Nursing Elites

1. Which therapeutic communication technique involves restating the patient's message to ensure understanding?

• A. Clarification
• B. Reflection
• C. Summarization
• D. Paraphrasing

Correct answer: D

Rationale: Paraphrasing is the correct therapeutic communication technique where the nurse restates the patient's message in their own words to confirm understanding. This technique helps in validating the patient's feelings and ensuring that both parties are in agreement, leading to effective communication and rapport building. Choice A, 'Clarification,' involves seeking further information to enhance understanding rather than restating the message. Choice B, 'Reflection,' involves echoing the patient's feelings to show empathy rather than restating the message. Choice C, 'Summarization,' involves condensing the main points of a conversation rather than restating a specific message.

2. When assessing a patient with major depressive disorder, which of the following is a common cognitive symptom?

• A. Hallucinations
• B. Delusions
• C. Lack of appetite
• D. Negative self-talk

Correct answer: D

Rationale: Negative self-talk is a common cognitive symptom of major depressive disorder. It involves a pattern of negative thoughts and beliefs about oneself, which can significantly impact a patient's self-esteem and overall outlook on life. Hallucinations and delusions are more commonly associated with other mental health conditions like schizophrenia, while lack of appetite is typically considered a physical symptom of depression rather than a cognitive one.

3. Which intervention should a healthcare professional implement to help a patient with social anxiety disorder?

• A. Encourage participation in group therapy sessions.
• B. Suggest practicing relaxation techniques during social interactions.
• C. Advise the patient to avoid social situations that cause anxiety.
• D. Teach the patient cognitive restructuring techniques.

Correct answer: D

Rationale: Teaching cognitive restructuring techniques is an effective intervention for patients with social anxiety disorder. This approach helps individuals challenge and change their negative thought patterns, leading to improved coping mechanisms in social situations. Choice A, encouraging participation in group therapy sessions, may be overwhelming for individuals with social anxiety. Choice B, suggesting relaxation techniques, may offer short-term relief but does not address the underlying cognitive distortions. Choice C, advising avoidance of social situations, reinforces avoidance behaviors and does not promote long-term improvement in managing social anxiety.

4. During the working phase of a therapeutic relationship, a client with methamphetamine use disorder displays transference behavior. Which action by the client indicates transference behavior?

• A. The client asks the nurse if they will go out to dinner together
• B. The client accuses the nurse of being controlling just like an ex-partner
• C. The client reminds the nurse of a friend who died from substance toxicity
• D. The client becomes angry and threatens to engage in self-harm

Correct answer: B

Rationale: Transference occurs when a client projects feelings, often unconscious, onto the nurse that are associated with significant figures in their past or present life. In this scenario, the client accusing the nurse of being controlling like an ex-partner demonstrates transference behavior by attributing characteristics of someone from their past onto the nurse. Choices A, C, and D do not reflect transference behavior. Choice A involves a social invitation, which is not necessarily transference. Choice C is more related to countertransference as it triggers memories in the nurse, not the client. Choice D describes aggressive behavior and self-harm threats, which are not indicative of transference.

5. A patient with obsessive-compulsive disorder (OCD) spends hours washing their hands. Which nursing intervention is most appropriate?

• A. Encouraging the patient to stop washing their hands
• B. Allowing the patient to wash hands at specified times
• C. Ignoring the patient's behavior
• D. Setting strict limits on the time allowed for hand washing

Correct answer: B

Rationale: In managing a patient with OCD who spends excessive time washing hands, allowing the patient to wash hands at specified times is the most appropriate nursing intervention. This approach helps establish a structured routine for hand washing, which can assist in managing OCD symptoms without reinforcing the behavior. Encouraging the patient to stop washing hands may lead to increased anxiety and resistance. Ignoring the behavior can perpetuate the cycle of OCD, and setting strict limits on hand washing time may cause distress and may not effectively address the underlying issues associated with OCD.

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