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. When discharging a patient with schizophrenia on risperidone, what is an important point to include in the discharge teaching?

• A. Avoiding foods high in tyramine is essential.
• B. Getting blood levels checked regularly is necessary.
• C. Being cautious when driving due to possible drowsiness is crucial.
• D. Taking this medication on an as-needed basis is recommended.

Correct answer: B

Rationale: Regular monitoring of blood levels is crucial for patients taking risperidone to ensure the medication is at therapeutic levels and to prevent potential toxicity. This monitoring helps healthcare providers adjust the dosage as needed to optimize treatment outcomes and minimize adverse effects.

3. In an emergency mental health facility, a nurse is caring for a group of clients. The nurse should identify that which of the following clients requires a temporary emergency admission?

• A. A client with schizophrenia who has delusions of grandeur
• B. A client with manifestations of depression who attempted suicide a year ago
• C. A client with borderline personality disorder who assaulted a homeless man with a metal rod
• D. A client with bipolar disorder who paces quickly around the room while talking to themselves

Correct answer: C

Rationale: The correct answer is C. A client with borderline personality disorder who has committed an assault poses a risk to others and themselves, necessitating temporary emergency admission for safety and further assessment. Choices A, B, and D do not indicate an immediate risk to self or others that would require temporary emergency admission.

4. A patient with generalized anxiety disorder is being taught about buspirone. Which statement indicates the patient needs further teaching?

• A. I should take this medication consistently rather than on an as-needed basis.
• B. It may take a few weeks to feel the full effect of this medication.
• C. This medication has a lower risk of dependency compared to benzodiazepines.
• D. I should avoid drinking alcohol while taking this medication.

Correct answer: A

Rationale: The correct answer is A because buspirone is not meant to be taken on an as-needed basis. It should be taken consistently to achieve optimal effectiveness in managing generalized anxiety disorder. Taking it as needed may lead to inadequate symptom control and reduced therapeutic benefits.

5. Which of the following is an example of a cognitive-behavioral therapy (CBT) technique?

• A. Free association
• B. Thought stopping
• C. Dream analysis
• D. Systematic desensitization

Correct answer: B

Rationale: Thought stopping is a specific cognitive-behavioral therapy (CBT) technique aimed at helping individuals manage and interrupt negative or intrusive thoughts. This technique involves identifying and stopping negative thought patterns to promote healthier thinking and emotional well-being. Free association and dream analysis are associated with psychoanalytic therapy, while systematic desensitization is a technique commonly used in behavior therapy.

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