Nursing Elites

1. Which symptom is most commonly associated with social anxiety disorder?

• A. Fear of speaking in public
• B. Recurrent, intrusive thoughts
• C. Flashbacks of traumatic events
• D. Persistent low mood

Correct answer: A

Rationale: Fear of speaking in public is a hallmark symptom of social anxiety disorder. Individuals with social anxiety disorder often experience intense fear or anxiety about social situations where they may be scrutinized or judged by others, such as speaking in public. This fear can significantly impact their daily functioning and quality of life, making it a key feature in diagnosing social anxiety disorder. Recurrent, intrusive thoughts, flashbacks of traumatic events, and persistent low mood are more commonly associated with other mental health conditions, such as obsessive-compulsive disorder, post-traumatic stress disorder, and depression, respectively. Therefore, choice A is the correct answer as it aligns with the characteristic symptom of social anxiety disorder.

2. 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.

3. A patient with agoraphobia has difficulty leaving their home. Which nursing intervention would be most effective?

• A. Encourage the patient to make small, gradual steps outside the home.
• B. Advise the patient to avoid crowded places.
• C. Suggest that the patient focus on their breathing when anxious.
• D. Provide the patient with information about support groups.

Correct answer: A

Rationale: Encouraging the patient to make small, gradual steps outside the home is the most effective nursing intervention for agoraphobia. This approach helps the patient confront their fear gradually and build confidence in managing their symptoms. By taking small steps, the patient can start to expand their comfort zone and reduce anxiety associated with leaving their home, ultimately aiding in their recovery and increasing their independence. Choices B, C, and D are not as effective as choice A. Advising the patient to avoid crowded places does not address the underlying issue of agoraphobia. Suggesting that the patient focus on their breathing when anxious may help manage immediate symptoms but does not address the fear of leaving home. Providing information about support groups is beneficial but may not directly address the patient's difficulty leaving their home.

4. Which therapeutic approach is most effective for a patient with generalized anxiety disorder (GAD)?

• A. Psychoanalytic therapy
• B. Cognitive-behavioral therapy (CBT)
• C. Humanistic therapy
• D. Gestalt therapy

Correct answer: B

Rationale: Cognitive-behavioral therapy (CBT) is the most effective therapeutic approach for generalized anxiety disorder (GAD). CBT helps individuals identify and modify negative thought patterns and behaviors that contribute to anxiety. It focuses on changing cognitive distortions and maladaptive behaviors, providing practical strategies to manage anxiety symptoms effectively. Numerous studies have shown the effectiveness of CBT in treating GAD by helping patients develop coping mechanisms and skills to address their anxiety. Choice A, Psychoanalytic therapy, is not the most effective for GAD as it primarily focuses on exploring unconscious conflicts and childhood experiences rather than providing immediate coping strategies. Choice C, Humanistic therapy, emphasizes personal growth and self-improvement, which may not directly target the specific symptoms of GAD. Choice D, Gestalt therapy, focuses on increasing self-awareness and personal responsibility, which might not address the cognitive distortions and behavioral patterns associated with GAD as directly as CBT does.

5. When a patient with schizophrenia is taking haloperidol, what is a priority assessment for the nurse?

• A. Assessing for signs of tardive dyskinesia
• B. Monitoring for signs of neuroleptic malignant syndrome
• C. Checking for signs of depression
• D. Monitoring for changes in appetite

Correct answer: B

Rationale: Monitoring for signs of neuroleptic malignant syndrome is crucial for patients taking haloperidol. Neuroleptic malignant syndrome is a rare but serious side effect that can occur with antipsychotic medications like haloperidol. It presents with symptoms such as high fever, unstable blood pressure, confusion, muscle rigidity, and autonomic dysfunction. Early detection and intervention are essential to prevent serious complications.

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