Nursing Elites

1. A patient with posttraumatic stress disorder (PTSD) is experiencing flashbacks. What is the best initial intervention?

• A. Encouraging the patient to avoid triggers
• B. Encouraging the patient to talk about their feelings
• C. Providing the patient with relaxation techniques
• D. Advising the patient to avoid social situations

Correct answer: C

Rationale: The best initial intervention for a patient with PTSD experiencing flashbacks is to provide relaxation techniques. This approach helps the patient manage flashbacks by focusing on the present moment, promoting relaxation, and reducing anxiety associated with the traumatic memories. Encouraging the patient to avoid triggers or social situations may not address the immediate distress caused by flashbacks, while talking about feelings may not be as effective as providing immediate tools to manage the distressing symptoms.

2. When developing a care plan for a patient with borderline personality disorder, which intervention should be included to address self-harm behaviors?

• A. Encouraging the patient to keep a journal of their thoughts and feelings.
• B. Setting clear and consistent boundaries with the patient.
• C. Providing the patient with coping skills to manage their emotions.
• D. Developing a safety plan with the patient.

Correct answer: D

Rationale: Developing a safety plan with the patient is crucial when addressing self-harm behaviors in individuals with borderline personality disorder. This intervention helps outline steps to take during a crisis, identifies triggers, and provides strategies to prevent self-harm incidents. It involves collaboratively creating a plan between the patient and the healthcare team to ensure a structured and supportive approach to managing potentially dangerous situations.

3. A client is discussing free associations as a therapeutic tool with a nurse. Which of the following client statements indicates an understanding of this technique?

• A. “I will write down my dreams as soon as I wake up.”
• B. “I might begin to associate my therapist with important people in my life.”
• C. “I can learn to express myself in a nonaggressive manner.”
• D. “I should say the first thing that comes to my mind.”

Correct answer: D

Rationale: Free association is a psychoanalytic technique where the client is encouraged to say the first thing that comes to their mind without censoring or filtering. This technique helps uncover unconscious thoughts and emotions. Choice D, “I should say the first thing that comes to my mind,” indicates an understanding of free association as it aligns with the principle of allowing thoughts to flow freely without inhibition. Choices A, B, and C do not reflect an understanding of free association and its purpose, making them incorrect. A, focusing on writing down dreams, does not relate to the immediate expression of thoughts. B, associating the therapist with important people, and C, learning to express oneself nonaggressively, do not capture the essence of free association as a technique for exploring unconscious processes.

4. What is a priority intervention for a patient with severe anxiety?

• A. Encouraging the patient to discuss their feelings in detail.
• B. Providing a calm and quiet environment.
• C. Encouraging the patient to participate in group activities.
• D. Providing detailed information about their treatment plan.

Correct answer: B

Rationale: When dealing with a patient experiencing severe anxiety, providing a calm and quiet environment is a priority intervention. This approach helps reduce stimuli and anxiety levels, creating a more soothing atmosphere for the individual. Encouraging the patient to discuss their feelings in detail or participate in group activities may be beneficial in certain situations, but establishing a peaceful setting takes precedence when managing severe anxiety. Providing detailed information about their treatment plan, although important, may not be the immediate priority when the patient is in a state of severe anxiety and needs a calming environment first.

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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