Nursing Elites

1. In planning care for the termination phase of a nurse-client relationship, which of the following actions should the nurse include in the plan of care?

• A. Discussing ways to use new behaviors
• B. Practicing new problem-solving skills
• C. Developing goals
• D. Establishing boundaries

Correct answer: A

Rationale: During the termination phase of a nurse-client relationship, it is crucial to discuss ways to use new behaviors. This helps the client integrate and apply the skills and strategies they have acquired during the therapeutic process into their daily life. By focusing on the application of new behaviors, the client can maintain progress and continue to grow even after the professional relationship has ended. Practicing new problem-solving skills, developing goals, and establishing boundaries are important aspects of the therapeutic process but are more commonly addressed in earlier phases of the nurse-client relationship. Therefore, the correct action to include in the plan of care during the termination phase is discussing ways to use new behaviors.

2. The school nurse has been alerted to the fact that an 8-year-old boy routinely playacts as a police officer, 'locking up' other children on the playground to the point where the children get scared. The nurse recognizes that this behavior is most likely an indication of:

• A. The need to dominate others
• B. Inventing traumatic events
• C. A need to develop close relationships
• D. A potential symptom of traumatization

Correct answer: D

Rationale: When an 8-year-old boy engages in playacting as a police officer that instills fear in other children, it can be indicative of a potential symptom of traumatization. This behavior may reflect the child's attempt to process or express experiences of trauma, leading to a manifestation of such distress in his play interactions with others.

3. A patient with panic disorder is prescribed alprazolam. Which instruction is most important for the nurse to include in the teaching plan?

• A. Avoid driving until you know how the medication affects you.
• B. Take the medication with food to avoid stomach upset.
• C. Take the medication at bedtime to help with sleep.
• D. Increase the dose if you do not feel better in a few days.

Correct answer: A

Rationale: The most important instruction for a patient prescribed alprazolam is to avoid driving until they know how the medication affects them. Alprazolam can cause drowsiness and impaired coordination, which may affect the ability to drive safely. This caution is crucial to prevent accidents and ensure the safety of the patient and others on the road.

4. A patient is being assessed for generalized anxiety disorder (GAD). Which symptom is the patient most likely to report?

• A. Excessive worrying about various aspects of life.
• B. Extreme mood swings between euphoria and depression.
• C. Persistent thoughts of self-harm.
• D. Hearing voices that others do not hear.

Correct answer: A

Rationale: Patients with generalized anxiety disorder (GAD) commonly present with excessive worrying about various aspects of life. This persistent and uncontrollable worry is a hallmark symptom of GAD and can significantly impact daily functioning and quality of life. Extreme mood swings (choice B), persistent thoughts of self-harm (choice C), and auditory hallucinations (choice D) are more indicative of other mental health conditions like bipolar disorder, depression, and schizophrenia, respectively. These symptoms are not specific to GAD.

5. When assessing a patient with major depressive disorder, which of the following is a common cognitive symptom?

• A. Hallucinations
• B. Delusions
• C. Lack of appetite
• D. Negative self-talk

Correct answer: D

Rationale: Negative self-talk is a common cognitive symptom of major depressive disorder. It involves a pattern of negative thoughts and beliefs about oneself, which can significantly impact a patient's self-esteem and overall outlook on life. Hallucinations and delusions are more commonly associated with other mental health conditions like schizophrenia, while lack of appetite is typically considered a physical symptom of depression rather than a cognitive one.

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