Nursing Elites

1. When assessing a patient with generalized anxiety disorder (GAD), which symptom would the nurse most likely observe?

• A. Flashbacks
• B. Excessive worry
• C. Hallucinations
• D. Compulsive behaviors

Correct answer: B

Rationale: Excessive worry is a characteristic feature of generalized anxiety disorder (GAD). Patients with GAD experience persistent and excessive worry about various aspects of their life, such as work, health, or family, even when there is little or no reason for concern. This chronic worrying can significantly impact their daily functioning and quality of life. Flashbacks are more commonly associated with post-traumatic stress disorder (PTSD), hallucinations are more typical in conditions like schizophrenia, while compulsive behaviors are seen in obsessive-compulsive disorder (OCD). Therefore, in the context of GAD, excessive worry is the symptom that the nurse is most likely to observe.

2. Which of the following is a common side effect of antipsychotic medications?

• A. Hyperactivity
• B. Weight loss
• C. Extrapyramidal symptoms
• D. Insomnia

Correct answer: C

Rationale: Extrapyramidal symptoms, such as tremors and rigidity, are frequently observed as side effects of antipsychotic medications. These symptoms result from the medications' influence on dopamine receptors in the brain. Choice A, hyperactivity, is not a typical side effect of antipsychotic medications. Choice B, weight loss, is less common compared to weight gain. Choice D, insomnia, though possible, is not as prevalent as extrapyramidal symptoms in individuals taking antipsychotic medications.

3. A client with post-traumatic stress disorder (PTSD) is experiencing flashbacks. Which of the following interventions should the nurse implement?

• A. Encourage the client to ignore the flashbacks.
• B. Stay with the client and offer reassurance.
• C. Instruct the client to avoid discussing the traumatic event.
• D. Encourage the client to engage in group therapy.

Correct answer: B

Rationale: During a flashback, it is essential for the nurse to stay with the client and offer reassurance. This approach can help the client feel safe and supported during a distressing experience. Encouraging the client to ignore the flashbacks may lead to increased anxiety and distress. Instructing the client to avoid discussing the traumatic event can hinder the therapeutic process of addressing and processing the trauma. While group therapy can be beneficial, it may not be the immediate intervention needed during a flashback.

4. Which of the following are symptoms of a panic attack? Select one that does not apply.

• A. Chest pain
• B. Normal breathing
• C. Dizziness
• D. Hot flashes

Correct answer: B

Rationale: Symptoms of a panic attack can include chest pain, shortness of breath, dizziness, and hot flashes. Normal breathing is not a symptom of a panic attack; instead, individuals experiencing a panic attack may often exhibit rapid or shallow breathing patterns. Therefore, the correct answer is B. Choices A, C, and D are typical symptoms associated with panic attacks, making them incorrect answers.

5. When under stress, a client routinely uses an excessive amount of alcohol. Finding her drunk, her husband yells at her about the chronic alcohol abuse. Which reaction should the nurse recognize as the use of the defense mechanism of denial?

• A. Hiding liquor bottles in a closet
• B. Yelling at their son for slouching in his chair
• C. Burning dinner on purpose
• D. Saying to the spouse, 'I don't drink too much!'

Correct answer: D

Rationale: The nurse should recognize the client's statement 'I don't drink too much!' as the use of the defense mechanism of denial. This response indicates the client's refusal to acknowledge the reality of excessive alcohol consumption, which is a key characteristic of denial. By denying the problem, the client avoids facing the negative consequences and feelings associated with their alcohol abuse. Choices A, B, and C do not exhibit denial but rather represent different defense mechanisms. Hiding liquor bottles in a closet might indicate the defense mechanism of concealment, yelling at their son for slouching in his chair could reflect displacement, and burning dinner on purpose might suggest passive-aggressive behavior.

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