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. What is the most appropriate intervention for a patient experiencing severe anxiety?

• A. Encourage the patient to talk about their anxiety.
• B. Teach the patient deep breathing exercises.
• C. Remain with the patient and provide a calm presence.
• D. Suggest the patient engage in physical activity.

Correct answer: C

Rationale: When a patient is experiencing severe anxiety, remaining with the patient and providing a calm presence is the most appropriate intervention. This approach can help the patient feel supported and safe, which can help in reducing their anxiety levels. Encouraging the patient to talk about their anxiety may not be suitable during a severe anxiety episode, as it can potentially escalate their distress. Teaching deep breathing exercises can be helpful, but in cases of severe anxiety, the patient may find it challenging to focus on such techniques. Suggesting physical activity may not be suitable as the patient might not be in a state to engage in such activities when experiencing severe anxiety.

3. A patient diagnosed with dissociative identity disorder has been undergoing therapy for several months. Which outcome indicates that the patient is progressing in therapy?

• A. The patient has developed a strong therapeutic relationship with the therapist.
• B. The patient’s different personalities are beginning to merge.
• C. The patient is able to recall traumatic events without dissociating.
• D. The patient reports fewer gaps in memory.

Correct answer: B

Rationale: In dissociative identity disorder, the merging of different personalities is a crucial indicator of progress in therapy. As the different identities merge, it signifies that the patient is integrating fragmented aspects of their self, leading to a more cohesive sense of identity and a reduction in dissociative symptoms. This process is a significant therapeutic milestone in the treatment of dissociative identity disorder as it promotes internal cohesion and decreases internal conflict. Choices A, C, and D are incorrect because while developing a strong therapeutic relationship, recalling traumatic events without dissociating, and reporting fewer gaps in memory are important aspects of therapy, the merging of different personalities is specifically indicative of substantial progress in treating dissociative identity disorder.

4. A patient with major depressive disorder is struggling to cope. Which intervention is most appropriate to help the patient develop better coping skills?

• A. Encouraging the patient to express their feelings through art
• B. Providing the patient with information about their diagnosis
• C. Encouraging the patient to keep a journal of their thoughts and feelings
• D. Providing the patient with a structured daily routine

Correct answer: D

Rationale: Providing a patient with major depressive disorder a structured daily routine can help them establish a sense of stability, which is crucial for coping with their condition. Routine provides predictability and helps in organizing activities, promoting a sense of accomplishment and control, which can be especially beneficial for individuals struggling with depression.

5. When a patient is diagnosed with major depressive disorder, which nursing diagnosis should be the priority?

• A. Imbalanced nutrition: less than body requirements
• B. Risk for suicide
• C. Disturbed sleep pattern
• D. Ineffective coping

Correct answer: B

Rationale: The priority nursing diagnosis for a patient diagnosed with major depressive disorder is 'Risk for suicide.' This is the priority as it addresses the immediate risk of self-harm in individuals suffering from major depressive disorder. Monitoring and intervening to prevent self-harm take precedence over other nursing diagnoses in this scenario.

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