Nursing Elites

1. A client has generalized anxiety disorder (GAD), and a nurse is providing care. Which of the following interventions should the nurse avoid implementing?

• A. Encourage the client to express their feelings
• B. Monitor daily caloric intake and weight
• C. Promote regular physical activity
• D. Discourage the use of caffeine

Correct answer: B

Rationale: In caring for a client with generalized anxiety disorder (GAD), it is important to encourage the client to express their feelings, promote regular physical activity, and discourage the use of caffeine. Addressing weight and caloric intake monitoring may exacerbate anxiety related to body image, and focusing on these aspects can be distressing for the client. Therefore, monitoring daily caloric intake and weight should be avoided in this scenario.

2. A physically and emotionally healthy client has just been fired. During a routine office visit, he states to a nurse: 'Perhaps this was the best thing to happen. Maybe I'll look into pursuing an art degree.' How should the nurse characterize the client's appraisal of the job loss stressor?

• A. Irrelevant
• B. Harm/loss
• C. Threatening
• D. Challenging

Correct answer: D

Rationale: The client's statement indicates that he views the job loss as an opportunity for growth and a new direction in life rather than a threat or harm/loss. He sees it as a challenge and is considering it positively, demonstrating resilience and adaptability in the face of adversity. Choice A, 'Irrelevant,' is incorrect as the client's response shows relevance and a positive outlook. Choice B, 'Harm/loss,' is incorrect as the client does not express a sense of harm or loss but rather opportunity. Choice C, 'Threatening,' is incorrect as the client's response does not convey fear or threat but rather a positive reframe of the situation.

3. A client experiencing alcohol withdrawal is being cared for by a nurse. Which symptom should the nurse identify as a priority to address?

• A. Insomnia
• B. Nausea and vomiting
• C. Increased heart rate
• D. Tremors

Correct answer: C

Rationale: Increased heart rate is a critical symptom to address in a client experiencing alcohol withdrawal as it can indicate potential cardiovascular complications. Monitoring and managing the increased heart rate promptly is essential to prevent adverse outcomes.

4. Which statement by the patient indicates a need for further teaching regarding the treatment of major depressive disorder?

• A. I have been on this antidepressant for 3 days. I understand that the full effect may take weeks to occur.
• B. I am going to ask my nurse practitioner to discontinue my Prozac today and let me start taking a monoamine oxidase inhibitor tomorrow.
• C. I may ask to have my medication changed to Wellbutrin due to the problems I am having being romantic with my wife.
• D. I realize that there are many antidepressants and it might take a while until we find the one that works best for me.

Correct answer: B

Rationale: Choice B indicates a need for further teaching because the patient is planning to switch directly from Prozac, an SSRI, to a monoamine oxidase inhibitor (MAOI) without allowing for a washout period. This abrupt switch poses a risk of serotonin syndrome, which can be life-threatening. It is essential to educate the patient about the importance of consulting healthcare providers before changing medications to prevent potential adverse effects.

5. A nursing instructor is teaching a group of students about intimate partner violence. Which response by the students indicates no further teaching is needed?

• A. Alaska Native women report the highest rate of intimate partner violence.
• B. Caucasian women report the lowest rate of intimate partner violence.
• C. African American women report the highest rate of intimate partner violence.
• D. Asian women report the lowest rate of intimate partner violence.

Correct answer: A

Rationale: The correct answer is A. Alaska Native women do report the highest rate of intimate partner violence. This statistic is important for healthcare professionals to be aware of to provide culturally sensitive care and interventions. Choices B, C, and D are incorrect statements. While it is essential to understand disparities in intimate partner violence rates among different populations, in this context, the focus is on recognizing the accurate information provided about Alaska Native women.

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