked the doctor about your concerns?”
• D. “I understand you’re concerned. Let’s discuss what concerns you specifically.”

Correct answer: D

Rationale: When providing reassurance to a caregiver about their child’s condition, it's essential to acknowledge their concern and address it specifically. Response D demonstrates empathy and a willingness to discuss the caregiver's specific concerns, which can help in providing accurate information and support to them. Choices A and B provide general reassurance without addressing the caregiver's specific concerns, which may not alleviate their worries effectively. Choice C deflects the question back to the caregiver and suggests consulting the doctor without directly engaging with the caregiver's worries, which may not offer the needed support and reassurance.

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