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. A client with obsessive-compulsive disorder (OCD) spends several hours each day washing her hands. Which intervention should the nurse implement?

• A. Encourage the client to wash her hands less frequently.
• B. Set a time limit for hand washing.
• C. Teach the client relaxation techniques.
• D. Discourage the client from washing her hands.

Correct answer: B

Rationale: Setting a time limit for hand washing is an appropriate intervention for a client with OCD who spends excessive time on this compulsive behavior. By setting a time limit, the nurse can help the client gradually reduce the compulsive behavior, promoting a more manageable approach to hand washing without completely discouraging it. Encouraging the client to wash her hands less frequently (Choice A) may not address the root of the issue and could lead to increased anxiety. Teaching relaxation techniques (Choice C) may be helpful for overall anxiety management but may not directly address the excessive hand washing behavior. Discouraging the client from washing her hands (Choice D) may increase anxiety and resistance, making it a less effective intervention.

3. A patient is being educated about the difference between mental health and mental illness. Which statement by the patient reflects an accurate understanding of mental health?

• A. Mental health is the absence of any stressors.
• B. Mental health is successful adaptation to stressors in the internal and external environment.
• C. Mental health is incongruence between thoughts, feelings, and behavior.
• D. Mental health is a diagnostic category in the DSM-5.

Correct answer: B

Rationale: The correct answer is B. Mental health is defined as the successful adaptation to stressors in the internal and external environment. This includes having thoughts, feelings, and behaviors that are age-appropriate and congruent with cultural and societal norms. Mental health is not solely the absence of stressors or incongruence between thoughts, feelings, and behavior, nor is it a specific diagnostic category in the DSM-5. Choice A is incorrect because mental health is not just the absence of stressors but the ability to adapt to them. Choice C is wrong as mental health involves congruence, not incongruence, between thoughts, feelings, and behaviors. Choice D is inaccurate as mental health is a broader concept than a specific diagnostic category in the DSM-5.

4. A healthcare provider is providing care for a patient with schizophrenia. Which symptom would be considered a positive symptom of this disorder?

• A. Alogia
• B. Anhedonia
• C. Delusions
• D. Flat affect

Correct answer: C

Rationale: Delusions are considered a positive symptom of schizophrenia. Positive symptoms represent an excess or distortion of normal functions, such as hallucinations, delusions, or disorganized speech or behavior. In contrast, negative symptoms involve a decrease or absence of normal functions, like alogia (poverty of speech), anhedonia (inability to experience pleasure), and flat affect (reduced expression of emotions). Therefore, in the context of schizophrenia, delusions fall under the category of positive symptoms.

5. A client has been prescribed lorazepam (Ativan) for the treatment of anxiety. Which of the following instructions should the nurse include?

• A. Take the medication with food to avoid stomach upset.
• B. Avoid driving until you know how the medication affects you.
• C. Take the medication on an empty stomach.
• D. Double the dose if you miss a dose.

Correct answer: B

Rationale: The correct answer is B because lorazepam (Ativan) can cause dizziness and drowsiness, so the client should avoid driving until they know how the medication affects them. This instruction is crucial for ensuring the client's safety and preventing any potential accidents or harm. Choice A is incorrect because lorazepam does not necessarily need to be taken with food. Choice C is incorrect as it contradicts the usual recommendation of taking lorazepam with or without food. Choice D is incorrect and dangerous advice as doubling the dose of lorazepam can lead to overdose and serious complications.

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