Nursing Elites

1. A client with borderline personality disorder exhibits self-mutilating behavior. Which nursing intervention should the nurse implement to address this behavior?

• A. Encourage the client to discuss underlying issues.
• B. Set firm limits on the client's behavior.
• C. Provide a safe environment to prevent self-harm.
• D. Discuss the consequences of self-mutilating behavior.

Correct answer: C

Rationale: The correct intervention when dealing with a client exhibiting self-mutilating behavior, especially with borderline personality disorder, is to provide a safe environment to prevent self-harm. This approach is crucial in ensuring the client's physical safety and well-being. Setting firm limits may be appropriate in some situations, but the immediate priority is to prevent self-harm. Encouraging the client to discuss underlying issues and discussing consequences are important aspects of therapy; however, in the case of acute self-mutilating behavior, the primary focus should be on creating a safe environment to prevent harm.

2. A patient with social anxiety disorder is prescribed propranolol. The nurse understands that this medication is used primarily to:

• A. Reduce anxiety symptoms
• B. Improve mood
• C. Increase energy levels
• D. Enhance social interactions

Correct answer: A

Rationale: The correct answer is A: Reduce anxiety symptoms. Propranolol, a beta-blocker, is primarily used to reduce physical symptoms of anxiety, such as rapid heartbeat and trembling, in patients with social anxiety disorder. It does not directly affect mood, energy levels, or social interactions. Choice B is incorrect because propranolol does not target mood improvement. Choice C is incorrect because propranolol does not aim to increase energy levels. Choice D is incorrect because propranolol does not enhance social interactions; its primary role is in reducing physical symptoms of anxiety.

3. Which of the following interventions are appropriate for a client experiencing a panic attack? Select one that does not apply.

• A. Stay with the client and remain calm
• B. Encourage deep breathing
• C. Move the client to a quiet environment
• D. Mindfulness meditation

Correct answer: D

Rationale: During a panic attack, it is crucial to provide immediate support to the client. Appropriate interventions include staying with the client and remaining calm, encouraging deep breathing, and moving the client to a quiet environment. However, mindfulness meditation, which involves focusing on the present moment and may require a certain level of concentration, may not be feasible or effective during an acute panic attack. The priority is to help the client feel safe and supported, which the other interventions address more directly. Mindfulness meditation might not be suitable during a panic attack due to the heightened state of anxiety and the need for immediate calming techniques.

4. A nurse is providing discharge instructions to a client who has been prescribed fluoxetine (Prozac). Which information should the nurse include?

• A. Take the medication with food to avoid stomach upset.
• B. Avoid drinking alcohol while taking this medication.
• C. Report any unusual side effects to the healthcare provider.
• D. It may take several weeks for this medication to take effect.

Correct answer: B

Rationale: Clients taking fluoxetine (Prozac) should avoid alcohol to prevent adverse interactions.

5. A healthcare provider is assessing a client with generalized anxiety disorder (GAD). Which of the following findings shouldn't the healthcare provider expect?

• A. Restlessness
• B. Fatigue
• C. Excessive worry
• D. Mania

Correct answer: D

Rationale: In clients with generalized anxiety disorder (GAD), common symptoms include restlessness, fatigue, excessive worry, and irritability. Mania is not typically associated with GAD; instead, it is a key feature of bipolar disorder. Therefore, the healthcare provider should not expect to find mania in a client with GAD.

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