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 of the following interventions is most effective in managing a patient with obsessive-compulsive disorder (OCD)?

• A. Encouraging the patient to engage in repetitive behaviors.
• B. Helping the patient to understand that their thoughts are irrational.
• C. Providing the patient with a structured daily routine.
• D. Allowing the patient to avoid situations that trigger their obsessions.

Correct answer: B

Rationale: The most effective intervention in managing a patient with obsessive-compulsive disorder (OCD) is helping the patient to understand that their thoughts are irrational. This cognitive-behavioral approach can assist in reducing the frequency and intensity of obsessive thoughts and compulsive behaviors by challenging and reframing maladaptive beliefs and thought patterns associated with OCD. Encouraging the patient to engage in repetitive behaviors (choice A) reinforces the compulsive behavior rather than addressing the underlying issue. Providing a structured daily routine (choice C) may help in some cases but does not directly target the irrational thoughts and beliefs. Allowing the patient to avoid trigger situations (choice D) can provide temporary relief but does not address the core problem of irrational thoughts and behaviors.

3. Which of the following is an example of a cognitive-behavioral therapy (CBT) technique?

• A. Free association
• B. Thought stopping
• C. Dream analysis
• D. Systematic desensitization

Correct answer: B

Rationale: Thought stopping is a specific cognitive-behavioral therapy (CBT) technique aimed at helping individuals manage and interrupt negative or intrusive thoughts. This technique involves identifying and stopping negative thought patterns to promote healthier thinking and emotional well-being. Free association and dream analysis are associated with psychoanalytic therapy, while systematic desensitization is a technique commonly used in behavior therapy.

4. A patient with borderline personality disorder is admitted to the psychiatric unit. Which behavior is most characteristic of this disorder?

• A. Avoiding social interactions due to fear of rejection.
• B. Engaging in impulsive and self-destructive behaviors.
• C. Having a grandiose sense of self-importance.
• D. Exhibiting a pattern of unstable relationships.

Correct answer: B

Rationale: Borderline personality disorder is characterized by impulsivity and self-destructive behaviors, such as substance abuse, reckless driving, and self-harm. These behaviors are often used to cope with intense emotional distress and are a key feature of this disorder. While individuals with borderline personality disorder may also struggle with unstable relationships, the hallmark feature that sets it apart is the impulsivity and self-destructive behaviors. Avoiding social interactions due to fear of rejection is more characteristic of avoidant personality disorder. Having a grandiose sense of self-importance is a feature of narcissistic personality disorder.

5. Which symptom is most indicative of obsessive-compulsive disorder (OCD)?

• A. Flashbacks of traumatic events
• B. Persistent, intrusive thoughts
• C. Frequent mood swings
• D. Auditory hallucinations

Correct answer: B

Rationale: Persistent, intrusive thoughts are a hallmark symptom of obsessive-compulsive disorder. Individuals with OCD experience persistent and unwanted thoughts or obsessions that are intrusive and cause significant distress. These thoughts often lead to repetitive behaviors or compulsions to try to alleviate the anxiety or distress caused by the obsessions. Flashbacks of traumatic events (Choice A), frequent mood swings (Choice C), and auditory hallucinations (Choice D) are not typical symptoms of OCD. Flashbacks are more commonly associated with post-traumatic stress disorder, mood swings can be seen in mood disorders, and auditory hallucinations are more characteristic of psychotic disorders.

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