Nursing Elites

1. A nurse is providing education to a patient newly prescribed buspirone for generalized anxiety disorder (GAD). Which statement by the patient indicates a need for further teaching?

• A. I can take this medication as needed for immediate relief of anxiety.
• B. It may take several weeks before I notice the full effects of the medication.
• C. I should avoid drinking alcohol while taking this medication.
• D. This medication is less likely to make me drowsy compared to other anxiety medications.

Correct answer: A

Rationale: Buspirone is not for immediate relief of anxiety

2. Which patient statement suggests the presence of dissociative amnesia?

• A. I keep forgetting where I put my keys.
• B. I don’t remember the accident that brought me here or the past two days.
• C. Sometimes I feel like I’m watching myself from outside my body.
• D. I often lose track of time when I’m reading.

Correct answer: B

Rationale: The correct answer is B because the statement reflects a significant gap in memory related to a traumatic event, which is characteristic of dissociative amnesia. Choice A is more indicative of normal forgetfulness and absentmindedness. Choice C suggests depersonalization or dissociative identity disorder rather than dissociative amnesia. Choice D describes a common experience related to concentration while reading, not memory loss as seen in dissociative amnesia.

3. In an acute mental health facility, a nurse is communicating with a client. The client states, “I can’t sleep. I stay up all night.” The nurse responds, “You are having difficulty sleeping?” Which of the following therapeutic communication techniques is the nurse demonstrating?

• A. Offering general leads
• B. Summarizing
• C. Focusing
• D. Restating

Correct answer: D

Rationale: The nurse is using the restating technique, where the nurse paraphrases or repeats the main idea expressed by the client to show understanding and encourage further communication. Restating helps clarify the client's message and fosters a therapeutic relationship. Choice A, offering general leads, involves encouraging the client to continue talking with nonverbal or minimal verbal prompts. Summarizing (Choice B) involves condensing and organizing the client's message. Focusing (Choice C) involves centering the conversation on a key element or topic.

4. In cognitive processing therapy for PTSD, what is the primary goal for the patient?

• A. To help the patient process the trauma and reduce avoidance behaviors.
• B. To help the patient confront and process the trauma in a safe environment.
• C. To help the patient understand the impact of the trauma on their current thoughts and behaviors.
• D. To help the patient avoid triggers that remind them of the trauma.

Correct answer: C

Rationale: The primary goal of cognitive processing therapy for PTSD is to help the patient understand the impact of the trauma on their current thoughts and behaviors. Through this therapy, individuals learn to identify and challenge maladaptive beliefs related to the traumatic event, ultimately helping them to process the trauma and develop healthier coping mechanisms. This approach aims to address the cognitive distortions and negative thoughts that have resulted from the trauma, facilitating healing and recovery.

5. Carolina is surprised when her patient does not show for a regularly scheduled appointment. When contacted, the patient states, “I don’t need to come see you anymore. I have found a therapy app on my phone that I love.” How should Carolina respond to this news?

• A. That sounds exciting; would you be willing to visit and show me the app?
• B. At this time, there is no real evidence that the app can replace our therapy.
• C. I am not sure that is a good idea right now; we are so close to progress.
• D. Why would you think that is a better option than meeting with me?

Correct answer: A

Rationale: Carolina should respond by showing interest in the app, as it can help maintain the therapeutic relationship and provide an opportunity to evaluate the app's effectiveness together. By asking the patient to visit and show the app, Carolina demonstrates openness to exploring new tools that the patient finds helpful, while also ensuring that the patient's well-being remains a priority. This approach fosters communication, allows for a collaborative discussion on how the app fits into the patient's treatment plan, and may potentially address any concerns or misconceptions the patient has about the app replacing traditional therapy.

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