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. The school nurse has been alerted to the fact that an 8-year-old boy routinely playacts as a police officer, 'locking up' other children on the playground to the point where the children get scared. The nurse recognizes that this behavior is most likely an indication of:

• A. The need to dominate others
• B. Inventing traumatic events
• C. A need to develop close relationships
• D. A potential symptom of traumatization

Correct answer: D

Rationale: When an 8-year-old boy engages in playacting as a police officer that instills fear in other children, it can be indicative of a potential symptom of traumatization. This behavior may reflect the child's attempt to process or express experiences of trauma, leading to a manifestation of such distress in his play interactions with others.

3. What is the primary goal of eye movement desensitization and reprocessing (EMDR) when treating a patient with posttraumatic stress disorder (PTSD)?

• A. To help the patient confront and process traumatic memories
• B. To help the patient change negative thought patterns
• C. To help the patient develop relaxation techniques
• D. To help the patient avoid triggers

Correct answer: A

Rationale: The primary goal of eye movement desensitization and reprocessing (EMDR) in treating patients with posttraumatic stress disorder (PTSD) is to help them confront and process traumatic memories. EMDR uses bilateral stimulation to facilitate the processing of distressing memories, leading to their desensitization and reprocessing, ultimately reducing PTSD symptoms.

4. What assessment question will provide insight into the effects of a woman’s circadian rhythms on her quality of life?

• A. How much sleep do you usually get each night?
• B. Does your heart ever seem to skip a beat?
• C. When was the last time you had a fever?
• D. Do you have problems urinating?

Correct answer: A

Rationale: Inquiring about the amount of sleep a woman gets each night is crucial in understanding how her circadian rhythms may be affecting her quality of life. Circadian rhythms play a significant role in regulating sleep-wake cycles, and disruptions in these rhythms can impact overall well-being and quality of life.

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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