Nursing Elites

1. A client is being assessed by a nurse after being diagnosed with anorexia nervosa. Which of the following findings should the nurse expect?

• A. Weight gain and increased appetite
• B. Lanugo on the face and back
• C. Increased body temperature and tachycardia
• D. Hyperactivity and distractibility

Correct answer: B

Rationale: In anorexia nervosa, individuals often develop lanugo, fine soft hair, on the face and back. This is a physiological response to the body's attempt to conserve heat due to a lack of subcutaneous fat. It is a common physical finding in clients with anorexia nervosa and can be a sign of severe malnutrition. Choices A, C, and D are incorrect because weight gain and increased appetite, increased body temperature and tachycardia, and hyperactivity and distractibility are not typically associated with anorexia nervosa. In fact, weight loss, decreased appetite, hypothermia, and bradycardia are more commonly seen in individuals with anorexia nervosa.

2. When interviewing a distressed client who was fired after 15 years of loyal employment, which of the following questions would best assist in determining the client's appraisal of the situation? Select all that apply.

• A. What caused the stressful situation?
• B. Have you ever experienced a similar stressful situation?
• C. Who do you think is to blame for this situation?
• D. Why do you think you were fired from your job?

Correct answer: B

Rationale: The question 'Have you ever experienced a similar stressful situation?' is the most appropriate as it assesses the client's coping resources and encourages reflection on past experiences. This question can help the client consider alternative ways to deal with stress. Asking about the cause of the stressful situation may provide insight into the current situation but does not directly assess coping abilities. Inquiring about blame does not focus on coping strategies but may encourage negative thinking and a sense of victimization. Questioning why the client was fired is a nontherapeutic approach that can hinder communication by putting the client on the defensive.

3. Which medication is commonly prescribed for the treatment of panic disorder?

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

Correct answer: B

Rationale: Clonazepam, a benzodiazepine, is commonly prescribed for the treatment of panic disorder due to its anxiolytic properties. It helps reduce the frequency and intensity of panic attacks by acting on the central nervous system to produce a calming effect. Haloperidol is an antipsychotic medication, lithium is primarily used for bipolar disorder, and fluoxetine is a selective serotonin reuptake inhibitor (SSRI) commonly used for depression and some anxiety disorders, but not as a first-line treatment for panic disorder.

4. Which therapeutic approach is considered most effective for treating posttraumatic stress disorder (PTSD)?

• A. Cognitive processing therapy
• B. Psychoanalysis
• C. Medication management
• D. Group therapy

Correct answer: A

Rationale: Cognitive processing therapy is a specialized form of cognitive-behavioral therapy that has been shown to be highly effective in treating posttraumatic stress disorder (PTSD). This therapy focuses on helping individuals process and make sense of their traumatic experiences, leading to symptom reduction and improved coping mechanisms. Psychoanalysis, medication management, and group therapy can be beneficial in some cases, but cognitive processing therapy is specifically tailored for addressing the symptoms and underlying causes of PTSD. Psychoanalysis may not be as effective for PTSD due to its focus on unconscious conflicts rather than trauma processing. Medication management can be useful as an adjunct to therapy but does not address the core issues of PTSD. Group therapy can provide support but may not offer the individualized approach that cognitive processing therapy provides.

5. A client is experiencing alcohol withdrawal. Which intervention should be included in the plan of care?

• A. Administer benzodiazepines as prescribed.
• B. Monitor the client's vital signs every 4 hours.
• C. Provide a high-protein diet.
• D. Encourage the client to drink plenty of fluids.

Correct answer: A

Rationale: Administering benzodiazepines as prescribed is a crucial intervention in managing alcohol withdrawal. Benzodiazepines help alleviate symptoms such as anxiety, agitation, and seizures commonly seen in alcohol withdrawal. Monitoring vital signs is important to assess the client's physiological stability, but addressing the withdrawal symptoms with benzodiazepines is a priority to prevent severe complications. Providing a high-protein diet and encouraging fluid intake are important for overall health but do not directly manage alcohol withdrawal symptoms.

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