Nursing Elites

1. 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.

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 positively in the face of adversity. Christopher's positive outlook and academic success despite experiencing neglect demonstrate his resilience in coping with challenging circumstances. Choice A, Temperament, refers to inherent traits and is not the most fitting explanation for Christopher's response. Genetic factors (Choice B) play a role in development but do not directly explain Christopher's ability to cope. The paradoxical effects of neglect (Choice D) typically refer to unexpected positive outcomes, which do not fully capture Christopher's situation.

3. A patient with schizophrenia is prescribed risperidone. Which statement by the patient indicates understanding of the medication?

• A. I should take this medication at the same time every day.
• B. I can stop taking this medication once I feel better.
• C. I should avoid drinking alcohol while taking this medication.
• D. I should take this medication on an as-needed basis.

Correct answer: A

Rationale: The correct answer is A because taking the medication at the same time every day helps maintain consistent blood levels and effectiveness. Consistency in dosing is crucial for the medication to work optimally in managing symptoms of schizophrenia. Option B is incorrect because stopping the medication abruptly can lead to a worsening of symptoms. Option C is important as alcohol can interact with the medication and cause adverse effects. Option D is incorrect because risperidone is typically taken regularly, not on an as-needed basis, to manage symptoms effectively.

4. A healthcare professional is caring for a group of clients. Which of the following clients should the healthcare professional consider for referral to an assertive community treatment (ACT) group?

• A. A client in an acute care mental health facility who has fallen several times while running down the hallway
• B. A client who lives at home and keeps forgetting to come in for a scheduled monthly antipsychotic injection for schizophrenia
• C. A client in a day treatment program who reports increasing anxiety during group therapy
• D. A client in a weekly grief support group who reports still missing a deceased partner who has been dead for 3 months

Correct answer: B

Rationale: The client who lives at home and repeatedly forgets to come in for a scheduled monthly antipsychotic injection for schizophrenia should be considered for referral to an assertive community treatment (ACT) group. ACT teams provide intensive community-based treatment and support for individuals with severe mental illness who may have difficulty adhering to treatment on their own. Choices A, C, and D do not describe individuals with severe mental illness who have difficulty adhering to treatment or need intensive community-based support, which are the typical candidates for referral to an ACT group.

5. What is the primary goal of exposure therapy for a patient with specific phobia?

• A. To eliminate the phobic response completely
• B. To increase the patient's exposure to the feared object
• C. To help the patient confront and reduce their fear gradually
• D. To provide immediate relief from anxiety symptoms

Correct answer: C

Rationale: The primary goal of exposure therapy for a patient with a specific phobia is to help them confront their fear gradually, leading to a reduction in their fear response over time. This gradual exposure helps the individual learn to manage and cope with their phobia, ultimately reducing the intensity of their fear reactions. Choice A is incorrect because while the goal is to reduce the fear response, complete elimination may not always be feasible. Choice B is incorrect as the focus is not solely on increasing exposure but on gradual confrontation. Choice D is incorrect as the therapy aims for long-term reduction rather than immediate relief.

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