Nursing Elites

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

• A. Encouraging the patient to stop washing their hands
• B. Allowing the patient to wash hands at specified times
• C. Ignoring the patient's behavior
• D. Setting strict limits on the time allowed for hand washing

Correct answer: B

Rationale: In managing a patient with OCD who spends excessive time washing hands, allowing the patient to wash hands at specified times is the most appropriate nursing intervention. This approach helps establish a structured routine for hand washing, which can assist in managing OCD symptoms without reinforcing the behavior. Encouraging the patient to stop washing hands may lead to increased anxiety and resistance. Ignoring the behavior can perpetuate the cycle of OCD, and setting strict limits on hand washing time may cause distress and may not effectively address the underlying issues associated with OCD.

2. In treating PTSD, which type of therapy is most commonly recommended?

• A. Cognitive-behavioral therapy (CBT)
• B. Psychoanalytic therapy
• C. Humanistic therapy
• D. Gestalt therapy

Correct answer: A

Rationale: Cognitive-behavioral therapy (CBT) is the most commonly recommended therapy for PTSD due to its effectiveness in helping patients identify and change negative thoughts and behaviors associated with trauma. This therapy focuses on providing practical coping strategies to manage symptoms and process traumatic experiences. Psychoanalytic therapy, humanistic therapy, and gestalt therapy are less commonly used for PTSD as they may not target the specific symptoms and cognitive distortions associated with this disorder.

3. While being treated in an inpatient facility, what is the most appropriate intervention for a patient with anorexia nervosa?

• A. Allowing the patient to eat alone to reduce stress
• B. Monitoring the patient's weight daily
• C. Encouraging the patient to exercise daily
• D. Providing the patient with a high-calorie diet

Correct answer: B

Rationale: Monitoring the patient's weight daily is the most appropriate intervention for a patient with anorexia nervosa being treated in an inpatient facility. This approach helps healthcare providers track the patient's progress, assess nutritional status, and promptly identify any concerning changes or trends that may require intervention.

4. What is the priority intervention for a patient admitted for an overdose of sedatives and diagnosed with dissociative identity disorder?

• A. Conducting a suicide assessment
• B. Arranging for placement in a group home
• C. Providing a low-stimulation environment
• D. Establishing trust and rapport

Correct answer: A

Rationale: Conducting a suicide assessment is the priority intervention for a patient admitted for an overdose of sedatives and diagnosed with dissociative identity disorder. In this scenario, the immediate concern is to assess the risk of harm to the patient's life. It is crucial to determine if the overdose was intentional and if the patient has suicidal ideation or intent. Arranging for placement in a group home (choice B) may be necessary at a later stage depending on the patient's needs, but it is not the priority in this urgent situation. Providing a low-stimulation environment (choice C) and establishing trust and rapport (choice D) are important aspects of care but addressing the immediate risk of suicide takes precedence in this case.

5. In an emergency mental health facility, a nurse is caring for a group of clients. The nurse should identify that which of the following clients requires a temporary emergency admission?

• A. A client with schizophrenia who has delusions of grandeur
• B. A client with manifestations of depression who attempted suicide a year ago
• C. A client with borderline personality disorder who assaulted a homeless man with a metal rod
• D. A client with bipolar disorder who paces quickly around the room while talking to themselves

Correct answer: C

Rationale: The correct answer is C. A client with borderline personality disorder who has committed an assault poses a risk to others and themselves, necessitating temporary emergency admission for safety and further assessment. Choices A, B, and D do not indicate an immediate risk to self or others that would require temporary emergency admission.

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