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. 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.

3. A patient with generalized anxiety disorder is being taught about buspirone. Which statement indicates the patient needs further teaching?

• A. I should take this medication consistently rather than on an as-needed basis.
• B. It may take a few weeks to feel the full effect of this medication.
• C. This medication has a lower risk of dependency compared to benzodiazepines.
• D. I should avoid drinking alcohol while taking this medication.

Correct answer: A

Rationale: The correct answer is A because buspirone is not meant to be taken on an as-needed basis. It should be taken consistently to achieve optimal effectiveness in managing generalized anxiety disorder. Taking it as needed may lead to inadequate symptom control and reduced therapeutic benefits.

4. Which of the following medications is commonly used to treat panic disorder?

• A. Lithium
• B. Diazepam
• C. Haloperidol
• D. Clozapine

Correct answer: B

Rationale: Diazepam, a benzodiazepine, is commonly used to treat panic disorder due to its anxiolytic effects. It helps reduce feelings of anxiety and panic by acting on the central nervous system. Lithium is primarily used for bipolar disorder, while Haloperidol and Clozapine are antipsychotic medications used for conditions like schizophrenia. Therefore, the correct choice for treating panic disorder among the options provided is Diazepam.

5. Carolina is surprised when her patient does not show for a regularly scheduled appointment. When contacted, the patient states, ‘I don’t need to come see you anymore. I have found a therapy app on my phone that I love.’ How should Carolina respond to this news?

• A. That sounds exciting; would you be willing to visit and show me the app?
• B. At this time, there is no real evidence that the app can replace our therapy.
• C. I am not sure that is a good idea right now; we are so close to progress.
• D. Why would you think that is a better option than meeting with me?

Correct answer: A

Rationale: Carolina should respond with openness and curiosity to maintain a positive therapeutic relationship. By showing interest in the patient's new therapy method and inviting them to share the app, Carolina demonstrates a willingness to explore alternative approaches while also ensuring the patient feels heard and valued in their decision-making process. Choice B is incorrect because it dismisses the patient's choice without exploring it further. Choice C focuses more on Carolina's concerns rather than engaging with the patient's decision. Choice D comes off as defensive and may make the patient feel misunderstood or judged.

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