Nursing Elites

1. A client with obsessive-compulsive disorder (OCD) spends hours each day washing her hands. Which intervention should the nurse implement to help the client reduce this behavior?

• A. Encourage the client to set a time limit for washing hands.
• B. Encourage the client to wash hands only when necessary.
• C. Encourage the client to use hand sanitizer instead of washing.
• D. Encourage the client to explore the reasons behind the hand washing.

Correct answer: A

Rationale: Setting a time limit for hand washing is an effective intervention in managing obsessive-compulsive disorder (OCD) symptoms. By establishing boundaries around the behavior, the client can gradually work towards reducing the excessive hand washing and regaining control over the compulsion. Choice B is not as effective because it does not address the underlying compulsion. Choice C may not be helpful as it may not satisfy the client's need for cleanliness and could reinforce the behavior. Choice D, while important in therapy, may not be the most immediate intervention needed to address the excessive hand washing behavior.

2. A client with generalized anxiety disorder (GAD) is being discharged. Which of the following instructions should the nurse include in the discharge teaching? Select one that does not apply.

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

Correct answer: D

Rationale: When discharging a client with GAD, it is important to provide instructions that promote holistic well-being and support without exacerbating the condition. Practicing relaxation techniques daily, avoiding caffeine and alcohol, and engaging in regular physical activity can help manage anxiety symptoms effectively. These strategies focus on self-care and healthy lifestyle choices. Seeking support from friends and family also plays a crucial role in maintaining mental health. However, using benzodiazepines as the first line of treatment is not recommended due to their potential for dependence and other associated risks. Non-pharmacological interventions and therapy are usually preferred as initial approaches in managing GAD. Therefore, the option 'D: Use benzodiazepines as the first line of treatment' is incorrect and should not be included in the discharge teaching for a client with GAD.

3. A client with major depressive disorder is receiving cognitive-behavioral therapy (CBT). Which outcome indicates that the therapy is effective?

• A. The client identifies and challenges negative thoughts.
• B. The client reports an increase in suicidal thoughts.
• C. The client experiences an increase in anxiety.
• D. The client shows no change in behavior.

Correct answer: A

Rationale: In cognitive-behavioral therapy, identifying and challenging negative thoughts is a fundamental aspect of the treatment process. This cognitive restructuring helps individuals with major depressive disorder to develop healthier thinking patterns and cope more effectively with their emotions, which ultimately leads to improvement in their mental health. Therefore, when a client is able to identify and challenge negative thoughts, it indicates that they are actively engaging in the therapeutic process and making progress towards better mental well-being.

4. A student finds that they come down with a sinus infection toward the end of every semester. When this occurs, which stage of stress is the student most likely experiencing?

• A. Alarm reaction stage
• B. Stage of resistance
• C. Stage of exhaustion
• D. Fight-or-flight stage

Correct answer: C

Rationale: The student is most likely experiencing the stage of exhaustion. In this stage, the body's exposure to stress has been prolonged, and adaptive energy has been depleted. As a result, diseases of adaptation, such as the recurrent sinus infection in this case, are more likely to occur. The alarm reaction stage is the initial stage of the stress response, where the body perceives a threat and activates the fight-or-flight response. The stage of resistance is when the body tries to adapt and cope with the stressor. The fight-or-flight response is the immediate reaction to a perceived threat, involving physiological changes to prepare the body to either fight the stressor or flee from it.

5. A healthcare provider is providing care for a patient with attention-deficit/hyperactivity disorder (ADHD). Which therapeutic intervention is most effective for this condition?

• A. Group therapy
• B. Cognitive-behavioral therapy
• C. Psychoanalysis
• D. Family therapy

Correct answer: B

Rationale: Cognitive-behavioral therapy (CBT) is the most effective therapeutic intervention for managing ADHD symptoms. CBT helps individuals with ADHD develop coping strategies, improve focus, organization, and time management skills, and address behavioral challenges effectively. Group therapy might not provide the specific skills training needed for ADHD management. Psychoanalysis focuses on exploring deeper unconscious processes and may not be as practical for addressing ADHD symptoms. Family therapy can be beneficial for family dynamics but may not directly target individual ADHD symptoms as effectively as CBT.

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