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. Which medication is commonly used to treat obsessive-compulsive disorder (OCD)?

• A. Lorazepam
• B. Fluoxetine
• C. Lithium
• D. Haloperidol

Correct answer: B

Rationale: The correct answer is Fluoxetine (Choice B). Fluoxetine, an SSRI (Selective Serotonin Reuptake Inhibitor), is commonly used in the treatment of obsessive-compulsive disorder (OCD). SSRIs like Fluoxetine are considered first-line medications for managing OCD symptoms by helping to increase serotonin levels in the brain, which plays a role in mood regulation and anxiety reduction. Choice A, Lorazepam, is a benzodiazepine primarily used for anxiety disorders but is not a first-line treatment for OCD. Choice C, Lithium, is typically used in conditions like bipolar disorder, not OCD. Choice D, Haloperidol, is an antipsychotic medication and is not commonly used to treat OCD.

3. When developing a care plan for a patient with generalized anxiety disorder (GAD), which long-term goal is most appropriate?

• A. The patient will experience no episodes of anxiety.
• B. The patient will recognize and modify anxiety-provoking thoughts.
• C. The patient will avoid situations that cause anxiety.
• D. The patient will take medication as prescribed.

Correct answer: B

Rationale: The most appropriate long-term goal for managing generalized anxiety disorder is for the patient to recognize and modify anxiety-provoking thoughts. By addressing and modifying these thoughts, the patient can develop coping mechanisms and strategies to manage their anxiety more effectively in the long term. Choices A and C are not ideal long-term goals as complete elimination of anxiety episodes or avoidance of anxiety-provoking situations may not be realistic or sustainable. Choice D focuses solely on medication adherence, which is important but does not address the core cognitive-behavioral aspects of managing anxiety in GAD.

4. A healthcare provider is assessing a patient with generalized anxiety disorder (GAD). Which symptom would be most indicative of this disorder?

• A. Frequent nightmares
• B. Persistent worrying about multiple issues
• C. Excessive sleeping
• D. Loss of interest in daily activities

Correct answer: B

Rationale: Persistent worrying about multiple issues is a hallmark symptom of generalized anxiety disorder (GAD). Individuals with GAD often experience excessive, uncontrollable worry about various aspects of their life, such as work, relationships, and health. This persistent and excessive worrying distinguishes GAD from normal everyday concerns and is a defining feature of the disorder. Frequent nightmares (Choice A) are more commonly associated with conditions like post-traumatic stress disorder (PTSD) rather than GAD. Excessive sleeping (Choice C) is not a typical symptom of GAD, as individuals with GAD often experience difficulty falling or staying asleep due to their anxious thoughts. Loss of interest in daily activities (Choice D) is more characteristic of conditions like depression rather than GAD.

5. In an outpatient mental health clinic, a nurse is preparing to conduct an initial client interview. Which of the following actions should the nurse identify as a priority?

• A. Coordinate holistic care with social services
• B. Identify the client’s perception of their mental health status
• C. Include the client’s family in the interview
• D. Educate the client about their current mental health disorder

Correct answer: B

Rationale: During an initial client interview in a mental health clinic, it is essential for the nurse to prioritize identifying the client’s perception of their mental health status. Understanding how the client views their mental health can provide valuable insights into their condition, concerns, and needs, facilitating the development of a tailored and effective care plan. Coordinating holistic care with social services, including the client’s family in the interview, and educating the client about their current mental health disorder are important aspects of care but may not be the priority during the initial interview, where understanding the client's own perspective is crucial.

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