Nursing Elites

1. A patient with obsessive-compulsive disorder (OCD) performs hand washing repeatedly. Which nursing intervention is most appropriate?

• A. Restricting the patient from washing hands
• B. Setting strict limits on the patient's hand washing
• C. Allowing the patient to wash hands at specified times
• D. Ignoring the patient's behavior

Correct answer: C

Rationale: Allowing the patient to wash hands at specified times is the most appropriate nursing intervention for a patient with OCD who repetitively performs hand washing. This intervention provides structure by allowing the patient to engage in the behavior at designated times, helping to reduce the compulsion gradually. Restricting or setting strict limits may increase anxiety and worsen the condition, while ignoring the behavior does not address the underlying issue of OCD.

2. Which assessment question, when asked by the nurse, demonstrates an understanding of comorbid mental health conditions associated with major depressive disorder?

• A. Do rules apply to you?
• B. What do you do to manage anxiety?
• C. Do you have a history of disordered eating?
• D. Do you think that you drink too much?

Correct answer: B

Rationale: The correct answer is B. Inquiring about anxiety management demonstrates an understanding of the common comorbid condition of anxiety often seen alongside major depressive disorder. Anxiety and depression frequently coexist, and addressing anxiety management can provide insights into the patient's overall mental health status. Choices A, C, and D are incorrect because they do not directly address comorbid mental health conditions associated with major depressive disorder.

3. The school staff 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 staff 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: This behavior of playacting as a police officer and 'locking up' other children to the point of causing fear may suggest that the child is displaying potential symptoms of traumatization. It could indicate that the child has experienced or witnessed traumatic events, leading to the replication of such scenarios as a coping mechanism or way to process the trauma. Choices A, B, and C are incorrect because the behavior described is more indicative of a potential trauma response rather than a need to dominate others, invent traumatic events, or develop close relationships.

4. A patient diagnosed with panic disorder asks the nurse about the purpose of deep breathing exercises. Which explanation by the nurse is most accurate?

• A. Deep breathing helps distract you from your anxiety.
• B. Deep breathing can prevent future panic attacks.
• C. Deep breathing helps reduce physical symptoms of anxiety.
• D. Deep breathing increases your overall lung capacity.

Correct answer: C

Rationale: Deep breathing helps reduce the physical symptoms of anxiety, such as rapid heartbeat and shortness of breath.

5. A healthcare provider is educating a patient about the side effects of selective serotonin reuptake inhibitors (SSRIs). Which side effect should the provider emphasize?

• A. Weight gain
• B. Increased libido
• C. Nausea
• D. Insomnia

Correct answer: C

Rationale: When educating patients about SSRIs, it is crucial to emphasize the common side effect of nausea. Nausea is a frequently reported side effect of SSRIs that can impact adherence to treatment. By highlighting this side effect, patients can be better prepared and informed about what to expect when taking these medications. Choices A, B, and D are incorrect as weight gain, increased libido, and insomnia are not typically associated with SSRIs as common side effects. Nausea is a more relevant and prevalent side effect to address with patients.

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