Nursing Elites

1. A female high school teacher who was a child of alcoholic parents seeks counseling at the community health clinic because of depression over a student who was killed by a drunk driver. After several weeks of counseling, which client behavior is the best indicator that the client is coping well with anxiety related to the student’s death?

• A. Signs a safety contract with the nurse agreeing not to hurt herself or others
• B. Confronts her parents about the hurt she felt as a child of alcoholic parents
• C. Becomes the faculty sponsor for Students Against Drunk Driving (SADD)
• D. Describes her feelings about the student’s death in detail

Correct answer: C

Rationale: Becoming the faculty sponsor for Students Against Drunk Driving (SADD) is the best indicator that the client is coping well with anxiety related to the student’s death. This choice demonstrates active involvement in preventing similar tragedies, showing that the client is channeling her emotions into positive action and advocacy. Option A, signing a safety contract, is important for safety but does not directly address coping with the anxiety related to the student's death. Option B, confronting her parents about past hurt, may be beneficial for personal growth but does not directly reflect coping with the current situation. Option D, describing feelings in detail, is a positive step in therapy but does not necessarily indicate coping well with the anxiety related to the student's death.

2. A client with post-traumatic stress disorder (PTSD) is struggling with flashbacks and nightmares. Which therapeutic approach should the nurse include in the care plan?

• A. Cognitive-behavioral therapy.
• B. Electroconvulsive therapy (ECT).
• C. Medication management only.
• D. Relaxation training and mindfulness.

Correct answer: A

Rationale: Corrected Question: A client with post-traumatic stress disorder (PTSD) experiencing flashbacks and nightmares would benefit from cognitive-behavioral therapy (CBT) in the care plan. CBT is an evidence-based therapeutic approach that focuses on identifying and changing negative thought patterns and behaviors associated with PTSD symptoms. This helps the client learn coping strategies to manage distressing symptoms like flashbacks and nightmares.\nIncorrect Choices Rationale: B) Electroconvulsive therapy (ECT) is not indicated for PTSD and is typically used for severe depression that has not responded to other treatments. C) Medication management alone may not address the underlying cognitive and behavioral aspects of PTSD. D) Relaxation training and mindfulness can be helpful as adjunctive therapies but may not be as effective as CBT in specifically targeting and modifying PTSD symptoms.

3. Which statement made by a patient prescribed bupropion (Wellbutrin) demonstrates that the medication education the patient received was effective? Select all that apply.

• A. I hope Wellbutrin will help my depression and also help me to finally quit smoking.
• B. I'm happy to hear that I won't need to worry too much about weight gain.
• C. It's okay to take Wellbutrin since I haven't had a seizure in 6 months.
• D. I need to be careful about driving since the medication could make me drowsy.

Correct answer: A

Rationale: Choice A is the correct answer. The patient expressing a desire for Wellbutrin to address both depression and smoking cessation indicates an understanding of the medication's dual benefits. This demonstrates effective medication education as the patient comprehends the drug's purposes. Choice B is incorrect because weight gain is a common side effect of bupropion, so the statement contradicts this fact. Choice C is incorrect as a history of seizures is a contraindication for bupropion, so this statement shows a misunderstanding of the medication's safety profile. Choice D is incorrect because bupropion is not typically associated with sedation, so the concern about drowsiness is not directly related to this medication.

4. A female client, who is wearing dirty clothes and has a foul body odor, comes to the clinic reporting feeling scared because she is being stalked. What action is most important for the nurse to take?

• A. Assure the client that she will be seen by a healthcare provider today.
• B. Recommend that the client speaks with a social worker.
• C. Ask the client if she feels comfortable sharing why she is being stalked.
• D. Offer the client a safe place to relax before interviewing her.

Correct answer: D

Rationale: The most important action for the nurse to take in this scenario is to offer the client a safe place to relax before interviewing her. The client's disheveled appearance and foul body odor suggest she may be in distress or facing challenging circumstances. By providing her with a safe and comfortable environment to relax, the nurse can help alleviate some of her distress and establish trust. This approach is crucial as the client is already feeling scared due to being stalked, indicating underlying mental health concerns. Assuring the client that she will be seen by a healthcare provider today (choice A) may not address her immediate need for safety and comfort. Recommending she speaks with a social worker (choice B) may be beneficial later but does not address the immediate need for a safe space. Asking the client if she feels comfortable sharing why she is being stalked (choice C) is not appropriate as the priority is ensuring her safety and comfort first.

5. During an exacerbation of schizophrenia symptoms, which intervention should the nurse prioritize for a client with a history of schizophrenia?

• A. Encourage adherence to the medication regimen.
• B. Increase social interactions with peers.
• C. Provide a high-stimulation environment.
• D. Assess for safety risks related to the exacerbation.

Correct answer: D

Rationale: During an exacerbation of schizophrenia symptoms, the nurse should prioritize assessing for safety risks. This is critical because individuals with schizophrenia may experience heightened risks to themselves or others during this period. Encouraging adherence to the medication regimen (Choice A) is important but ensuring immediate safety takes precedence. Increasing social interactions with peers (Choice B) and providing a high-stimulation environment (Choice C) can potentially exacerbate symptoms and should be avoided during an exacerbation.

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