Nursing Elites

1. In an acute mental health facility, a nurse is communicating with a client. The client states, “I can’t sleep. I stay up all night.” The nurse responds, “You are having difficulty sleeping?” Which of the following therapeutic communication techniques is the nurse demonstrating?

• A. Offering general leads
• B. Summarizing
• C. Focusing
• D. Restating

Correct answer: D

Rationale: The nurse is using the restating technique, where the nurse paraphrases or repeats the main idea expressed by the client to show understanding and encourage further communication. Restating helps clarify the client's message and fosters a therapeutic relationship. Choice A, offering general leads, involves encouraging the client to continue talking with nonverbal or minimal verbal prompts. Summarizing (Choice B) involves condensing and organizing the client's message. Focusing (Choice C) involves centering the conversation on a key element or topic.

2. Which of the following is an example of a mood stabilizer used to treat bipolar disorder?

• A. Fluoxetine
• B. Lithium
• C. Haloperidol
• D. Lorazepam

Correct answer: B

Rationale: Lithium is a widely recognized mood stabilizer used in the treatment of bipolar disorder. It helps to control mood swings, prevent manic episodes, and reduce the risk of suicidal behavior in individuals with bipolar disorder. Fluoxetine is an antidepressant, Haloperidol is an antipsychotic, and Lorazepam is a benzodiazepine used for anxiety and insomnia, none of which are primary mood stabilizers for bipolar disorder.

3. What medication is frequently prescribed for patients with generalized anxiety disorder (GAD)?

• A. Fluoxetine
• B. Sertraline
• C. Buspirone
• D. Diazepam

Correct answer: C

Rationale: Buspirone is a medication commonly prescribed for generalized anxiety disorder (GAD) due to its effectiveness and lower risk of dependency compared to benzodiazepines like diazepam. While fluoxetine and sertraline are selective serotonin reuptake inhibitors (SSRIs) often used for various anxiety disorders, buspirone is specifically indicated for GAD.

4. When developing a care plan for a patient with generalized anxiety disorder (GAD), which short-term goal is most appropriate?

• A. The patient will experience no episodes of anxiety within the next week.
• B. The patient will learn and practice relaxation techniques.
• C. The patient will avoid all anxiety-provoking situations.
• D. The patient will be medication-free within a month.

Correct answer: B

Rationale: Option B, 'The patient will learn and practice relaxation techniques,' is the most appropriate short-term goal for managing generalized anxiety disorder. Teaching relaxation techniques can help the patient develop coping mechanisms and reduce anxiety levels in the immediate future, making it a realistic and beneficial goal. Options A and C are not feasible in the short term as complete elimination of anxiety episodes or avoidance of all anxiety-provoking situations may not be achievable or practical within a week. Option D is not a suitable short-term goal as it overlooks the potential need for medication in managing generalized anxiety disorder.

5. A patient with agoraphobia has difficulty leaving their home. Which nursing intervention would be most effective?

• A. Encourage the patient to make small, gradual steps outside the home.
• B. Advise the patient to avoid crowded places.
• C. Suggest that the patient focus on their breathing when anxious.
• D. Provide the patient with information about support groups.

Correct answer: A

Rationale: Encouraging the patient to make small, gradual steps outside the home is the most effective nursing intervention for agoraphobia. This approach helps the patient confront their fear gradually and build confidence in managing their symptoms. By taking small steps, the patient can start to expand their comfort zone and reduce anxiety associated with leaving their home, ultimately aiding in their recovery and increasing their independence. Choices B, C, and D are not as effective as choice A. Advising the patient to avoid crowded places does not address the underlying issue of agoraphobia. Suggesting that the patient focus on their breathing when anxious may help manage immediate symptoms but does not address the fear of leaving home. Providing information about support groups is beneficial but may not directly address the patient's difficulty leaving their home.

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