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. Which assessment question, when asked by the nurse, demonstrates an understanding of comorbid mental health conditions associated with major depressive disorder?

• A. Do rules apply to you?
• B. What do you do to manage anxiety?
• C. Do you have a history of disordered eating?
• D. Do you think that you drink too much?

Correct answer: B

Rationale: The correct answer is B. Inquiring about anxiety management demonstrates an understanding of the common comorbid condition of anxiety often seen alongside major depressive disorder. Anxiety and depression frequently coexist, and addressing anxiety management can provide insights into the patient's overall mental health status. Choices A, C, and D are incorrect because they do not directly address comorbid mental health conditions associated with major depressive disorder.

3. A healthcare professional is assessing a patient with bipolar disorder. Which finding suggests the patient is experiencing a manic episode?

• A. Decreased need for sleep
• B. Feelings of worthlessness
• C. Increased need for sleep
• D. Avoidance of social interactions

Correct answer: A

Rationale: During a manic episode in patients with bipolar disorder, they often experience a decreased need for sleep. This symptom is characterized by feeling rested after only a few hours of sleep, or even feeling like they can go without sleep for extended periods without feeling tired. The increased energy levels and racing thoughts during a manic episode contribute to the decreased need for sleep.

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

• A. The patient will experience no episodes of anxiety within the next week.
• B. The patient will learn and practice relaxation techniques.
• C. The patient will avoid all anxiety-provoking situations.
• D. The patient will be medication-free within a month.

Correct answer: B

Rationale: Option B, 'The patient will learn and practice relaxation techniques,' is the most appropriate short-term goal for managing generalized anxiety disorder. Teaching relaxation techniques can help the patient develop coping mechanisms and reduce anxiety levels in the immediate future, making it a realistic and beneficial goal. Options A and C are not feasible in the short term as complete elimination of anxiety episodes or avoidance of all anxiety-provoking situations may not be achievable or practical within a week. Option D is not a suitable short-term goal as it overlooks the potential need for medication in managing generalized anxiety disorder.

5. A healthcare provider is assessing a patient with generalized anxiety disorder (GAD). Which symptom would be most indicative of this disorder?

• A. Frequent nightmares
• B. Persistent worrying about multiple issues
• C. Excessive sleeping
• D. Loss of interest in daily activities

Correct answer: B

Rationale: Persistent worrying about multiple issues is a hallmark symptom of generalized anxiety disorder (GAD). Individuals with GAD often experience excessive, uncontrollable worry about various aspects of their life, such as work, relationships, and health. This persistent and excessive worrying distinguishes GAD from normal everyday concerns and is a defining feature of the disorder. Frequent nightmares (Choice A) are more commonly associated with conditions like post-traumatic stress disorder (PTSD) rather than GAD. Excessive sleeping (Choice C) is not a typical symptom of GAD, as individuals with GAD often experience difficulty falling or staying asleep due to their anxious thoughts. Loss of interest in daily activities (Choice D) is more characteristic of conditions like depression rather than GAD.

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