Nursing Elites

1. A healthcare provider is assessing a patient with generalized anxiety disorder (GAD). Which symptom would be most indicative of this disorder?

• A. Frequent nightmares
• B. Persistent worrying about multiple issues
• C. Excessive sleeping
• D. Loss of interest in daily activities

Correct answer: B

Rationale: Persistent worrying about multiple issues is a hallmark symptom of generalized anxiety disorder (GAD). Individuals with GAD often experience excessive, uncontrollable worry about various aspects of their life, such as work, relationships, and health. This persistent and excessive worrying distinguishes GAD from normal everyday concerns and is a defining feature of the disorder. Frequent nightmares (Choice A) are more commonly associated with conditions like post-traumatic stress disorder (PTSD) rather than GAD. Excessive sleeping (Choice C) is not a typical symptom of GAD, as individuals with GAD often experience difficulty falling or staying asleep due to their anxious thoughts. Loss of interest in daily activities (Choice D) is more characteristic of conditions like depression rather than GAD.

2. What is the primary goal of exposure therapy for a patient with specific phobia?

• A. To eliminate the phobic response completely
• B. To increase the patient's exposure to the feared object
• C. To help the patient confront and reduce their fear gradually
• D. To provide immediate relief from anxiety symptoms

Correct answer: C

Rationale: The primary goal of exposure therapy for a patient with a specific phobia is to help them confront their fear gradually, leading to a reduction in their fear response over time. This gradual exposure helps the individual learn to manage and cope with their phobia, ultimately reducing the intensity of their fear reactions. Choice A is incorrect because while the goal is to reduce the fear response, complete elimination may not always be feasible. Choice B is incorrect as the focus is not solely on increasing exposure but on gradual confrontation. Choice D is incorrect as the therapy aims for long-term reduction rather than immediate relief.

3. A patient is experiencing a manic episode. Which intervention is most effective?

• A. Encouraging the patient to participate in group activities
• B. Providing a low-stimulation environment
• C. Allowing the patient to move freely around the unit
• D. Engaging the patient in competitive games

Correct answer: B

Rationale: During a manic episode, individuals may be overwhelmed by stimuli. Providing a low-stimulation environment can help reduce excessive sensory input and minimize exacerbation of manic behaviors. This intervention aims to create a calm and structured setting that supports the individual in managing their symptoms effectively.

4. Which therapeutic approach is most effective for a patient with generalized anxiety disorder (GAD)?

• A. Psychoanalytic therapy
• B. Cognitive-behavioral therapy (CBT)
• C. Humanistic therapy
• D. Gestalt therapy

Correct answer: B

Rationale: Cognitive-behavioral therapy (CBT) is the most effective therapeutic approach for generalized anxiety disorder (GAD). CBT helps individuals identify and modify negative thought patterns and behaviors that contribute to anxiety. It focuses on changing cognitive distortions and maladaptive behaviors, providing practical strategies to manage anxiety symptoms effectively. Numerous studies have shown the effectiveness of CBT in treating GAD by helping patients develop coping mechanisms and skills to address their anxiety. Choice A, Psychoanalytic therapy, is not the most effective for GAD as it primarily focuses on exploring unconscious conflicts and childhood experiences rather than providing immediate coping strategies. Choice C, Humanistic therapy, emphasizes personal growth and self-improvement, which may not directly target the specific symptoms of GAD. Choice D, Gestalt therapy, focuses on increasing self-awareness and personal responsibility, which might not address the cognitive distortions and behavioral patterns associated with GAD as directly as CBT does.

5. When a patient with schizophrenia is taking haloperidol, what is a priority assessment for the nurse?

• A. Assessing for signs of tardive dyskinesia
• B. Monitoring for signs of neuroleptic malignant syndrome
• C. Checking for signs of depression
• D. Monitoring for changes in appetite

Correct answer: B

Rationale: Monitoring for signs of neuroleptic malignant syndrome is crucial for patients taking haloperidol. Neuroleptic malignant syndrome is a rare but serious side effect that can occur with antipsychotic medications like haloperidol. It presents with symptoms such as high fever, unstable blood pressure, confusion, muscle rigidity, and autonomic dysfunction. Early detection and intervention are essential to prevent serious complications.

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