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. When a patient is diagnosed with major depressive disorder, which nursing diagnosis should be the priority?

• A. Imbalanced nutrition: less than body requirements
• B. Risk for suicide
• C. Disturbed sleep pattern
• D. Ineffective coping

Correct answer: B

Rationale: The priority nursing diagnosis for a patient diagnosed with major depressive disorder is 'Risk for suicide.' This is the priority as it addresses the immediate risk of self-harm in individuals suffering from major depressive disorder. Monitoring and intervening to prevent self-harm take precedence over other nursing diagnoses in this scenario.

3. When caring for a patient with dissociative identity disorder, which nursing intervention is a priority?

• A. Providing detailed education about the condition
• B. Monitoring for signs of self-harm or suicidal ideation
• C. Encouraging the patient to recall traumatic events
• D. Helping the patient develop a strong sense of identity

Correct answer: B

Rationale: When caring for a patient with dissociative identity disorder, the priority nursing intervention is to monitor for signs of self-harm or suicidal ideation. Ensuring patient safety is crucial, as individuals with this disorder may be at increased risk of self-harm or suicidal behaviors. Providing education about the condition is beneficial but ensuring immediate safety takes precedence. Encouraging the patient to recall traumatic events can be detrimental and should be done cautiously under professional guidance. While helping the patient develop a strong sense of identity is important in the long term, it is not the immediate priority when safety is a concern.

4. Which therapeutic approach is most effective for a patient with generalized anxiety disorder (GAD)?

• A. Psychoanalytic therapy
• B. Cognitive-behavioral therapy (CBT)
• C. Humanistic therapy
• D. Gestalt therapy

Correct answer: B

Rationale: Cognitive-behavioral therapy (CBT) is the most effective therapeutic approach for generalized anxiety disorder (GAD). CBT helps individuals identify and modify negative thought patterns and behaviors that contribute to anxiety. It focuses on changing cognitive distortions and maladaptive behaviors, providing practical strategies to manage anxiety symptoms effectively. Numerous studies have shown the effectiveness of CBT in treating GAD by helping patients develop coping mechanisms and skills to address their anxiety. Choice A, Psychoanalytic therapy, is not the most effective for GAD as it primarily focuses on exploring unconscious conflicts and childhood experiences rather than providing immediate coping strategies. Choice C, Humanistic therapy, emphasizes personal growth and self-improvement, which may not directly target the specific symptoms of GAD. Choice D, Gestalt therapy, focuses on increasing self-awareness and personal responsibility, which might not address the cognitive distortions and behavioral patterns associated with GAD as directly as CBT does.

5. 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.

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