Nursing Elites

1. During a panic attack, what is the most appropriate nursing intervention?

• A. Encourage the patient to talk about their feelings.
• B. Provide a quiet, non-stimulating environment.
• C. Administer prescribed medication immediately.
• D. Teach the patient relaxation techniques.

Correct answer: B

Rationale: During a panic attack, a quiet, non-stimulating environment is the most appropriate nursing intervention. This helps reduce stimuli that may exacerbate the panic attack and allows the individual to focus on calming down. Encouraging the patient to talk about their feelings may not be effective during an acute panic attack as the focus should be on reducing stimuli. Administering medication should follow healthcare provider's orders and may not be the initial intervention. Teaching relaxation techniques is beneficial in managing anxiety but may not be the priority during the acute phase of a panic attack where reducing stimuli is crucial.

2. In schizophrenia, a patient is experiencing negative symptoms. Which of the following is a negative symptom?

• A. Hallucinations
• B. Delusions
• C. Apathy
• D. Disorganized speech

Correct answer: C

Rationale: In schizophrenia, negative symptoms refer to deficits in normal emotional responses or other thought processes. Apathy is a negative symptom characterized by a lack of interest, enthusiasm, or concern. Hallucinations (seeing or hearing things that aren't there), delusions (false beliefs), and disorganized speech are positive symptoms, which involve the presence of abnormal behaviors or thoughts.

3. A nurse hears a newly licensed nurse discussing a client’s hallucinations in the hallway with another nurse. Which of the following actions should the nurse take first?

• A. Notify the nurse manager
• B. Tell the nurse to stop discussing the behavior
• C. Provide an in-service program about confidentiality
• D. Complete an incident report

Correct answer: B

Rationale: The correct action the nurse should take first in this situation is to tell the newly licensed nurse to stop discussing the client's hallucinations with another nurse. Maintaining client confidentiality is a critical aspect of nursing practice. By addressing the behavior immediately, the nurse helps prevent the inappropriate sharing of sensitive information about a client. Choice A is not the first action to take because addressing the behavior directly is more immediate and can prevent further breaches of confidentiality. Choice C is not the priority at this moment as immediate action is required to address the current situation. Choice D, completing an incident report, should come after addressing the immediate issue and ensuring that the inappropriate behavior ceases.

4. A 33-year-old female diagnosed with bipolar I disorder has been functioning well on lithium for 11 months. At her most recent checkup, the psychiatric nurse practitioner states, ‘You are ready to enter the maintenance therapy stage, so at this time I am going to adjust your dosage by prescribing:'

• A. A higher dosage
• B. Once-a-week dosing
• C. A lower dosage
• D. A different drug

Correct answer: C

Rationale: As the patient transitions to maintenance therapy, the typical approach involves decreasing the dosage to a lower level. This adjustment is made to find the minimum effective dose needed for symptom control while reducing the potential side effects associated with long-term use. Choosing a higher dosage (A) would not align with the goal of maintenance therapy, as it may increase the risk of adverse effects. Once-a-week dosing (B) is not a common adjustment for lithium, which is usually prescribed daily for bipolar disorder. Switching to a different drug (D) is typically considered if the current medication is ineffective or intolerable, not as a routine step in transitioning to maintenance therapy.

5. A client is discussing free associations as a therapeutic tool with a nurse. Which of the following client statements indicates an understanding of this technique?

• A. “I will write down my dreams as soon as I wake up.”
• B. “I might begin to associate my therapist with important people in my life.”
• C. “I can learn to express myself in a nonaggressive manner.”
• D. “I should say the first thing that comes to my mind.”

Correct answer: D

Rationale: Free association is a psychoanalytic technique where the client is encouraged to say the first thing that comes to their mind without censoring or filtering. This technique helps uncover unconscious thoughts and emotions. Choice D, “I should say the first thing that comes to my mind,” indicates an understanding of free association as it aligns with the principle of allowing thoughts to flow freely without inhibition. Choices A, B, and C do not reflect an understanding of free association and its purpose, making them incorrect. A, focusing on writing down dreams, does not relate to the immediate expression of thoughts. B, associating the therapist with important people, and C, learning to express oneself nonaggressively, do not capture the essence of free association as a technique for exploring unconscious processes.

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