Nursing Elites

1. Which assessment finding best supports dissociative fugue?

• A. The patient states that he cannot remember important information about himself.
• B. The patient is found to be wandering in a park and cannot remember his name or where he lives.
• C. The patient reports feeling as if she is outside her body and observing herself from a distance.
• D. The patient has a sudden onset of symptoms after experiencing a traumatic event.

Correct answer: B

Rationale: The key feature of dissociative fugue is sudden, unexpected travel away from home during which the individual may not be able to recall their identity or past events. Choice B best reflects this by describing a scenario where the patient is found wandering in a park and unable to remember their name or residence, which aligns with the characteristic dissociative amnesia seen in dissociative fugue. Choices A, C, and D do not directly support dissociative fugue. Choice A refers more to general dissociative amnesia, Choice C describes depersonalization/derealization disorder, and Choice D suggests acute stress reaction rather than dissociative fugue.

2. A patient with posttraumatic stress disorder (PTSD) is experiencing nightmares. Which intervention should the nurse include in the care plan?

• A. Encouraging the patient to journal before bedtime
• B. Teaching relaxation techniques
• C. Avoiding discussing the nightmares directly
• D. Developing a safety plan

Correct answer: B

Rationale: Teaching relaxation techniques is an appropriate intervention for a patient with PTSD experiencing nightmares. Relaxation techniques can help the patient manage anxiety and improve sleep quality, potentially decreasing the frequency and intensity of nightmares. By teaching relaxation techniques, the nurse empowers the patient to actively cope with and reduce the distressing symptoms of PTSD, contributing to overall therapeutic outcomes.

3. A patient with bipolar disorder is experiencing a depressive episode. Which intervention is most appropriate?

• A. Encouraging the patient to participate in physical activities.
• B. Providing a stimulating environment to keep the patient engaged.
• C. Allowing the patient to isolate until they feel better.
• D. Encouraging the patient to express their feelings and concerns.

Correct answer: D

Rationale: During a depressive episode in bipolar disorder, it is essential to encourage patients to express their feelings and concerns. This intervention helps them feel heard, supported, and can aid in managing their emotions effectively.

4. Which symptom is most commonly associated with obsessive-compulsive disorder (OCD)?

• A. Frequent mood swings
• B. Intrusive, repetitive thoughts
• C. Hallucinations
• D. Flashbacks

Correct answer: B

Rationale: The correct answer is B: Intrusive, repetitive thoughts. Intrusive, repetitive thoughts are the hallmark symptom of obsessive-compulsive disorder (OCD). Individuals with OCD experience persistent, unwanted thoughts or obsessions that lead to repetitive behaviors or compulsions. These thoughts are intrusive and difficult to control, causing significant distress and interfering with daily activities. While mood swings, hallucinations, and flashbacks can be present in other mental health conditions, they are not the primary symptoms associated with OCD.

5. Which symptom is most commonly associated with generalized anxiety disorder (GAD)?

• A. Frequent panic attacks
• B. Persistent and excessive worry
• C. Recurrent, intrusive thoughts
• D. Compulsive behaviors

Correct answer: B

Rationale: The correct answer is B: Persistent and excessive worry. Generalized anxiety disorder (GAD) is characterized by persistent and excessive worry about a variety of things, even when there is little or no reason to worry. This worry is difficult to control and can significantly impact daily life. While panic attacks, recurrent intrusive thoughts, and compulsive behaviors can occur in other anxiety disorders, persistent and excessive worry is the hallmark symptom of GAD. Therefore, choices A, C, and D are incorrect as they do not represent the primary symptom associated with GAD.

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