Nursing Elites

1. A client is diagnosed with obsessive-compulsive disorder (OCD), and a nurse is planning care. Which of the following interventions should the nurse exclude from the care plan?

• A. Allowing the client to perform rituals initially
• B. Discouraging the client from washing their hands
• C. Monitoring for suicidal ideation
• D. Providing a structured schedule of activities

Correct answer: C

Rationale: The correct answer is monitoring for suicidal ideation. When caring for a client with OCD, interventions should include allowing the client to perform rituals initially, setting limits on the time allowed for rituals, encouraging the client to verbalize feelings, and providing a structured schedule of activities. Monitoring for suicidal ideation is crucial in assessing the client's safety and mental health status, but it is not a direct intervention specific to managing OCD symptoms.

2. When using therapeutic communication with a withdrawn patient who has major depression, an effective method of managing the silence is to:

• A. Engage in a quiet meditation
• B. Ask simple questions even if the patient will not answer
• C. Use the technique of making observations
• D. Simply sit quietly and leave when the patient falls asleep

Correct answer: C

Rationale: Using the technique of making observations is an effective method of managing silence when communicating with a withdrawn patient who has major depression. This approach can encourage the patient to engage and feel understood without the pressure to respond, fostering a therapeutic connection and helping the patient open up at their own pace.

3. A client diagnosed with major depressive disorder is being educated by a nurse about the use of antidepressants. Which of the following statements by the client indicates a need for further teaching?

• A. I should avoid alcohol while taking this medication.
• B. It may take several weeks for the medication to take effect.
• C. I can stop taking my medication once I feel better.
• D. I should not discontinue the medication abruptly.

Correct answer: C

Rationale: The correct answer is C. The client stating, 'I can stop taking my medication once I feel better,' indicates a need for further teaching. It is crucial for clients with major depressive disorder to understand that they should continue taking their medication as prescribed even if they start feeling better. Stopping the medication prematurely can lead to a relapse of symptoms. Choices A, B, and D are correct statements. Avoiding alcohol while taking antidepressants helps prevent interactions and side effects. Understanding that it may take several weeks for the medication to show its full effect is important for managing expectations. Additionally, not discontinuing the medication abruptly is crucial to prevent withdrawal effects or a recurrence of depressive symptoms.

4. A healthcare professional is teaching a patient about relaxation techniques to manage anxiety. Which technique is the healthcare professional most likely to recommend?

• A. Deep breathing exercises
• B. Physical exercise
• C. Mindfulness meditation
• D. Journaling

Correct answer: A

Rationale: Deep breathing exercises are a widely recommended technique for managing anxiety and promoting relaxation. By focusing on deep, slow breaths, individuals can activate the body's relaxation response, leading to decreased anxiety levels and an overall sense of calm. This technique is easy to learn, can be practiced anywhere, and is often suggested by healthcare professionals as a first-line approach for anxiety management. Physical exercise, mindfulness meditation, and journaling are also beneficial for mental well-being but may not be the first choice when specifically targeting acute anxiety management.

5. April, a 10-year-old admitted to inpatient pediatric care, has been getting more and more wound up and is losing self-control in the day room. Time-out does not appear to be an effective tool for April to engage in self-reflection. April's mother admits to putting her in time-out up to 20 times a day. The nurse recognizes that:

• A. Time-out is an important part of April's baseline discipline.
• B. Time-out is no longer an effective therapeutic measure.
• C. April enjoys time-out, and acts out to get some alone time.
• D. Time-out will need to be replaced with seclusion and restraint.

Correct answer: B

Rationale: Frequent use of time-out has reduced its effectiveness as a therapeutic measure for April.

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