Nursing Elites

1. 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.

2. Child protective services have removed 10-year-old Christopher from his parents’ home due to neglect. Christopher reveals to the nurse that he considers the woman next door his “nice” mom, that he loves school, and gets above-average grades. The strongest explanation for this response is:

• A. Temperament
• B. Genetic factors
• C. Resilience
• D. Paradoxical effects of neglect

Correct answer: C

Rationale: Resilience is the ability to adapt well despite adversity, which is demonstrated by Christopher's positive relationships and school performance. Despite the challenging situation of being removed from his parents' home, Christopher's ability to form a positive bond with the neighbor, enjoy school, and excel academically showcases his resilience in coping with the circumstances.

3. 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.

4. A patient with social anxiety disorder is prescribed a beta-blocker. Which symptom is this medication most likely intended to address?

• A. Panic attacks
• B. Tremors and palpitations
• C. Recurrent, intrusive thoughts
• D. Depression

Correct answer: B

Rationale: Beta-blockers are commonly used to alleviate physical symptoms associated with anxiety disorders, such as tremors and palpitations. These medications help manage the autonomic symptoms of anxiety, like increased heart rate and trembling, which are often prominent in social anxiety disorder. Beta-blockers do not primarily target cognitive symptoms like recurrent, intrusive thoughts (choice C), panic attacks (choice A), or depression (choice D) in social anxiety disorder.

5. A patient is being assessed for generalized anxiety disorder (GAD). Which symptom is the patient most likely to report?

• A. Excessive worrying about various aspects of life.
• B. Extreme mood swings between euphoria and depression.
• C. Persistent thoughts of self-harm.
• D. Hearing voices that others do not hear.

Correct answer: A

Rationale: Patients with generalized anxiety disorder (GAD) commonly present with excessive worrying about various aspects of life. This persistent and uncontrollable worry is a hallmark symptom of GAD and can significantly impact daily functioning and quality of life. Extreme mood swings (choice B), persistent thoughts of self-harm (choice C), and auditory hallucinations (choice D) are more indicative of other mental health conditions like bipolar disorder, depression, and schizophrenia, respectively. These symptoms are not specific to GAD.

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