Nursing Elites

1. A healthcare professional is conducting education on anxiety and stress management. Which of the following should be identified as the most important initial step in learning how to manage anxiety?

• A. Diagnostic blood tests
• B. Awareness of factors creating stress
• C. Relaxation exercises
• D. Identifying support systems

Correct answer: B

Rationale: The correct answer is B: Awareness of factors creating stress. In managing anxiety, the first crucial step is recognizing and being aware of the factors that contribute to stress. Without this awareness, it becomes challenging to effectively address and manage anxiety. Diagnostic blood tests are not typically the initial step in managing anxiety; they may be used to rule out other medical conditions but are not the primary focus. While relaxation exercises can be helpful in managing anxiety, understanding the root causes of stress takes precedence. Identifying support systems is important but comes after recognizing the stress factors to develop a comprehensive management plan.

2. A client is diagnosed with somatic symptom disorder. Which of the following behaviors should the nurse expect?

• A. Excessive worry about physical symptoms
• B. Fear of gaining weight
• C. Frequent visits to healthcare providers
• D. Persistent depressive mood

Correct answer: C

Rationale: Individuals with somatic symptom disorder often exhibit frequent visits to healthcare providers due to their excessive worry about physical symptoms. They seek reassurance and explanations for their perceived medical issues, even when there is no organic basis for their complaints. This behavior is a characteristic feature of somatic symptom disorder and distinguishes it from other conditions. Choices A, B, and D are incorrect. Excessive worry about physical symptoms may occur but it is not the primary behavior associated with this disorder. Fear of gaining weight is more characteristic of eating disorders, and persistent depressive mood is more indicative of mood disorders rather than somatic symptom disorder.

3. When assessing a client experiencing severe anxiety, which symptom should the nurse expect to observe?

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

Correct answer: B

Rationale: When a client is experiencing severe anxiety, a rapid heart rate is a common physiological response. This increased heart rate is due to the body's fight-or-flight response, where adrenaline is released, causing the heart to beat faster. Monitoring the client's heart rate is crucial in assessing and managing their anxiety. Restlessness (choice A) can also be present in anxiety but is more of a behavioral manifestation rather than a physiological symptom. Sweating (choice C) can occur in anxiety, but it is not as specific or consistent as a rapid heart rate. Dry mouth (choice D) is associated with anxiety but is not as immediate or directly linked to the body's physiological response to stress as a rapid heart rate.

4. Identical twins vary in their responses to stress. One twin may become anxious and irritable, while the other may withdraw and cry. How should the nurse explain these different reactions to stress to the parents?

• A. Reactions to stress are relative rather than absolute; individual responses to stress vary.
• B. It is abnormal for identical twins to react differently to similar stressors.
• C. Identical twins should share the same temperament and respond similarly to stress.
• D. Environmental influences weigh more heavily than genetic influences on reactions to stress.

Correct answer: A

Rationale: Individual responses to stress can vary significantly due to factors such as perception, past experiences, and environmental influences, in addition to genetic factors. It is not unusual for identical twins to exhibit different reactions to stress as their individual personalities and coping mechanisms play a significant role in how they respond to stressful situations. Choice A is the correct answer because it acknowledges the variability in responses to stress among individuals. Choice B is incorrect because it wrongly labels differing reactions in identical twins as abnormal, when in reality, it is a natural phenomenon. Choice C is incorrect as it assumes that identical twins should always have the same temperament and response to stress, which is not always the case. Choice D is incorrect because it oversimplifies the complex interplay between genetic and environmental factors in shaping responses to stress.

5. A client is experiencing a panic attack. Which action should the nurse take first?

• A. Remain with the client and offer reassurance.
• B. Administer an anti-anxiety medication as prescribed.
• C. Encourage the client to engage in physical activity.
• D. Encourage the client to breathe deeply and slowly.

Correct answer: A

Rationale: During a panic attack, the immediate priority for the nurse is to provide support and reassurance to the client. Remaining with the client helps establish a sense of safety and trust, which can help calm the client during an episode of panic. Administering medication, encouraging physical activity, and deep breathing techniques are beneficial interventions, but offering reassurance and support should be the initial step to address the immediate emotional distress and anxiety experienced by the client.

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