Nursing Elites

1. A patient with obsessive-compulsive disorder (OCD) frequently washes their hands. Which nursing intervention is most appropriate?

• A. Allow the patient to wash their hands, then gradually limit the time spent on this behavior.
• B. Discourage the patient from discussing their obsessions.
• C. Encourage the patient to suppress their compulsive behaviors.
• D. Avoid setting limits on the patient's compulsive behaviors.

Correct answer: A

Rationale: In managing a patient with OCD who frequently washes their hands, it is important to understand that compulsive behaviors provide temporary relief from anxiety. Allowing the patient to engage in their rituals initially and then gradually setting limits on the time spent can help them gain control over their compulsions. This approach supports the patient without causing undue distress, ultimately assisting in managing OCD symptoms effectively. Choice B is incorrect as discouraging the patient from discussing their obsessions can hinder therapeutic communication and understanding of their condition. Choice C is wrong because encouraging the patient to suppress their compulsive behaviors may increase their anxiety and lead to worsening symptoms. Choice D is also incorrect as avoiding setting limits on the patient's compulsive behaviors does not help the patient in gaining control over their OCD symptoms.

2. A patient with panic disorder is being cared for by a healthcare provider. Which medication is commonly prescribed as a first-line treatment?

• A. Benzodiazepines
• B. Tricyclic antidepressants
• C. Selective serotonin reuptake inhibitors (SSRIs)
• D. Monoamine oxidase inhibitors (MAOIs)

Correct answer: C

Rationale: Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed as a first-line treatment for panic disorder due to their efficacy and lower risk of dependence and tolerance development compared to benzodiazepines. Tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs) are not typically recommended as initial treatments for panic disorder because of their side effect profiles and the availability of safer and more effective options like SSRIs.

3. When the caregiver of a child asks the nurse for reassurance about their child’s condition, which of the following responses should the nurse make?

• A. “I think your child is getting better. What have you noticed?”
• B. “I’m sure everything will be okay. It just takes time to heal.”
• C. “I’m not sure what’s wrong. Have you asked the doctor about your concerns?”
• D. “I understand you’re concerned. Let’s discuss what concerns you specifically.”

Correct answer: D

Rationale: When providing reassurance to a caregiver about their child’s condition, it's essential to acknowledge their concern and address it specifically. Response D demonstrates empathy and a willingness to discuss the caregiver's specific concerns, which can help in providing accurate information and support to them. Choices A and B provide general reassurance without addressing the caregiver's specific concerns, which may not alleviate their worries effectively. Choice C deflects the question back to the caregiver and suggests consulting the doctor without directly engaging with the caregiver's worries, which may not offer the needed support and reassurance.

4. When orienting a new client to a mental health unit, which of the following statements should the nurse make about the unit’s community meetings?

• A. “Clients gather to discuss their treatment plans together.”
• B. “Staff establish a specific agenda for community meetings.”
• C. “Clients meet with staff to discuss common problems.”
• D. “Community meetings provide an opportunity to explore personal mental health issues.”

Correct answer: C

Rationale: During community meetings in a mental health unit, clients come together with staff to discuss common problems they may be facing. These meetings are designed to foster a sense of community and provide support and guidance to clients. Choice A is incorrect because community meetings focus on discussions beyond individual treatment plans. Choice B is incorrect as while staff may facilitate the meetings, the focus is on clients' concerns, not a predetermined agenda. Choice D is incorrect as the primary purpose of community meetings is to address shared challenges, not individual mental health issues.

5. Which individual is likely experiencing symptoms of derealization?

• A. I just feel like I’m looking at life through a fog and that can’t be my face in the mirror.
• B. I cannot recall why I’m living in this town or how I got here.
• C. There are just too many people living in my head now.
• D. I feel like I’m going to die, I’m having a heart attack.

Correct answer: A

Rationale: The individual describing feeling like they are looking at life through a fog and questioning their reflection in the mirror is likely experiencing symptoms of derealization. Derealization involves feelings of detachment from one's surroundings, which can manifest as a sense of unreality or distortion of the environment. Choice B describes dissociative amnesia, which involves memory loss related to personal information or traumatic events. Choice C suggests dissociative identity disorder (DID), where a person experiences two or more distinct identities or personality states. Choice D indicates symptoms of a panic attack, such as fearing imminent death and physical sensations like a heart attack.

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