Nursing Elites

1. In planning care for the termination phase of a nurse-client relationship, which of the following actions should the nurse include in the plan of care?

• A. Discussing ways to use new behaviors
• B. Practicing new problem-solving skills
• C. Developing goals
• D. Establishing boundaries

Correct answer: A

Rationale: During the termination phase of a nurse-client relationship, it is crucial to discuss ways to use new behaviors. This helps the client integrate and apply the skills and strategies they have acquired during the therapeutic process into their daily life. By focusing on the application of new behaviors, the client can maintain progress and continue to grow even after the professional relationship has ended. Practicing new problem-solving skills, developing goals, and establishing boundaries are important aspects of the therapeutic process but are more commonly addressed in earlier phases of the nurse-client relationship. Therefore, the correct action to include in the plan of care during the termination phase is discussing ways to use new behaviors.

2. A patient is being assessed for generalized anxiety disorder (GAD). Which symptom is the patient most likely to report?

• A. Excessive worrying about various aspects of life.
• B. Extreme mood swings between euphoria and depression.
• C. Persistent thoughts of self-harm.
• D. Hearing voices that others do not hear.

Correct answer: A

Rationale: Patients with generalized anxiety disorder (GAD) commonly present with excessive worrying about various aspects of life. This persistent and uncontrollable worry is a hallmark symptom of GAD and can significantly impact daily functioning and quality of life. Extreme mood swings (choice B), persistent thoughts of self-harm (choice C), and auditory hallucinations (choice D) are more indicative of other mental health conditions like bipolar disorder, depression, and schizophrenia, respectively. These symptoms are not specific to GAD.

3. When caring for a client with anorexia nervosa, which of the following examples demonstrates the nurse’s use of interpersonal communication?

• A. The nurse discusses the client’s weight loss during a health care team meeting
• B. The nurse examines their own personal feelings about clients with anorexia nervosa
• C. The nurse asks the client about their personal body image perception
• D. The nurse presents an educational session about anorexia nervosa to a large group of adolescents

Correct answer: C

Rationale: Interpersonal communication involves engaging in a conversation where the nurse asks the client about their personal body image perception. This demonstrates a direct interaction aimed at understanding the client's feelings and thoughts, which is essential in providing holistic care to individuals with anorexia nervosa. Choices A, B, and D do not directly involve the nurse-client interaction that characterizes interpersonal communication. A is more related to team communication, B focuses on the nurse's personal reflection, and D pertains to delivering educational content to a group rather than engaging in a one-on-one conversation with a client.

4. When a patient is diagnosed with major depressive disorder, which nursing diagnosis should be the priority?

• A. Imbalanced nutrition: less than body requirements
• B. Risk for suicide
• C. Disturbed sleep pattern
• D. Ineffective coping

Correct answer: B

Rationale: The priority nursing diagnosis for a patient diagnosed with major depressive disorder is 'Risk for suicide.' This is the priority as it addresses the immediate risk of self-harm in individuals suffering from major depressive disorder. Monitoring and intervening to prevent self-harm take precedence over other nursing diagnoses in this scenario.

5. When caring for a patient with dissociative identity disorder, which nursing intervention is a priority?

• A. Providing detailed education about the condition
• B. Monitoring for signs of self-harm or suicidal ideation
• C. Encouraging the patient to recall traumatic events
• D. Helping the patient develop a strong sense of identity

Correct answer: B

Rationale: When caring for a patient with dissociative identity disorder, the priority nursing intervention is to monitor for signs of self-harm or suicidal ideation. Ensuring patient safety is crucial, as individuals with this disorder may be at increased risk of self-harm or suicidal behaviors. Providing education about the condition is beneficial but ensuring immediate safety takes precedence. Encouraging the patient to recall traumatic events can be detrimental and should be done cautiously under professional guidance. While helping the patient develop a strong sense of identity is important in the long term, it is not the immediate priority when safety is a concern.

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