Nursing Elites

1. When developing a care plan for a patient with generalized anxiety disorder (GAD), which long-term goal is most appropriate?

• A. The patient will experience no episodes of anxiety.
• B. The patient will recognize and modify anxiety-provoking thoughts.
• C. The patient will avoid situations that cause anxiety.
• D. The patient will take medication as prescribed.

Correct answer: B

Rationale: The most appropriate long-term goal for managing generalized anxiety disorder is for the patient to recognize and modify anxiety-provoking thoughts. By addressing and modifying these thoughts, the patient can develop coping mechanisms and strategies to manage their anxiety more effectively in the long term. Choices A and C are not ideal long-term goals as complete elimination of anxiety episodes or avoidance of anxiety-provoking situations may not be realistic or sustainable. Choice D focuses solely on medication adherence, which is important but does not address the core cognitive-behavioral aspects of managing anxiety in GAD.

2. Child protective services have removed 10-year-old Christopher from his parents’ home due to neglect. Christopher reveals to the nurse that he considers the woman next door his ‘nice’ mom, that he loves school, and gets above-average grades. The strongest explanation for this response is:

• A. Temperament
• B. Genetic factors
• C. Resilience
• D. Paradoxical effects of neglect

Correct answer: C

Rationale: Resilience is the ability to adapt positively in the face of adversity. Christopher's positive outlook and academic success despite experiencing neglect demonstrate his resilience in coping with challenging circumstances. Choice A, Temperament, refers to inherent traits and is not the most fitting explanation for Christopher's response. Genetic factors (Choice B) play a role in development but do not directly explain Christopher's ability to cope. The paradoxical effects of neglect (Choice D) typically refer to unexpected positive outcomes, which do not fully capture Christopher's situation.

3. What is the most appropriate intervention for a patient experiencing a panic attack?

• A. Encourage the patient to talk about their feelings.
• B. Provide a quiet and non-stimulating environment.
• C. Administer prescribed medication immediately.
• D. Teach the patient relaxation techniques.

Correct answer: B

Rationale: During a panic attack, it is crucial to provide a quiet and non-stimulating environment to help the patient feel safe and reduce sensory overload. This approach can help the patient focus on calming down and regaining control. Encouraging the patient to talk about their feelings may exacerbate the panic attack by increasing stress and arousal levels. Administering medication should be done following healthcare provider's orders, as it may not be appropriate to give medication immediately without proper assessment. Teaching relaxation techniques might not be effective during the acute phase of a panic attack when the individual is overwhelmed by intense anxiety.

4. A patient diagnosed with panic disorder asks the nurse about the purpose of deep breathing exercises. Which explanation by the nurse is most accurate?

• A. Deep breathing helps distract you from your anxiety.
• B. Deep breathing can prevent future panic attacks.
• C. Deep breathing helps reduce physical symptoms of anxiety.
• D. Deep breathing increases your overall lung capacity.

Correct answer: C

Rationale: Deep breathing helps reduce the physical symptoms of anxiety, such as rapid heartbeat and shortness of breath.

5. 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.

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