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 client tells a nurse, 'Don’t tell anyone, but I hid a sharp knife under my mattress to protect myself from my threatening roommate.' Which of the following actions should the nurse take?

• A. Keep the client’s communication confidential, but talk to the client daily using therapeutic communication to convince them to admit to hiding the knife
• B. Keep the client’s communication confidential, but watch the client and their roommate closely
• C. Tell the client that this must be reported to the health care team because it concerns the health and safety of the client and others
• D. Report the incident to the health care team but do not inform the client of the intention to do so

Correct answer: C

Rationale: In this scenario, the nurse must prioritize the safety of the client and others. The client's disclosure of hiding a sharp knife under the mattress poses a significant risk. It is crucial for the nurse to inform the health care team about this situation to ensure immediate intervention and prevent any harm. Confidentiality is important in nursing care, but in cases where there is a clear threat to safety, the duty to protect overrides the duty of confidentiality. Reporting the incident to the health care team is essential to address the safety concerns and provide appropriate support and intervention for the client. Choices A and B are incorrect because while confidentiality is important, the immediate safety concern outweighs keeping the client's communication confidential or simply monitoring the situation. Choice D is incorrect as it does not involve informing the client, which can impact the therapeutic relationship and trust between the nurse and the client.

3. 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.

4. When orienting a new client to a mental health unit, which of the following statements should the nurse make about the unit’s community meetings?

• A. “Clients gather to discuss their treatment plans together.”
• B. “Staff establish a specific agenda for community meetings.”
• C. “Clients meet with staff to discuss common problems.”
• D. “Community meetings provide an opportunity to explore personal mental health issues.”

Correct answer: C

Rationale: During community meetings in a mental health unit, clients come together with staff to discuss common problems they may be facing. These meetings are designed to foster a sense of community and provide support and guidance to clients. Choice A is incorrect because community meetings focus on discussions beyond individual treatment plans. Choice B is incorrect as while staff may facilitate the meetings, the focus is on clients' concerns, not a predetermined agenda. Choice D is incorrect as the primary purpose of community meetings is to address shared challenges, not individual mental health issues.

5. A client has a new prescription for disulfiram for the treatment of alcohol use disorder. The nurse informs the client that this medication can cause nausea and vomiting when alcohol is consumed. Which of the following types of treatment is this method an example of?

• A. Aversion therapy
• B. Flooding
• C. Biofeedback
• D. Dialectical behavior therapy

Correct answer: A

Rationale: Aversion therapy is a form of behavioral therapy that aims to create a negative response to a stimulus, in this case, alcohol consumption. Disulfiram is used in aversion therapy to induce unpleasant effects when alcohol is consumed, such as nausea and vomiting, to deter the individual from drinking. Therefore, the use of disulfiram in this context exemplifies aversion therapy. Flooding involves exposing an individual to a feared object or situation to overcome anxiety; biofeedback teaches self-regulation techniques, and dialectical behavior therapy is a type of cognitive-behavioral therapy focusing on acceptance and change strategies, which are not directly related to the use of disulfiram for alcohol use disorder.

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