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. A healthcare professional is assessing a patient with bipolar disorder. Which finding suggests the patient is experiencing a manic episode?

• A. Decreased need for sleep
• B. Feelings of worthlessness
• C. Increased need for sleep
• D. Avoidance of social interactions

Correct answer: A

Rationale: During a manic episode in patients with bipolar disorder, they often experience a decreased need for sleep. This symptom is characterized by feeling rested after only a few hours of sleep, or even feeling like they can go without sleep for extended periods without feeling tired. The increased energy levels and racing thoughts during a manic episode contribute to the decreased need for sleep.

3. Which patient behavior is consistent with therapeutic communication?

• A. Offering your opinion when asked to provide support.
• B. Summarizing the essence of the patient’s comments in your own words.
• C. Avoiding interrupting periods of silence to allow the patient space to think.
• D. Providing positive reinforcement when the patient expresses themselves.

Correct answer: B

Rationale: Summarizing the essence of the patient’s comments in your own words is a key component of therapeutic communication. This behavior demonstrates active listening, ensures understanding of the patient's message, and encourages further discussion. By summarizing, you show the patient that you are engaged and interested, which helps them feel heard and valued. Offering your opinion (choice A) may bias the patient's thoughts and feelings, interrupting periods of silence (choice C) may prevent the patient from processing their thoughts, and providing positive reinforcement (choice D) may not always be appropriate or necessary in therapeutic communication.

4. April, a 10-year-old admitted to inpatient pediatric care, has been becoming increasingly agitated and losing control in the day room. Time-out has proven to be ineffective for April to engage in self-reflection. April’s mother mentions using time-out up to 20 times a day. The nurse acknowledges that:

• A. Time-out is a crucial aspect of April’s baseline discipline.
• B. Time-out is no longer an effective intervention.
• C. April finds enjoyment in time-out and misbehaves to seek solitude.
• D. Time-out will have to be replaced with seclusion and restraint.

Correct answer: B

Rationale: The scenario describes how April's behavior is not improving with the frequent use of time-out, indicating that it is no longer an effective intervention. When a strategy such as time-out loses its effectiveness due to overuse, it is crucial to explore alternative therapeutic measures to address the underlying issues effectively.

5. A patient with obsessive-compulsive disorder (OCD) performs hand washing repeatedly. Which nursing intervention is most appropriate?

• A. Restricting the patient from washing hands
• B. Setting strict limits on the patient's hand washing
• C. Allowing the patient to wash hands at specified times
• D. Ignoring the patient's behavior

Correct answer: C

Rationale: Allowing the patient to wash hands at specified times is the most appropriate nursing intervention for a patient with OCD who repetitively performs hand washing. This intervention provides structure by allowing the patient to engage in the behavior at designated times, helping to reduce the compulsion gradually. Restricting or setting strict limits may increase anxiety and worsen the condition, while ignoring the behavior does not address the underlying issue of OCD.

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