Nursing Elites

1. A patient with agoraphobia has difficulty leaving their home. Which nursing intervention would be most effective?

• A. Encourage the patient to make small, gradual steps outside the home.
• B. Advise the patient to avoid crowded places.
• C. Suggest that the patient focus on their breathing when anxious.
• D. Provide the patient with information about support groups.

Correct answer: A

Rationale: Encouraging the patient to make small, gradual steps outside the home is the most effective nursing intervention for agoraphobia. This approach helps the patient confront their fear gradually and build confidence in managing their symptoms. By taking small steps, the patient can start to expand their comfort zone and reduce anxiety associated with leaving their home, ultimately aiding in their recovery and increasing their independence. Choices B, C, and D are not as effective as choice A. Advising the patient to avoid crowded places does not address the underlying issue of agoraphobia. Suggesting that the patient focus on their breathing when anxious may help manage immediate symptoms but does not address the fear of leaving home. Providing information about support groups is beneficial but may not directly address the patient's difficulty leaving their home.

2. After a severe automobile accident, Mr. and Mrs. Johnson were brought to the hospital. Mrs. Johnson is unable to remember anything about the accident or the two days preceding it. The nurse recognizes this as:

• A. Generalized amnesia
• B. Localized amnesia
• C. Selective amnesia
• D. Continuous amnesia

Correct answer: B

Rationale: Localized amnesia refers to an inability to recall specific events, often traumatic, within a particular time frame. In this case, Mrs. Johnson's memory loss about the accident and the preceding two days aligns with the characteristics of localized amnesia. Generalized amnesia involves a more extensive memory loss, often encompassing a person's entire life, which is not the case here. Selective amnesia involves forgetting specific details but not a whole chunk of time like in this scenario. Continuous amnesia is not a recognized term in psychology.

3. What principle about patient communication should guide a nurse's fear of 'saying the wrong thing' to a patient?

• A. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation.
• B. Patients are more interested in talking to you than listening to what you have to say, so they are not likely to be offended.
• C. Considering the patient's history, there is little chance that the comment will do any actual harm.
• D. Most people with a mental illness have, by necessity, developed a high tolerance for forgiveness.

Correct answer: A

Rationale: Effective patient communication is guided by the principle that patients value genuine acceptance, respect, and concern from their caregivers. This approach helps to build trust and fosters effective communication, enhancing the nurse-patient relationship. Choice B is incorrect because patients value both talking and listening in effective communication. Choice C is incorrect because a nurse should always consider the impact of their words on the patient, regardless of the patient's history. Choice D is incorrect as it generalizes about people with mental illness and forgiveness, which is not directly relevant to patient communication.

4. Luc’s family comes home one evening to find him extremely agitated, and they suspect he is in a full manic episode. The family calls emergency medical services. While one medic is talking with Luc and his family, the other medic is counting something on his desk. What is the medic most likely counting?

• A. Hypodermic needles
• B. Fast food wrappers
• C. Empty soda cans
• D. Energy drink containers

Correct answer: D

Rationale: The medic is most likely counting energy drink containers. Energy drink containers could indicate high caffeine intake, which can exacerbate manic episodes by increasing agitation and exacerbating symptoms in individuals with mood disorders.

5. While being treated in an inpatient facility, what is the most appropriate intervention for a patient with anorexia nervosa?

• A. Allowing the patient to eat alone to reduce stress
• B. Monitoring the patient's weight daily
• C. Encouraging the patient to exercise daily
• D. Providing the patient with a high-calorie diet

Correct answer: B

Rationale: Monitoring the patient's weight daily is the most appropriate intervention for a patient with anorexia nervosa being treated in an inpatient facility. This approach helps healthcare providers track the patient's progress, assess nutritional status, and promptly identify any concerning changes or trends that may require intervention.

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