Nursing Elites

1. A nursing student new to psychiatric-mental health nursing asks a peer what resources he can use to identify the symptoms present in a specific psychiatric disorder. The best answer would be:

• A. Nursing Interventions Classification (NIC)
• B. Nursing Outcomes Classification (NOC)
• C. NANDA-I nursing diagnoses
• D. DSM-5

Correct answer: D

Rationale: The DSM-5 is the standard classification of mental disorders used by mental health professionals in the U.S. It provides criteria for diagnosing different psychiatric disorders based on symptoms and clinical observations. Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC) are focused on nursing interventions and outcomes, respectively, while NANDA-I nursing diagnoses are related to identifying nursing problems and their contributing factors.

2. A patient presents in the Emergency Department immediately following a shooting incident in a school where she has been teaching. There is no evidence of physical injury, but she appears very hyperactive and talkative. Which of these symptoms manifested by the patient is an uncommon initial biological response to stress?

• A. Constricted pupils
• B. Watery eyes
• C. Palpitations
• D. Increased heart rate

Correct answer: A

Rationale: Increased lacrimal secretions, palpitations, and increased heart rate are common initial biological responses to stress. Constricted pupils are not typical in the initial response to stress and are more associated with the opposite response, the Rest and Digest system. Watery eyes, palpitations, and increased heart rate are indicative of the body's fight or flight response to stress. Unusual food cravings are not a typical biological response to stress.

3. In the treatment of a patient with obsessive-compulsive disorder (OCD) using cognitive-behavioral therapy (CBT), which specific type of CBT is most effective?

• A. Dialectical behavior therapy
• B. Exposure and response prevention
• C. Interpersonal therapy
• D. Supportive therapy

Correct answer: B

Rationale: Exposure and response prevention (ERP) is a specific type of CBT that is considered the most effective treatment for OCD. ERP involves exposing the individual to anxiety-provoking stimuli and preventing the usual compulsive responses, leading to a decreased anxiety response over time. This type of therapy helps individuals learn to tolerate the anxiety triggered by obsessions without engaging in compulsions, ultimately reducing OCD symptoms. Choices A, C, and D are incorrect. Dialectical behavior therapy (Choice A) is more commonly used for treating conditions like borderline personality disorder, not OCD. Interpersonal therapy (Choice C) focuses on improving interpersonal relationships and communication skills, which is not the primary approach for OCD. Supportive therapy (Choice D) provides emotional support and guidance but is not as effective as ERP in treating OCD.

4. A healthcare professional is assessing a client who is experiencing severe anxiety. Which of the following symptoms should the healthcare professional expect to observe?

• A. Restlessness
• B. Rapid heart rate
• C. Sweating
• D. Dry mouth

Correct answer: B

Rationale: Rapid heart rate is a characteristic symptom of severe anxiety due to the body's fight-or-flight response being activated. This physiological response leads to an increased heart rate to prepare the body to deal with perceived threats. Healthcare professionals should be vigilant in monitoring and managing this symptom in clients experiencing severe anxiety.

5. 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.

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