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. A patient is experiencing a manic episode. Which intervention is most effective?

• A. Encouraging the patient to participate in group activities
• B. Providing a low-stimulation environment
• C. Allowing the patient to move freely around the unit
• D. Engaging the patient in competitive games

Correct answer: B

Rationale: During a manic episode, individuals may be overwhelmed by stimuli. Providing a low-stimulation environment can help reduce excessive sensory input and minimize exacerbation of manic behaviors. This intervention aims to create a calm and structured setting that supports the individual in managing their symptoms effectively.

3. Which therapeutic approach is most effective for a patient with generalized anxiety disorder (GAD)?

• A. Psychoanalytic therapy
• B. Cognitive-behavioral therapy (CBT)
• C. Humanistic therapy
• D. Gestalt therapy

Correct answer: B

Rationale: Cognitive-behavioral therapy (CBT) is the most effective therapeutic approach for generalized anxiety disorder (GAD). CBT helps individuals identify and modify negative thought patterns and behaviors that contribute to anxiety. It focuses on changing cognitive distortions and maladaptive behaviors, providing practical strategies to manage anxiety symptoms effectively. Numerous studies have shown the effectiveness of CBT in treating GAD by helping patients develop coping mechanisms and skills to address their anxiety. Choice A, Psychoanalytic therapy, is not the most effective for GAD as it primarily focuses on exploring unconscious conflicts and childhood experiences rather than providing immediate coping strategies. Choice C, Humanistic therapy, emphasizes personal growth and self-improvement, which may not directly target the specific symptoms of GAD. Choice D, Gestalt therapy, focuses on increasing self-awareness and personal responsibility, which might not address the cognitive distortions and behavioral patterns associated with GAD as directly as CBT does.

4. During an intake assessment, a healthcare professional is evaluating a patient diagnosed with obsessive-compulsive disorder (OCD). Which question would be most appropriate?

• A. Do you often experience periods of sadness?
• B. Do you have difficulty controlling your worrying?
• C. Do you find yourself repeating behaviors or thoughts?
• D. Do you experience sudden, unexpected panic attacks?

Correct answer: C

Rationale: The most appropriate question when assessing a patient with obsessive-compulsive disorder (OCD) is to inquire about repeating behaviors or thoughts. This is a hallmark feature of OCD, where individuals often engage in repetitive actions or mental rituals to alleviate anxiety or distress. This behavior distinguishes OCD from other mental health conditions such as generalized anxiety disorder (choice B), major depressive disorder (choice A), and panic disorder (choice D). Therefore, recognizing repetitive behaviors or thoughts helps in identifying the presence of OCD and tailoring appropriate interventions for the patient.

5. What must be considered when preparing the teaching plan for a patient diagnosed with bipolar disorder who is being prescribed lithium therapy?

• A. Caffeine and alcohol can affect lithium levels.
• B. Lithium should be taken with meals to avoid gastrointestinal distress.
• C. Regular blood tests are required to monitor lithium levels.
• D. Lithium can cause weight gain.

Correct answer: C

Rationale: When preparing a teaching plan for a patient prescribed lithium therapy for bipolar disorder, it is crucial to emphasize the need for regular blood tests to monitor lithium levels. Monitoring levels is essential to ensure the drug's effectiveness and to manage potential side effects. While factors like caffeine and alcohol intake, taking lithium with meals, and the risk of weight gain may be relevant considerations, the primary focus should be on the necessity of regular blood tests for effective management of lithium therapy. Therefore, option C is the correct choice as it addresses a critical aspect of lithium therapy management.

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