Nursing Elites

1. When assessing a patient with generalized anxiety disorder (GAD), which symptom would a nurse most likely observe?

• A. Flashbacks
• B. Excessive worry
• C. Hallucinations
• D. Compulsive behaviors

Correct answer: B

Rationale: Excessive worry is a primary characteristic of generalized anxiety disorder (GAD). Patients with GAD experience persistent and excessive worry about various aspects of their lives, often anticipating disaster or catastrophic outcomes. This worry is difficult to control and can be accompanied by physical symptoms like restlessness, fatigue, irritability, muscle tension, and difficulty concentrating. Flashbacks are more commonly associated with post-traumatic stress disorder (PTSD), hallucinations are more typical of psychotic disorders, and compulsive behaviors are characteristic of obsessive-compulsive disorder (OCD). Therefore, when assessing a patient with GAD, a nurse would most likely observe excessive worry.

2. Which therapeutic communication statement might a psychiatric-mental health registered nurse use when a patient's nursing diagnosis is altered thought processes?

• A. I know you say you hear voices, but I cannot hear them.
• B. Stop listening to the voices, they are NOT real.
• C. You say you hear voices, what are they telling you?
• D. Please tell the voices to leave you alone for now.

Correct answer: C

Rationale: Asking about the content of the voices helps understand the patient's experience and assess risk.

3. Meditation has been shown to be an effective stress management technique. When meditation is effective, what should a healthcare professional expect to assess?

• A. An achieved state of relaxation
• B. An achieved insight into one's feelings
• C. A demonstration of appropriate role behaviors
• D. An enhanced ability to problem-solve

Correct answer: A

Rationale: Corrected Rationale: When meditation is effective, a healthcare professional should expect to assess an achieved state of relaxation. Meditation is known to facilitate a special state of consciousness through concentrated focus, leading to a sense of calm and relaxation. While meditation can sometimes provide insights into one's feelings, the primary outcome related to stress management is the promotion of relaxation. Choices C and D are not directly related to the typical outcomes of effective meditation for stress management.

4. During cognitive-behavioral therapy, a 12-year-old patient reports to the nurse practitioner:

• A. I was so mad I wanted to hit my mother.
• B. I thought that everyone at school hated me. That's not true. Most people like me and I have a friend named Todd.
• C. I forgot that you told me to breathe when I become angry.
• D. I scream as loud as I can when the train goes by the house.

Correct answer: B

Rationale: In cognitive-behavioral therapy, recognizing and challenging negative thoughts is crucial for progress. Choice B demonstrates the patient's ability to identify and correct distorted thoughts, indicating positive advancement in therapy. This cognitive restructuring is a key component of cognitive-behavioral therapy, helping individuals develop healthier thinking patterns and coping strategies.

5. An unemployed college graduate is experiencing severe anxiety over not finding a teaching position and has difficulty with independent problem-solving. During a routine physical examination, the graduate confides in the clinic nurse. Which is the most appropriate nursing intervention?

• A. Encourage the graduate to use alternative coping mechanisms such as relaxation exercises.
• B. Complete the problem-solving process for the graduate.
• C. Work through the problem-solving process with the graduate.
• D. Encourage the graduate to keep a journal.

Correct answer: C

Rationale: In situations where a client is experiencing severe anxiety and struggles with independent problem-solving, it is essential for the nurse to work through the problem-solving process together with the client. By doing so, the nurse can provide support and guidance to help the client navigate through their challenges effectively. Choice A is not the most appropriate as just encouraging alternative coping mechanisms may not address the root of the problem. Choice B of completing the problem-solving process for the graduate does not promote independence or skill development. Choice D of encouraging the graduate to keep a journal may be helpful but does not directly address the need for assistance in problem-solving during heightened anxiety.

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