Nursing Elites

1. A client is discussing free associations as a therapeutic tool with a nurse. Which of the following client statements indicates an understanding of this technique?

• A. “I will write down my dreams as soon as I wake up.”
• B. “I might begin to associate my therapist with important people in my life.”
• C. “I can learn to express myself in a nonaggressive manner.”
• D. “I should say the first thing that comes to my mind.”

Correct answer: D

Rationale: Free association is a psychoanalytic technique where the client is encouraged to say the first thing that comes to their mind without censoring or filtering. This technique helps uncover unconscious thoughts and emotions. Choice D, “I should say the first thing that comes to my mind,” indicates an understanding of free association as it aligns with the principle of allowing thoughts to flow freely without inhibition. Choices A, B, and C do not reflect an understanding of free association and its purpose, making them incorrect. A, focusing on writing down dreams, does not relate to the immediate expression of thoughts. B, associating the therapist with important people, and C, learning to express oneself nonaggressively, do not capture the essence of free association as a technique for exploring unconscious processes.

2. A patient with posttraumatic stress disorder (PTSD) is experiencing nightmares. Which intervention should the nurse include in the care plan?

• A. Encouraging the patient to journal before bedtime
• B. Teaching relaxation techniques
• C. Avoiding discussing the nightmares directly
• D. Developing a safety plan

Correct answer: B

Rationale: Teaching relaxation techniques is an appropriate intervention for a patient with PTSD experiencing nightmares. Relaxation techniques can help the patient manage anxiety and improve sleep quality, potentially decreasing the frequency and intensity of nightmares. By teaching relaxation techniques, the nurse empowers the patient to actively cope with and reduce the distressing symptoms of PTSD, contributing to overall therapeutic outcomes.

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

• A. Encourage the patient to discuss their feelings.
• B. Provide a quiet environment and stay with the patient.
• C. Administer prescribed medication immediately.
• D. Teach the patient relaxation techniques.

Correct answer: B

Rationale: During a panic attack, the most effective initial intervention is to provide a quiet environment and stay with the patient. This approach can help the patient feel safe and supported, which may help reduce the intensity and duration of the panic attack. Encouraging the patient to discuss their feelings may not be helpful during the acute phase of a panic attack as it can be overwhelming. Administering prescribed medication immediately is not typically the first-line intervention for panic attacks. Teaching relaxation techniques is beneficial in the long term but may not be the most effective immediate intervention during a panic attack.

4. When orienting a new client to a mental health unit, which of the following statements should the nurse make about the unit’s community meetings?

• A. “Clients gather to discuss their treatment plans together.”
• B. “Staff establish a specific agenda for community meetings.”
• C. “Clients meet with staff to discuss common problems.”
• D. “Community meetings provide an opportunity to explore personal mental health issues.”

Correct answer: C

Rationale: During community meetings in a mental health unit, clients come together with staff to discuss common problems they may be facing. These meetings are designed to foster a sense of community and provide support and guidance to clients. Choice A is incorrect because community meetings focus on discussions beyond individual treatment plans. Choice B is incorrect as while staff may facilitate the meetings, the focus is on clients' concerns, not a predetermined agenda. Choice D is incorrect as the primary purpose of community meetings is to address shared challenges, not individual mental health issues.

5. A healthcare provider is developing a care plan for a patient with posttraumatic stress disorder (PTSD). Which intervention should be included to help the patient manage flashbacks?

• A. Encouraging the patient to confront the trauma directly.
• B. Teaching the patient grounding techniques.
• C. Encouraging the patient to use relaxation techniques.
• D. Helping the patient develop a safety plan.

Correct answer: B

Rationale: Teaching grounding techniques is an effective intervention for managing flashbacks in patients with PTSD. Grounding techniques help individuals focus on the present moment, which can reduce the intensity of flashbacks and promote a sense of safety and stability.

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