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. Which patient behavior is consistent with therapeutic communication?

• A. Offering your opinion when asked to provide support.
• B. Summarizing the essence of the patient’s comments in your own words.
• C. Avoiding interrupting periods of silence to allow the patient space to think.
• D. Providing positive reinforcement when the patient expresses themselves.

Correct answer: B

Rationale: Summarizing the essence of the patient’s comments in your own words is a key component of therapeutic communication. This behavior demonstrates active listening, ensures understanding of the patient's message, and encourages further discussion. By summarizing, you show the patient that you are engaged and interested, which helps them feel heard and valued. Offering your opinion (choice A) may bias the patient's thoughts and feelings, interrupting periods of silence (choice C) may prevent the patient from processing their thoughts, and providing positive reinforcement (choice D) may not always be appropriate or necessary in therapeutic communication.

3. James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for the day shift and anxiously reports, “Last night, demons came to my room and tried to rape me.” Which response would be most therapeutic?

• A. There are no such things as demons. What you saw were hallucinations.
• B. It is not possible for anyone to enter your room at night. You are safe here.
• C. You seem very upset. Please tell me more about what you experienced last night.
• D. That must have been very frightening, but we’ll check on you at night and you’ll be safe.

Correct answer: C

Rationale: The most therapeutic response acknowledges the patient's emotional state and invites further discussion about their experience. By saying, 'You seem very upset. Please tell me more about what you experienced last night,' the nurse shows empathy and openness, providing a supportive environment for the patient to express their feelings and perceptions.

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

• A. Encourage the patient to talk about their feelings.
• B. Provide a safe, calm environment.
• C. Administer prescribed anti-anxiety medication.
• D. Teach the patient deep breathing exercises.

Correct answer: B

Rationale: The priority nursing intervention for a patient experiencing a panic attack is to provide a safe, calm environment. This action is crucial as it helps reduce the patient's anxiety and creates a sense of security, which can aid in managing the panic attack effectively. Encouraging the patient to talk about their feelings, administering medication, or teaching deep breathing exercises can be beneficial interventions, but creating a safe and calm environment takes precedence in addressing the immediate needs of the patient during a panic attack.

5. In treating PTSD, which type of therapy is most commonly recommended?

• A. Cognitive-behavioral therapy (CBT)
• B. Psychoanalytic therapy
• C. Humanistic therapy
• D. Gestalt therapy

Correct answer: A

Rationale: Cognitive-behavioral therapy (CBT) is the most commonly recommended therapy for PTSD due to its effectiveness in helping patients identify and change negative thoughts and behaviors associated with trauma. This therapy focuses on providing practical coping strategies to manage symptoms and process traumatic experiences. Psychoanalytic therapy, humanistic therapy, and gestalt therapy are less commonly used for PTSD as they may not target the specific symptoms and cognitive distortions associated with this disorder.

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