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 assessment question will provide information regarding the effects of a woman’s circadian rhythms on her quality of life?

• A. How much sleep do you usually get each night?
• B. Does your heart ever seem to skip a beat?
• C. When was the last time you had a fever?
• D. Do you have problems urinating?

Correct answer: A

Rationale: The correct answer is A: 'How much sleep do you usually get each night?' Asking about sleep patterns is essential to understand the impact of circadian rhythms on an individual's quality of life. Adequate sleep is closely linked to circadian rhythms, and disturbances in sleep patterns can significantly affect a person's well-being and daily functioning. Choices B, C, and D are not directly related to circadian rhythms and would not provide information specifically about how circadian rhythms affect quality of life.

3. When caring for a client with anorexia nervosa, which of the following examples demonstrates the nurse’s use of interpersonal communication?

• A. The nurse discusses the client’s weight loss during a health care team meeting
• B. The nurse examines their own personal feelings about clients with anorexia nervosa
• C. The nurse asks the client about their personal body image perception
• D. The nurse presents an educational session about anorexia nervosa to a large group of adolescents

Correct answer: C

Rationale: Interpersonal communication involves engaging in a conversation where the nurse asks the client about their personal body image perception. This demonstrates a direct interaction aimed at understanding the client's feelings and thoughts, which is essential in providing holistic care to individuals with anorexia nervosa. Choices A, B, and D do not directly involve the nurse-client interaction that characterizes interpersonal communication. A is more related to team communication, B focuses on the nurse's personal reflection, and D pertains to delivering educational content to a group rather than engaging in a one-on-one conversation with a client.

4. A patient with obsessive-compulsive disorder (OCD) spends hours washing their hands. Which nursing intervention is most appropriate?

• A. Encouraging the patient to stop washing their hands
• B. Allowing the patient to wash hands at specified times
• C. Ignoring the patient's behavior
• D. Setting strict limits on the time allowed for hand washing

Correct answer: B

Rationale: In managing a patient with OCD who spends excessive time washing hands, allowing the patient to wash hands at specified times is the most appropriate nursing intervention. This approach helps establish a structured routine for hand washing, which can assist in managing OCD symptoms without reinforcing the behavior. Encouraging the patient to stop washing hands may lead to increased anxiety and resistance. Ignoring the behavior can perpetuate the cycle of OCD, and setting strict limits on hand washing time may cause distress and may not effectively address the underlying issues associated with OCD.

5. A patient with a diagnosis of panic disorder is prescribed an SSRI. Which side effect should the nurse monitor for when the patient starts this medication?

• A. Increased heart rate
• B. Increased appetite
• C. Gastrointestinal disturbances
• D. Dry mouth

Correct answer: C

Rationale: When a patient with panic disorder is prescribed an SSRI, the nurse should monitor for gastrointestinal disturbances as a common side effect. SSRIs can cause gastrointestinal symptoms such as nausea, diarrhea, or abdominal discomfort, especially at the beginning of treatment. Increased heart rate (Choice A) is not a common side effect of SSRIs; it is more commonly associated with medications like stimulants. Increased appetite (Choice B) is not a typical side effect of SSRIs, as they are more likely to cause weight loss or appetite suppression. Dry mouth (Choice D) is a side effect seen more commonly with medications that have anticholinergic properties, not typically with SSRIs.

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