Nursing Elites

1. A client with generalized anxiety disorder is prescribed buspirone. Which statement by the client indicates a need for further teaching?

• A. I can stop taking this medication once I feel less anxious.
• B. I should avoid drinking alcohol while taking this medication.
• C. It may take several weeks for this medication to take full effect.
• D. This medication can cause dependency.

Correct answer: A

Rationale: The correct answer is A because it indicates a misunderstanding about buspirone. Buspirone should not be abruptly stopped, and patients should follow the prescribed regimen consistently. Stopping the medication without proper guidance can lead to adverse effects or a return of anxiety symptoms. Choices B, C, and D demonstrate an understanding of important aspects of buspirone therapy: avoiding alcohol due to interactions, being patient for the medication to reach full effectiveness, and being aware of the potential for dependency with this medication.

2. When under stress, a client routinely uses an excessive amount of alcohol. Finding her drunk, her husband yells at her about the chronic alcohol abuse. Which reaction should the nurse recognize as the use of the defense mechanism of denial?

• A. Hiding liquor bottles in a closet
• B. Yelling at their son for slouching in his chair
• C. Burning dinner on purpose
• D. Saying to the spouse, 'I don't drink too much!'

Correct answer: D

Rationale: The nurse should recognize the client's statement 'I don't drink too much!' as the use of the defense mechanism of denial. This response indicates the client's refusal to acknowledge the reality of excessive alcohol consumption, which is a key characteristic of denial. By denying the problem, the client avoids facing the negative consequences and feelings associated with their alcohol abuse. Choices A, B, and C do not exhibit denial but rather represent different defense mechanisms. Hiding liquor bottles in a closet might indicate the defense mechanism of concealment, yelling at their son for slouching in his chair could reflect displacement, and burning dinner on purpose might suggest passive-aggressive behavior.

3. Which behavior is consistent with therapeutic communication?

• A. Offering your opinion when asked to convey support.
• B. Summarizing the essence of the patient's comments in your own words.
• C. Interrupting periods of silence before they become awkward for the patient.
• D. Telling the patient they did well when you approve of their statements or actions.

Correct answer: B

Rationale: Summarizing the essence of the patient's comments in your own words is a key aspect of therapeutic communication as it demonstrates active listening and understanding. It shows the patient that their words have been heard and understood, fostering a sense of validation and empathy. Offering opinions, interrupting silence, or giving approval may not always align with the principles of therapeutic communication, which focus on patient-centered interactions and empathetic responses.

4. Meditation has been shown to be an effective stress management technique. When meditation is effective, what should a healthcare professional expect to assess?

• A. An achieved state of relaxation
• B. An achieved insight into one's feelings
• C. A demonstration of appropriate role behaviors
• D. An enhanced ability to problem-solve

Correct answer: A

Rationale: Corrected Rationale: When meditation is effective, a healthcare professional should expect to assess an achieved state of relaxation. Meditation is known to facilitate a special state of consciousness through concentrated focus, leading to a sense of calm and relaxation. While meditation can sometimes provide insights into one's feelings, the primary outcome related to stress management is the promotion of relaxation. Choices C and D are not directly related to the typical outcomes of effective meditation for stress management.

5. A client with obsessive-compulsive disorder (OCD) spends several hours each day washing her hands. Which intervention should the nurse implement?

• A. Encourage the client to wash her hands less frequently.
• B. Set a time limit for hand washing.
• C. Teach the client relaxation techniques.
• D. Discourage the client from washing her hands.

Correct answer: B

Rationale: Setting a time limit for hand washing is an appropriate intervention for a client with OCD who spends excessive time on this compulsive behavior. By setting a time limit, the nurse can help the client gradually reduce the compulsive behavior, promoting a more manageable approach to hand washing without completely discouraging it. Encouraging the client to wash her hands less frequently (Choice A) may not address the root of the issue and could lead to increased anxiety. Teaching relaxation techniques (Choice C) may be helpful for overall anxiety management but may not directly address the excessive hand washing behavior. Discouraging the client from washing her hands (Choice D) may increase anxiety and resistance, making it a less effective intervention.

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