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

• A. The patient will experience no episodes of anxiety within the next week.
• B. The patient will learn and practice relaxation techniques.
• C. The patient will avoid all anxiety-provoking situations.
• D. The patient will be medication-free within a month.

Correct answer: B

Rationale: Option B, 'The patient will learn and practice relaxation techniques,' is the most appropriate short-term goal for managing generalized anxiety disorder. Teaching relaxation techniques can help the patient develop coping mechanisms and reduce anxiety levels in the immediate future, making it a realistic and beneficial goal. Options A and C are not feasible in the short term as complete elimination of anxiety episodes or avoidance of all anxiety-provoking situations may not be achievable or practical within a week. Option D is not a suitable short-term goal as it overlooks the potential need for medication in managing generalized anxiety disorder.

3. A patient is receiving education about dietary restrictions while taking a monoamine oxidase inhibitor (MAOI). Which food should the patient avoid?

• A. Aged cheese
• B. Fresh vegetables
• C. Grilled chicken
• D. Fruit juices

Correct answer: A

Rationale: Patients taking MAOIs should avoid aged cheese as it contains high levels of tyramine, which can lead to a hypertensive crisis. Monoamine oxidase inhibitors can inhibit the breakdown of tyramine, leading to an excess accumulation in the body and potentially dangerous increases in blood pressure.

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. 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.

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