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 therapeutic intervention is most appropriate for a patient diagnosed with dissociative amnesia?

• A. Cognitive-behavioral therapy
• B. Hypnotherapy
• C. Electroconvulsive therapy
• D. Pharmacotherapy

Correct answer: B

Rationale: Hypnotherapy is the most appropriate therapeutic intervention for a patient diagnosed with dissociative amnesia. This approach aims to help the patient recover lost memories in a controlled environment, allowing them to process and integrate their memories effectively. Hypnotherapy can assist in uncovering and addressing the underlying issues contributing to dissociative amnesia. Cognitive-behavioral therapy focuses on changing negative patterns of thinking or behavior and may not directly address memory recovery. Electroconvulsive therapy is typically used for severe depression or certain mental disorders, not dissociative amnesia. Pharmacotherapy involves medication and is not the primary intervention for dissociative amnesia.

3. In planning care for the termination phase of a nurse-client relationship, which of the following actions should the nurse include in the plan of care?

• A. Discussing ways to use new behaviors
• B. Practicing new problem-solving skills
• C. Developing goals
• D. Establishing boundaries

Correct answer: A

Rationale: During the termination phase of a nurse-client relationship, it is crucial to discuss ways to use new behaviors. This helps the client integrate and apply the skills and strategies they have acquired during the therapeutic process into their daily life. By focusing on the application of new behaviors, the client can maintain progress and continue to grow even after the professional relationship has ended. Practicing new problem-solving skills, developing goals, and establishing boundaries are important aspects of the therapeutic process but are more commonly addressed in earlier phases of the nurse-client relationship. Therefore, the correct action to include in the plan of care during the termination phase is discussing ways to use new behaviors.

4. A community mental health nurse is planning care to address the issue of depression among older adult clients in the community. Which of the following interventions should the nurse implement as a method of tertiary prevention?

• A. Educating clients on health promotion techniques to reduce the risk of depression
• B. Performing screenings for depression at community health programs
• C. Establishing rehabilitation programs to decrease the effects of depression
• D. Providing support groups for clients at risk for depression

Correct answer: C

Rationale: Establishing rehabilitation programs to decrease the effects of depression is a method of tertiary prevention.

5. A 32-year-old female patient is diagnosed with generalized anxiety disorder (GAD). Which behavior would the nurse expect to observe?

• A. Complains of persistent and excessive worry.
• B. Frequently fidgets and has difficulty sitting still.
• C. Exhibits ritualistic behaviors.
• D. Reports periods of derealization.

Correct answer: A

Rationale: In generalized anxiety disorder (GAD), individuals often experience persistent and excessive worry about various aspects of their life. This worry is difficult to control and is disproportionate to the actual source of concern. The other options describe behaviors more commonly associated with other anxiety disorders like social anxiety disorder (frequent fidgeting and difficulty sitting still), obsessive-compulsive disorder (ritualistic behaviors), and depersonalization/derealization disorder (periods of derealization). Therefore, the correct behavior to expect in a patient with GAD is persistent and excessive worry.

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