Nursing Elites

1. Which of the following would be the most appropriate intervention for a patient experiencing severe anxiety?

• A. Encourage the patient to talk about their feelings.
• B. Use a firm, authoritative approach.
• C. Stay with the patient and provide a quiet environment.
• D. Suggest the patient watch TV to distract themselves.

Correct answer: C

Rationale: During a severe anxiety episode, it's crucial to stay with the patient and create a quiet environment. This approach helps reduce anxiety by providing a sense of safety and support. Encouraging the patient to talk about their feelings may not be effective during an acute episode of severe anxiety. Using a firm, authoritative approach can escalate the situation and worsen the anxiety. Suggesting distractions like watching TV may not address the root cause of the anxiety or provide the necessary support.

2. In a center for women who have been abused, which intervention would the nurse use for a woman whose husband has been abusing her for several years?

• A. Often times you don't need help, you just need to know when to go
• B. Under these circumstances, leaving your husband is the decision to make
• C. This must be very painful for you. We are here to help you
• D. Let's talk about your strengths. You have them, but sometimes they get lost in pain

Correct answer: C

Rationale: Choice C is the most appropriate intervention when working with a woman who has been abused by her husband. It acknowledges the woman's pain, expresses empathy, and offers support, creating a safe space for her to open up and seek help. This response shows understanding and compassion, which are crucial when dealing with individuals experiencing abuse.

3. A client has been diagnosed with generalized anxiety disorder. Which of the following findings should the nurse expect?

• A. Shortness of breath
• B. Chest pain
• C. Excessive worry
• D. Decreased appetite

Correct answer: C

Rationale: Individuals with generalized anxiety disorder commonly exhibit symptoms like excessive worry, restlessness, and difficulty concentrating. Physical manifestations such as muscle tension and sleep disturbances are also prevalent. Shortness of breath and chest pain are more commonly associated with panic attacks rather than generalized anxiety disorder. Decreased appetite may be present in some cases, but excessive worry is a hallmark characteristic of generalized anxiety disorder.

4. In pediatric mental health, there is a lack of sufficient numbers of community-based resources and providers, and there are long waiting lists for services. This has resulted in: Select one that doesn't apply.

• A. Children of color and poor economic conditions being underserved
• B. Increased stress in the family unit
• C. Markedly increased funding
• D. Premature termination of services

Correct answer: C

Rationale: The lack of resources in pediatric mental health leads to underserved populations, increased stress in the family unit, and premature termination of services. However, markedly increased funding does not align with the negative consequences of resource shortages; instead, it would be a potential solution to address the lack of resources and providers in pediatric mental health.

5. Which is a correct evaluation of the new psychiatric nurse's statement regarding a client's use of defense mechanisms?

• A. Defense mechanisms can be self-protective responses to stress and need not be eliminated.
• B. Defense mechanisms are a maladaptive attempt by the ego to manage anxiety and should always be eliminated.
• C. Defense mechanisms, used by individuals with weak ego integrity, should be discouraged but not eliminated.
• D. Defense mechanisms cause disintegration of the ego and should be fostered and encouraged.

Correct answer: A

Rationale: The correct evaluation is that defense mechanisms can be self-protective responses to stress and do not necessarily need to be eliminated. These mechanisms serve the purpose of reducing anxiety during times of stress. While some defense mechanisms may be maladaptive, they can also help individuals cope with challenging situations. It is essential for the nurse to recognize that addressing defense mechanisms should be done sensitively, as they may be crucial for the client's emotional regulation. Encouraging the development of healthy coping skills while acknowledging the role of defense mechanisms in managing stress is a balanced approach in psychiatric care. Choice B is incorrect because completely eliminating defense mechanisms is not always feasible or beneficial. Choice C is incorrect as it oversimplifies the relationship between defense mechanisms and ego integrity. Choice D is incorrect as it misrepresents the role of defense mechanisms in ego functions.

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