Nursing Elites

1. When developing a care plan for a patient with borderline personality disorder, which intervention should be included to address self-harm behaviors?

• A. Encouraging the patient to keep a journal of their thoughts and feelings.
• B. Setting clear and consistent boundaries with the patient.
• C. Providing the patient with coping skills to manage their emotions.
• D. Developing a safety plan with the patient.

Correct answer: D

Rationale: Developing a safety plan with the patient is crucial when addressing self-harm behaviors in individuals with borderline personality disorder. This intervention helps outline steps to take during a crisis, identifies triggers, and provides strategies to prevent self-harm incidents. It involves collaboratively creating a plan between the patient and the healthcare team to ensure a structured and supportive approach to managing potentially dangerous situations.

2. A patient with obsessive-compulsive disorder (OCD) performs hand washing repeatedly. Which nursing intervention is most appropriate?

• A. Restricting the patient from washing hands
• B. Setting strict limits on the patient's hand washing
• C. Allowing the patient to wash hands at specified times
• D. Ignoring the patient's behavior

Correct answer: C

Rationale: Allowing the patient to wash hands at specified times is the most appropriate nursing intervention for a patient with OCD who repetitively performs hand washing. This intervention provides structure by allowing the patient to engage in the behavior at designated times, helping to reduce the compulsion gradually. Restricting or setting strict limits may increase anxiety and worsen the condition, while ignoring the behavior does not address the underlying issue of OCD.

3. Carolina is surprised when her patient does not show for a regularly scheduled appointment. When contacted, the patient states, “I don’t need to come see you anymore. I have found a therapy app on my phone that I love.” How should Carolina respond to this news?

• A. That sounds exciting; would you be willing to visit and show me the app?
• B. At this time, there is no real evidence that the app can replace our therapy.
• C. I am not sure that is a good idea right now; we are so close to progress.
• D. Why would you think that is a better option than meeting with me?

Correct answer: A

Rationale: Carolina should respond by showing interest in the app, as it can help maintain the therapeutic relationship and provide an opportunity to evaluate the app's effectiveness together. By asking the patient to visit and show the app, Carolina demonstrates openness to exploring new tools that the patient finds helpful, while also ensuring that the patient's well-being remains a priority. This approach fosters communication, allows for a collaborative discussion on how the app fits into the patient's treatment plan, and may potentially address any concerns or misconceptions the patient has about the app replacing traditional therapy.

4. Tomas is a 21-year-old male with a recent diagnosis of schizophrenia. Tomas’s nurse recognizes that self-medicating with excessive alcohol is common in this disease and can co-occur along with:

• A. Generally good health despite the mental illness.
• B. An aversion to drinking fluids.
• C. Anxiety and depression.
• D. The ability to express his needs.

Correct answer: C

Rationale: Individuals with schizophrenia often turn to alcohol as a form of self-medication to manage co-occurring symptoms of anxiety and depression. This coping mechanism can exacerbate the underlying mental health condition and hinder proper treatment. Recognizing and addressing these co-occurring issues are essential in providing holistic care for individuals with schizophrenia.

5. What is the primary benefit of using exposure therapy for patients with phobias?

• A. To eliminate the phobia completely
• B. To gradually reduce the patient’s fear and anxiety
• C. To teach the patient relaxation techniques
• D. To provide immediate relief from anxiety

Correct answer: B

Rationale: The primary benefit of using exposure therapy for patients with phobias is to gradually reduce the patient's fear and anxiety. Exposure therapy involves exposing the individual to the feared object or situation in a controlled manner to help them confront their fears and learn that the perceived threat is not as harmful as initially believed. Over time, repeated exposure can lead to a decrease in anxiety and fear responses, helping the individual manage and overcome their phobia. Choice A is incorrect because exposure therapy aims to reduce fear and anxiety, not necessarily eliminate the phobia completely. Choice C is incorrect as although relaxation techniques might be part of the therapy, the primary goal is fear reduction. Choice D is incorrect as exposure therapy typically involves gradual exposure rather than providing immediate relief.

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