Nursing Elites

1. A patient is receiving education about dietary restrictions while taking a monoamine oxidase inhibitor (MAOI). Which food should the patient avoid?

• A. Aged cheese
• B. Fresh vegetables
• C. Grilled chicken
• D. Fruit juices

Correct answer: A

Rationale: Patients taking MAOIs should avoid aged cheese as it contains high levels of tyramine, which can lead to a hypertensive crisis. Monoamine oxidase inhibitors can inhibit the breakdown of tyramine, leading to an excess accumulation in the body and potentially dangerous increases in blood pressure.

2. What is the priority nursing intervention for a patient experiencing a panic attack?

• A. Encouraging the patient to focus on deep breathing exercises.
• B. Encouraging the patient to avoid any physical activity.
• C. Asking the patient to describe their feelings in detail.
• D. Providing the patient with detailed information about panic attacks.

Correct answer: A

Rationale: The priority nursing intervention for a patient experiencing a panic attack is to encourage them to focus on deep breathing exercises. This intervention helps the patient manage the physiological symptoms of a panic attack by promoting relaxation and reducing hyperventilation, which are common during such episodes. Deep breathing exercises can help regulate breathing patterns and alleviate feelings of anxiety and panic.

3. A 32-year-old female patient is diagnosed with generalized anxiety disorder (GAD). Which behavior would the nurse expect to observe?

• A. Complains of persistent and excessive worry.
• B. Frequently fidgets and has difficulty sitting still.
• C. Exhibits ritualistic behaviors.
• D. Reports periods of derealization.

Correct answer: A

Rationale: In generalized anxiety disorder (GAD), individuals often experience persistent and excessive worry about various aspects of their life. This worry is difficult to control and is disproportionate to the actual source of concern. The other options describe behaviors more commonly associated with other anxiety disorders like social anxiety disorder (frequent fidgeting and difficulty sitting still), obsessive-compulsive disorder (ritualistic behaviors), and depersonalization/derealization disorder (periods of derealization). Therefore, the correct behavior to expect in a patient with GAD is persistent and excessive worry.

4. A client is undergoing systematic desensitization for an extreme fear of elevators. Which of the following actions should be implemented with this form of therapy?

• A. Demonstrate riding in an elevator, then ask the client to imitate the behavior.
• B. Advise the client to say “stop” out loud every time they begin to feel an anxiety response related to an elevator.
• C. Gradually expose the client to an elevator while practicing relaxation techniques.
• D. Stay with the client in an elevator until the anxiety response diminishes.

Correct answer: C

Rationale: Systematic desensitization is a type of therapy used to help individuals overcome phobias or anxieties. It involves gradually exposing the client to the feared object or situation, in this case, an elevator, while simultaneously practicing relaxation techniques. This process helps the client associate relaxation with the previously feared stimulus, gradually reducing anxiety levels over time. Choice A is incorrect as it involves imitation rather than gradual exposure. Choice B is incorrect as it focuses on a verbal response rather than the systematic process of exposure and relaxation. Choice D is incorrect as it does not involve the systematic approach of gradually exposing the client while teaching relaxation techniques.

5. A patient with borderline personality disorder is admitted to the psychiatric unit. Which behavior is most characteristic of this disorder?

• A. Avoiding social interactions due to fear of rejection.
• B. Engaging in impulsive and self-destructive behaviors.
• C. Having a grandiose sense of self-importance.
• D. Exhibiting a pattern of unstable relationships.

Correct answer: B

Rationale: Borderline personality disorder is characterized by impulsivity and self-destructive behaviors, such as substance abuse, reckless driving, and self-harm. These behaviors are often used to cope with intense emotional distress and are a key feature of this disorder. While individuals with borderline personality disorder may also struggle with unstable relationships, the hallmark feature that sets it apart is the impulsivity and self-destructive behaviors. Avoiding social interactions due to fear of rejection is more characteristic of avoidant personality disorder. Having a grandiose sense of self-importance is a feature of narcissistic personality disorder.

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