Nursing Elites

1. A patient with generalized anxiety disorder (GAD) is prescribed buspirone. The nurse understands that buspirone is different from benzodiazepines because it:

• A. Has a high potential for abuse.
• B. Works immediately to relieve anxiety.
• C. Does not cause sedation.
• D. Is used for short-term treatment only.

Correct answer: C

Rationale: Buspirone is different from benzodiazepines because it does not cause sedation. Unlike benzodiazepines, buspirone has a lower potential for abuse and does not cause the sedative effects commonly seen with benzodiazepines. While benzodiazepines may work immediately to relieve anxiety, buspirone may take longer to show its therapeutic effects. Additionally, buspirone is not limited to short-term treatment only, making it a preferred choice in patients where sedation is a concern or in those with a history of substance abuse.

2. A client with schizophrenia is experiencing auditory hallucinations. Which nursing intervention is most appropriate to address this symptom?

• A. Encourage the client to discuss the voices.
• B. Instruct the client to listen to music to drown out the voices.
• C. Tell the client that the voices are not real.
• D. Distract the client from the voices.

Correct answer: A

Rationale: Encouraging the client to discuss the voices is the most appropriate nursing intervention when a client with schizophrenia is experiencing auditory hallucinations. By discussing the voices, the client can feel heard, understood, and supported. It allows the client to express their experiences, which can help in processing and coping with the hallucinations. This intervention promotes therapeutic communication and builds a trusting nurse-client relationship, which is essential in providing effective care for individuals with schizophrenia. Choice B is incorrect because instructing the client to listen to music to drown out the voices does not address the underlying issue and may not be effective in managing auditory hallucinations. Choice C is incorrect because telling the client that the voices are not real can invalidate the client's experiences and feelings, leading to further distress. Choice D is incorrect as solely distracting the client from the voices does not help in addressing the hallucinations or supporting the client in dealing with their symptoms.

3. A nursing instructor is teaching a group of students about intimate partner violence. Which response by the students indicates no further teaching is needed?

• A. Alaska Native women report the highest rate of intimate partner violence.
• B. Caucasian women report the lowest rate of intimate partner violence.
• C. African American women report the highest rate of intimate partner violence.
• D. Asian women report the lowest rate of intimate partner violence.

Correct answer: A

Rationale: The correct answer is A. Alaska Native women do report the highest rate of intimate partner violence. This statistic is important for healthcare professionals to be aware of to provide culturally sensitive care and interventions. Choices B, C, and D are incorrect statements. While it is essential to understand disparities in intimate partner violence rates among different populations, in this context, the focus is on recognizing the accurate information provided about Alaska Native women.

4. In treating a patient with generalized anxiety disorder (GAD) using cognitive-behavioral therapy (CBT), what is the most appropriate goal of this therapy?

• A. To explore the patient's childhood experiences.
• B. To reduce the patient's symptoms through medication.
• C. To change the patient's negative thought patterns.
• D. To improve the patient's social skills.

Correct answer: C

Rationale: The most appropriate goal of cognitive-behavioral therapy (CBT) in treating generalized anxiety disorder (GAD) is to change the patient's negative thought patterns. This therapy focuses on identifying and modifying distorted thinking patterns that contribute to anxiety. Exploring childhood experiences (Choice A) may be part of therapy, but the primary focus is on present thoughts and behaviors. While medication (Choice B) can help manage symptoms, CBT aims to address the root cause through cognitive restructuring. Improving social skills (Choice D) is not the primary goal of CBT for GAD, although it may be a secondary benefit as confidence improves with reduced anxiety.

5. A client states, 'I am the only one who can hear voices.' Which is the nurse's best response?

• A. Tell me more about these voices.
• B. Let's explore these voices together.
• C. How long have you been hearing these voices?
• D. Have you told anyone else about these voices?

Correct answer: A

Rationale: The best response for the nurse is to encourage the client to talk about their experiences with hearing voices. By asking the client to share more details about the voices, the nurse can gain insight into the nature of the auditory hallucinations and better understand the client's condition. This open-ended question allows the client to express themselves freely and helps build rapport and trust between the client and the nurse. Choices B, C, and D do not directly address the client's statement or encourage further elaboration, making them less effective responses in this context.

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