Nursing Elites

1. A client is being taught relaxation techniques to manage anxiety. Which of the following techniques should the instructor include in the teaching? Select one that doesn't apply.

• A. Deep breathing exercises
• B. Progressive muscle relaxation
• C. Mindfulness meditation
• D. Cognitive restructuring

Correct answer: D

Rationale: Relaxation techniques commonly used to manage anxiety include deep breathing exercises, progressive muscle relaxation, mindfulness meditation, and guided imagery. Cognitive restructuring, on the other hand, is a cognitive-behavioral technique aimed at identifying and changing negative thought patterns rather than a specific relaxation technique. Therefore, cognitive restructuring does not fall under the category of relaxation techniques and is not typically used to manage anxiety.

2. A healthcare provider is assessing a client with suspected bipolar disorder. Which of the following findings should the healthcare provider expect? Select one that does not apply.

• A. Periods of elevated mood
• B. Decreased need for sleep
• C. Flight of ideas
• D. Anhedonia

Correct answer: D

Rationale: Findings in a client with bipolar disorder typically include periods of elevated mood, decreased need for sleep, and flight of ideas. Anhedonia, characterized by the inability to experience pleasure, is more commonly associated with major depressive disorder. Therefore, the healthcare provider should not expect anhedonia in a client with suspected bipolar disorder. The other choices are characteristic features of bipolar disorder, such as mania or hypomania.

3. A patient with agoraphobia is unable to leave home. Which intervention should the nurse prioritize?

• A. Teach the patient relaxation techniques.
• B. Gradual exposure to feared situations.
• C. Encourage the patient to attend social gatherings.
• D. Provide education about the disorder.

Correct answer: B

Rationale: For a patient with agoraphobia, the priority intervention should be gradual exposure to feared situations. This approach helps the patient confront and gradually overcome their fear of leaving home, a common challenge in agoraphobia. By exposing the patient to feared situations in a step-by-step manner, they can learn to manage their anxiety and increase their confidence in leaving home. Teaching relaxation techniques (Choice A) can be beneficial but may not address the core issue of avoidance behavior. Encouraging the patient to attend social gatherings (Choice C) can be overwhelming and counterproductive at the initial stage of treatment. Providing education about the disorder (Choice D) is important but should come after addressing the immediate need for exposure therapy.

4. A client with bipolar disorder is experiencing a manic episode. Which of the following interventions should the nurse implement? Select one that does not apply.

• A. Provide a structured environment
• B. Encourage rest periods
• C. Limit setting on inappropriate behaviors
• D. Allow the client to engage in stimulating activities

Correct answer: D

Rationale: During a manic episode, it is essential to provide a structured environment to help the client maintain stability. Encouraging rest periods is crucial as excessive activity during mania can lead to exhaustion. Setting limits on inappropriate behaviors helps ensure the client's safety and the safety of others. Allowing the client to engage in stimulating activities can exacerbate manic symptoms by further increasing their energy levels and impulsivity. This can lead to a worsening of the manic episode and potentially risky behaviors. Therefore, allowing the client to engage in stimulating activities is not an appropriate intervention during a manic episode.

5. A patient with generalized anxiety disorder (GAD) is prescribed escitalopram. The nurse should educate the patient that the full therapeutic effect of this medication may take:

• A. 1-2 days
• B. 1-2 weeks
• C. 2-4 weeks
• D. 6-8 weeks

Correct answer: D

Rationale: Escitalopram, an SSRI used in treating generalized anxiety disorder, typically takes 6-8 weeks to achieve its full therapeutic effect. While some improvement may be noticed earlier, the maximum benefit is usually experienced after this timeframe. Options A, B, and C are incorrect because they underestimate the time required for escitalopram to reach its full effectiveness. Educating patients about the realistic timeline for medication effectiveness is crucial in managing expectations and ensuring adherence to the prescribed treatment.

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