Nursing Elites

1. A nurse is planning care for several clients attending community-based mental health programs. Which of the following clients should the nurse visit first?

• A. A client who received a burn on the arm while using a hot iron at home
• B. A client who requests a change of antipsychotic medication due to new adverse effects
• C. A client who reports hearing a voice saying that life is not worth living anymore
• D. A client who tells the nurse about experiencing manifestations of severe anxiety before and during a job interview

Correct answer: C

Rationale: The nurse should visit the client who reports hearing a voice saying that life is not worth living anymore first. This statement indicates potential suicidal ideation, which requires immediate intervention to ensure the client's safety. Choices A, B, and D do not present an immediate threat to the client's life. While burns, adverse effects of medication, and severe anxiety are important concerns, they do not pose an immediate risk of self-harm or suicide.

2. Which therapeutic communication technique is being used when the nurse says, 'Tell me more about what you are feeling right now'?

• A. Restating
• B. Clarification
• C. Reflection
• D. Exploration

Correct answer: D

Rationale: The correct answer is D, Exploration. In this scenario, the nurse is using the exploration technique to encourage the patient to elaborate further on their feelings. Exploration involves prompting the patient to delve deeper into their thoughts and emotions, fostering a more comprehensive discussion and understanding of their experiences.

3. A client has a new prescription for disulfiram for the treatment of alcohol use disorder. The nurse informs the client that this medication can cause nausea and vomiting when alcohol is consumed. Which of the following types of treatment is this method an example of?

• A. Aversion therapy
• B. Flooding
• C. Biofeedback
• D. Dialectical behavior therapy

Correct answer: A

Rationale: Aversion therapy is a form of behavioral therapy that aims to create a negative response to a stimulus, in this case, alcohol consumption. Disulfiram is used in aversion therapy to induce unpleasant effects when alcohol is consumed, such as nausea and vomiting, to deter the individual from drinking. Therefore, the use of disulfiram in this context exemplifies aversion therapy. Flooding involves exposing an individual to a feared object or situation to overcome anxiety; biofeedback teaches self-regulation techniques, and dialectical behavior therapy is a type of cognitive-behavioral therapy focusing on acceptance and change strategies, which are not directly related to the use of disulfiram for alcohol use disorder.

4. Which of the following medications is commonly used to treat attention deficit hyperactivity disorder (ADHD)?

• A. Sertraline
• B. Diazepam
• C. Methylphenidate
• D. Clozapine

Correct answer: C

Rationale: Methylphenidate is the correct answer. It is a stimulant medication commonly used to treat ADHD. Methylphenidate works by increasing the activity of certain chemicals in the brain that are involved in attention and impulse control. Sertraline is an antidepressant used for depression, anxiety, and other conditions, not ADHD. Diazepam is a benzodiazepine mainly prescribed for anxiety, muscle spasms, and seizures, not ADHD. Clozapine is an antipsychotic medication used for schizophrenia when other medications are ineffective, not for ADHD.

5. What is the most appropriate nursing diagnosis for a patient with agoraphobia who reports not having left their house in months?

• A. Social isolation
• B. Ineffective coping
• C. Risk for injury
• D. Impaired social interaction

Correct answer: A

Rationale: The nursing diagnosis 'Social isolation' is most appropriate for a patient with agoraphobia who has not left their house in months. Agoraphobia often leads to the avoidance of situations or places perceived as unsafe, resulting in social isolation. This diagnosis reflects the patient's limited social interactions and confinement to the home environment, which can impact their overall well-being and mental health. The other options are not as relevant in this scenario: 'Ineffective coping' does not directly address the social withdrawal aspect, 'Risk for injury' is not the primary concern presented, and 'Impaired social interaction' does not capture the extent of isolation described.

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