Nursing Elites

1. 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.

2. 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.

3. What intervention should the nurse implement when caring for a patient demonstrating manic behavior?

• A. Monitor the patient’s vital signs frequently.
• B. Engage the patient in calming activities.
• C. Offer the patient a quiet environment for relaxation.
• D. Reduce environmental stimuli and create a calm atmosphere.

Correct answer: D

Rationale: When caring for a patient demonstrating manic behavior, the nurse should implement the intervention of reducing environmental stimuli and creating a calm atmosphere. This approach is crucial in managing manic behavior as it helps decrease triggers that may worsen the patient's symptoms. Engaging the patient in calming activities (Choice B) may not be effective during a manic episode as the patient may have difficulty focusing. While offering a quiet environment for relaxation (Choice C) is beneficial, it may not be sufficient to address the heightened stimulation experienced during mania. Monitoring the patient’s vital signs frequently (Choice A) is important in general patient care but may not directly address the specific needs of a patient exhibiting manic behavior.

4. Which symptom is most commonly associated with social anxiety disorder?

• A. Fear of speaking in public
• B. Recurrent, intrusive thoughts
• C. Flashbacks of traumatic events
• D. Persistent low mood

Correct answer: A

Rationale: Fear of speaking in public is a hallmark symptom of social anxiety disorder. Individuals with social anxiety disorder often experience intense fear or anxiety about social situations where they may be scrutinized or judged by others, such as speaking in public. This fear can significantly impact their daily functioning and quality of life, making it a key feature in diagnosing social anxiety disorder. Recurrent, intrusive thoughts, flashbacks of traumatic events, and persistent low mood are more commonly associated with other mental health conditions, such as obsessive-compulsive disorder, post-traumatic stress disorder, and depression, respectively. Therefore, choice A is the correct answer as it aligns with the characteristic symptom of social anxiety disorder.

5. James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for the day shift and anxiously reports, “Last night, demons came to my room and tried to rape me.” Which response would be most therapeutic?

• A. There are no such things as demons. What you saw were hallucinations.
• B. It is not possible for anyone to enter your room at night. You are safe here.
• C. You seem very upset. Please tell me more about what you experienced last night.
• D. That must have been very frightening, but we’ll check on you at night and you’ll be safe.

Correct answer: C

Rationale: The most therapeutic response acknowledges the patient's emotional state and invites further discussion about their experience. By saying, 'You seem very upset. Please tell me more about what you experienced last night,' the nurse shows empathy and openness, providing a supportive environment for the patient to express their feelings and perceptions.

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