Nursing Elites

1. A patient with anorexia nervosa is being treated in an inpatient facility. Which intervention should be included in the care plan?

• A. Allowing the patient to eat alone to reduce stress
• B. Monitoring the patient's weight weekly
• C. Encouraging the patient to exercise daily
• D. Providing the patient with a high-calorie diet

Correct answer: B

Rationale: Monitoring the patient's weight weekly is crucial in the care of individuals with anorexia nervosa as it allows healthcare providers to track changes in weight, which is a key indicator of nutritional status. Regular weight monitoring helps in identifying any significant weight loss or gain, enabling prompt intervention and adjustment of the treatment plan to address the patient's nutritional needs effectively.

2. A patient with panic disorder is prescribed selective serotonin reuptake inhibitors (SSRIs). What should the nurse include in the patient’s education?

• A. SSRIs are fast-acting medications that can relieve anxiety immediately.
• B. It may take several weeks for the full therapeutic effects of SSRIs to be felt.
• C. SSRIs have a high potential for abuse and dependence.
• D. The patient should discontinue the medication once they feel better.

Correct answer: B

Rationale: Patients prescribed with SSRIs need to be educated that it may take several weeks for the full therapeutic effects of the medication to be experienced. This delay is important for patient understanding and compliance with the treatment plan. Choice A is incorrect because SSRIs do not provide immediate relief and may take weeks to show significant improvement. Choice C is inaccurate as SSRIs are not known for having a high potential for abuse and dependence. Choice D is incorrect as patients should never discontinue medication abruptly without consulting their healthcare provider.

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 with obsessive-compulsive disorder (OCD) spends hours washing their hands. Which nursing intervention is most appropriate?

• A. Encouraging the patient to stop washing their hands
• B. Allowing the patient to wash hands at specified times
• C. Ignoring the patient's behavior
• D. Setting strict limits on the time allowed for hand washing

Correct answer: B

Rationale: In managing a patient with OCD who spends excessive time washing hands, allowing the patient to wash hands at specified times is the most appropriate nursing intervention. This approach helps establish a structured routine for hand washing, which can assist in managing OCD symptoms without reinforcing the behavior. Encouraging the patient to stop washing hands may lead to increased anxiety and resistance. Ignoring the behavior can perpetuate the cycle of OCD, and setting strict limits on hand washing time may cause distress and may not effectively address the underlying issues associated with OCD.

5. April, a 10-year-old admitted to inpatient pediatric care, has been becoming increasingly agitated and losing control in the day room. Time-out has proven to be ineffective for April to engage in self-reflection. April’s mother mentions using time-out up to 20 times a day. The nurse acknowledges that:

• A. Time-out is a crucial aspect of April’s baseline discipline.
• B. Time-out is no longer an effective intervention.
• C. April finds enjoyment in time-out and misbehaves to seek solitude.
• D. Time-out will have to be replaced with seclusion and restraint.

Correct answer: B

Rationale: The scenario describes how April's behavior is not improving with the frequent use of time-out, indicating that it is no longer an effective intervention. When a strategy such as time-out loses its effectiveness due to overuse, it is crucial to explore alternative therapeutic measures to address the underlying issues effectively.

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