Nursing Elites

1. When caring for a client with major depressive disorder, what is the most appropriate short-term goal for the client?

• A. The client will report a decrease in depressive symptoms.
• B. The client will establish a sleep routine.
• C. The client will improve social interactions.
• D. The client will set realistic goals for the future.

Correct answer: A

Rationale: The most appropriate short-term goal for a client with major depressive disorder is for them to report a decrease in depressive symptoms. This goal is specific, measurable, and achievable, focusing on the primary symptoms of the disorder. By monitoring and assessing the client's self-reported improvement in depressive symptoms, the healthcare team can track progress and adjust interventions accordingly.

2. Which should the healthcare provider recognize as a DSM-5 disorder?

• A. Obesity
• B. Generalized anxiety disorder
• C. Hypertension
• D. Grief

Correct answer: B

Rationale: The DSM-5 categorizes mental health disorders for diagnostic purposes. Generalized anxiety disorder is one of the disorders listed in the DSM-5, characterized by persistent and excessive worry about various events or activities. This disorder falls under the category of anxiety disorders, which also include panic disorder, phobias, and others. Choices A, C, and D are not DSM-5 disorders. Obesity and hypertension are medical conditions, while grief, though a significant emotional response, is not classified as a mental health disorder in the DSM-5.

3. A client is under a great deal of stress. Which nursing recommendation would be least helpful in assisting the client in coping with stress? Select one that doesn't apply.

• A. Enjoy a pet.
• B. Spend time with a loved one.
• C. Listen to music.
• D. Focus on the stressors.

Correct answer: D

Rationale: Focusing on the stressors can exacerbate stress levels in the client's life rather than helping to cope with it. Engaging in activities such as enjoying a pet, spending time with loved ones, and listening to music are known to be stress-relieving and can aid in coping with stress. It is essential to encourage strategies that promote relaxation and positive emotions, rather than fixating on the stressors that may worsen the client's condition. Therefore, 'Focus on the stressors' is the least helpful recommendation as it does not contribute to stress management.

4. Which of the following interventions is most appropriate for a client experiencing severe anxiety?

• A. Encourage the client to talk about their feelings.
• B. Provide a quiet and calm environment.
• C. Encourage the client to exercise vigorously.
• D. Encourage the client to participate in group activities.

Correct answer: B

Rationale: In cases of severe anxiety, creating a quiet and calm environment is crucial as it can help reduce stimulation and promote relaxation. This environment can provide a sense of safety and security, which are essential for individuals experiencing heightened anxiety levels. Encouraging the client to talk about their feelings may not be suitable during severe anxiety as it can further escalate distress by focusing on the source of anxiety. Vigorous exercise and group activities may not be appropriate initially, as they can increase arousal levels rather than promoting a sense of calm needed to manage severe anxiety.

5. A psychiatric nurse observes that a client diagnosed with schizophrenia is pacing up and down the corridor. The client is muttering to himself, and his hands are trembling. Which of the following actions should the nurse take first?

• A. Ask the client if he is hearing voices.
• B. Offer the client a PRN medication for anxiety.
• C. Encourage the client to participate in a relaxation exercise.
• D. Remove the client to a quieter environment.

Correct answer: D

Rationale: The first action the nurse should take is to remove the client to a quieter environment. This intervention aims to reduce stimuli that may be contributing to the client's agitation and help create a calmer and more supportive setting for the client. Choices A, B, and C are not the priority in this situation as addressing the environmental factors should come first before exploring symptoms, offering medication, or engaging in relaxation exercises.

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