Nursing Elites

1. A nurse is planning care for several clients attending community-based mental health programs. Which of the following clients should the nurse visit first?

• A. A client who received a burn on the arm while using a hot iron at home
• B. A client who requests a change of antipsychotic medication due to new adverse effects
• C. A client who reports hearing a voice saying that life is not worth living anymore
• D. A client who tells the nurse about experiencing manifestations of severe anxiety before and during a job interview

Correct answer: C

Rationale: The nurse should visit the client who reports hearing a voice saying that life is not worth living anymore first. This statement indicates potential suicidal ideation, which requires immediate intervention to ensure the client's safety. Choices A, B, and D do not present an immediate threat to the client's life. While burns, adverse effects of medication, and severe anxiety are important concerns, they do not pose an immediate risk of self-harm or suicide.

2. Which intervention should a healthcare professional implement to help a patient with social anxiety disorder?

• A. Encourage participation in group therapy sessions.
• B. Suggest practicing relaxation techniques during social interactions.
• C. Advise the patient to avoid social situations that cause anxiety.
• D. Teach the patient cognitive restructuring techniques.

Correct answer: D

Rationale: Teaching cognitive restructuring techniques is an effective intervention for patients with social anxiety disorder. This approach helps individuals challenge and change their negative thought patterns, leading to improved coping mechanisms in social situations. Choice A, encouraging participation in group therapy sessions, may be overwhelming for individuals with social anxiety. Choice B, suggesting relaxation techniques, may offer short-term relief but does not address the underlying cognitive distortions. Choice C, advising avoidance of social situations, reinforces avoidance behaviors and does not promote long-term improvement in managing social anxiety.

3. Which symptom is most commonly associated with obsessive-compulsive disorder (OCD)?

• A. Frequent mood swings
• B. Intrusive, repetitive thoughts
• C. Hallucinations
• D. Flashbacks

Correct answer: B

Rationale: The correct answer is B: Intrusive, repetitive thoughts. Intrusive, repetitive thoughts are the hallmark symptom of obsessive-compulsive disorder (OCD). Individuals with OCD experience persistent, unwanted thoughts or obsessions that lead to repetitive behaviors or compulsions. These thoughts are intrusive and difficult to control, causing significant distress and interfering with daily activities. While mood swings, hallucinations, and flashbacks can be present in other mental health conditions, they are not the primary symptoms associated with OCD.

4. A healthcare provider is assessing a patient with generalized anxiety disorder (GAD). Which symptom would be most indicative of this disorder?

• A. Frequent nightmares
• B. Persistent worrying about multiple issues
• C. Excessive sleeping
• D. Loss of interest in daily activities

Correct answer: B

Rationale: Persistent worrying about multiple issues is a hallmark symptom of generalized anxiety disorder (GAD). Individuals with GAD often experience excessive, uncontrollable worry about various aspects of their life, such as work, relationships, and health. This persistent and excessive worrying distinguishes GAD from normal everyday concerns and is a defining feature of the disorder. Frequent nightmares (Choice A) are more commonly associated with conditions like post-traumatic stress disorder (PTSD) rather than GAD. Excessive sleeping (Choice C) is not a typical symptom of GAD, as individuals with GAD often experience difficulty falling or staying asleep due to their anxious thoughts. Loss of interest in daily activities (Choice D) is more characteristic of conditions like depression rather than GAD.

5. A patient with major depressive disorder is started on fluoxetine. What is a common side effect the nurse should monitor for?

• A. Weight gain
• B. Increased appetite
• C. Nausea
• D. Dry mouth

Correct answer: C

Rationale: Nausea is a common side effect of fluoxetine and should be monitored.

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