Nursing Elites

1. A client with generalized anxiety disorder (GAD) is being discharged. Which of the following instructions should the nurse not include in the discharge teaching?

• A. Practice relaxation techniques daily
• B. Avoid caffeine and alcohol
• C. Engage in regular physical activity
• D. Use benzodiazepines as the first-line treatment

Correct answer: D

Rationale: Discharge instructions for a client with GAD should include practicing relaxation techniques daily, avoiding caffeine and alcohol, engaging in regular physical activity, and seeking support from friends and family. Benzodiazepines are not recommended as the first-line treatment due to their potential for dependence and should not be included in the discharge teaching.

2. A client is experiencing progressive changes in memory that have interfered with personal, social, and occupational functioning. The client exhibits poor judgment and has a short attention span. The nurse recognizes these as classic signs of which condition?

• A. Delirium
• B. Mania
• C. Parkinsonism
• D. Alzheimer’s

Correct answer: D

Rationale: The client's presentation of progressive memory changes, poor judgment, and attention deficits align with classic signs of Alzheimer's disease. Alzheimer's is a neurodegenerative disorder characterized by cognitive decline that significantly impacts daily functioning. While delirium and mania may present with cognitive changes, Alzheimer's is specifically associated with progressive memory loss and cognitive impairment over time.

3. While assessing a distraught female high school student who is overly concerned because her parents can't afford horseback riding lessons, how should the nurse interpret the student's reaction to her perceived problem?

• A. The problem is endangering her well-being.
• B. The problem is personally relevant to her.
• C. The problem is based on immaturity.
• D. The problem is exceeding her capacity to cope.

Correct answer: B

Rationale: In this scenario, the student being overly concerned about not being able to afford horseback riding lessons indicates that the problem is personally relevant to her. Psychological stressors related to self-esteem and self-image are influenced by how an individual perceives a situation or event. Adolescents, in particular, place significance on self-image and feeling entitled to experiences that other adolescents have, which can lead to distress when such desires are not met. Choice A is incorrect because there is no indication that the student's physical well-being is at risk. Choice C is incorrect as it simplifies the issue by attributing it solely to immaturity. Choice D is incorrect as there is no evidence provided that the problem is beyond the student's coping abilities.

4. A client has been diagnosed with generalized anxiety disorder. Which of the following findings should the nurse expect?

• A. Shortness of breath
• B. Chest pain
• C. Excessive worry
• D. Decreased appetite

Correct answer: C

Rationale: Individuals with generalized anxiety disorder commonly exhibit symptoms like excessive worry, restlessness, and difficulty concentrating. Physical manifestations such as muscle tension and sleep disturbances are also prevalent. Shortness of breath and chest pain are more commonly associated with panic attacks rather than generalized anxiety disorder. Decreased appetite may be present in some cases, but excessive worry is a hallmark characteristic of generalized anxiety disorder.

5. Which therapeutic approach is considered most effective for treating posttraumatic stress disorder (PTSD)?

• A. Cognitive processing therapy
• B. Psychoanalysis
• C. Medication management
• D. Group therapy

Correct answer: A

Rationale: Cognitive processing therapy is a specialized form of cognitive-behavioral therapy that has been shown to be highly effective in treating posttraumatic stress disorder (PTSD). This therapy focuses on helping individuals process and make sense of their traumatic experiences, leading to symptom reduction and improved coping mechanisms. Psychoanalysis, medication management, and group therapy can be beneficial in some cases, but cognitive processing therapy is specifically tailored for addressing the symptoms and underlying causes of PTSD. Psychoanalysis may not be as effective for PTSD due to its focus on unconscious conflicts rather than trauma processing. Medication management can be useful as an adjunct to therapy but does not address the core issues of PTSD. Group therapy can provide support but may not offer the individualized approach that cognitive processing therapy provides.

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