Nursing Elites

1. During a panic attack, what is the nurse's priority intervention for a patient with panic disorder?

• A. Encourage the patient to verbalize their feelings.
• B. Provide reassurance and stay with the patient.
• C. Leave the patient alone to calm down.
• D. Distract the patient with a task.

Correct answer: B

Rationale: During a panic attack, the priority intervention for the nurse is to provide reassurance and stay with the patient. This action helps reduce fear and provides a sense of safety, which can aid in calming the patient and preventing further escalation of the panic attack. Encouraging the patient to verbalize their feelings (Choice A) may be beneficial after the acute phase of the panic attack. Leaving the patient alone (Choice C) may increase feelings of abandonment and escalate the panic attack. Distracting the patient with a task (Choice D) is not recommended during a panic attack as it may divert attention but not address the underlying anxiety and fear.

2. During a mental status examination, which of the following components should not be included in the assessment?

• A. Appearance and behavior
• B. Giving advice
• C. Mood and affect
• D. Cognitive function

Correct answer: B

Rationale: During a mental status examination, components such as appearance and behavior, mood and affect, and cognitive function are assessed. Giving advice is not a component of a mental status examination as it focuses on evaluating the client's mental state rather than providing guidance or recommendations.

3. A patient being treated for insomnia is prescribed ramelteon (Rozerem). Which comorbid mental health condition would make this medication the hypnotic of choice for this particular patient?

• A. Obsessive-compulsive disorder
• B. Generalized anxiety disorder
• C. Persistent depressive disorder
• D. Substance use disorder

Correct answer: D

Rationale: The correct answer is D, Substance use disorder. Ramelteon is preferred for patients with substance use disorder because it lacks abuse potential. This makes it a safer choice for individuals with a history of substance misuse. Choosing a medication with a lower risk of abuse in this population is crucial to prevent potential misuse or dependence issues.

4. A 33-year-old female diagnosed with bipolar I disorder has been functioning well on lithium for 11 months. At her most recent checkup, the psychiatric nurse practitioner states, 'You are ready to enter the maintenance therapy stage, so at this time I am going to adjust your dosage by prescribing:'

• A. A higher dosage
• B. Once-weekly dosing
• C. A lower dosage
• D. A different drug

Correct answer: C

Rationale: During the maintenance therapy stage for bipolar I disorder, it is common to lower the dosage of lithium to prevent side effects while still maintaining stability. Lowering the dosage helps to find the lowest effective dose that can still manage symptoms effectively with minimal side effects.

5. A 10-year-old boy breaks his mother's vase while playing. When the mother asks who broke the vase, the little boy says that his sister did it. The little boy is exhibiting which defense mechanism?

• A. Projection
• B. Displacement
• C. Dissociation
• D. Sublimation

Correct answer: A

Rationale: Projection is a defense mechanism where one attributes their own unacceptable thoughts, feelings, or impulses onto another person. In this scenario, the little boy is projecting his actions onto his sister by falsely claiming she broke the vase. Displacement involves transferring emotions from the original source to a substitute target. Dissociation is a disconnection between thoughts, identity, consciousness, and memory. Sublimation is the redirection of unacceptable impulses into socially acceptable activities.

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