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. Which of the following interventions are appropriate for a client experiencing a panic attack? Select one that does not apply.

• A. Stay with the client and remain calm
• B. Encourage deep breathing
• C. Move the client to a quiet environment
• D. Mindfulness meditation

Correct answer: D

Rationale: During a panic attack, it is crucial to provide immediate support to the client. Appropriate interventions include staying with the client and remaining calm, encouraging deep breathing, and moving the client to a quiet environment. However, mindfulness meditation, which involves focusing on the present moment and may require a certain level of concentration, may not be feasible or effective during an acute panic attack. The priority is to help the client feel safe and supported, which the other interventions address more directly. Mindfulness meditation might not be suitable during a panic attack due to the heightened state of anxiety and the need for immediate calming techniques.

3. A healthcare professional is assessing a client who is experiencing severe anxiety. Which of the following symptoms should the healthcare professional expect to observe?

• A. Restlessness
• B. Rapid heart rate
• C. Sweating
• D. Dry mouth

Correct answer: B

Rationale: Rapid heart rate is a characteristic symptom of severe anxiety due to the body's fight-or-flight response being activated. This physiological response leads to an increased heart rate to prepare the body to deal with perceived threats. Healthcare professionals should be vigilant in monitoring and managing this symptom in clients experiencing severe anxiety.

4. Which statement made by the patient demonstrates an understanding of the effective use of newly prescribed lithium to manage bipolar mania? Select one that doesn't apply.

• A. I remind myself to consistently drink six 12-ounce glasses of fluid every day.
• B. I discussed the diuretic prescribed by my cardiologist with my psychiatric care provider.
• C. Lithium may help me lose the few extra pounds I tend to carry around.
• D. I take my lithium on an empty stomach to help with absorption.

Correct answer: C

Rationale: Proper hydration, discussing other medications, and taking lithium with or without food are important for effective and safe use of lithium. However, lithium is not prescribed for weight loss, and its usage should not be associated with losing extra pounds.

5. A patient with generalized anxiety disorder (GAD) is prescribed buspirone. The nurse understands that buspirone is different from benzodiazepines because it:

• A. Has a high potential for abuse.
• B. Works immediately to relieve anxiety.
• C. Does not cause sedation.
• D. Is used for short-term treatment only.

Correct answer: C

Rationale: Buspirone is different from benzodiazepines because it does not cause sedation. Unlike benzodiazepines, buspirone has a lower potential for abuse and does not cause the sedative effects commonly seen with benzodiazepines. While benzodiazepines may work immediately to relieve anxiety, buspirone may take longer to show its therapeutic effects. Additionally, buspirone is not limited to short-term treatment only, making it a preferred choice in patients where sedation is a concern or in those with a history of substance abuse.

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