Nursing Elites

1. A patient with posttraumatic stress disorder (PTSD) is experiencing flashbacks. What is the best initial intervention?

• A. Encouraging the patient to avoid triggers
• B. Encouraging the patient to talk about their feelings
• C. Providing the patient with relaxation techniques
• D. Advising the patient to avoid social situations

Correct answer: C

Rationale: The best initial intervention for a patient with PTSD experiencing flashbacks is to provide relaxation techniques. This approach helps the patient manage flashbacks by focusing on the present moment, promoting relaxation, and reducing anxiety associated with the traumatic memories. Encouraging the patient to avoid triggers or social situations may not address the immediate distress caused by flashbacks, while talking about feelings may not be as effective as providing immediate tools to manage the distressing symptoms.

2. 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.

3. 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.

4. What is the primary benefit of using cognitive-behavioral therapy (CBT) for treating anxiety disorders?

• A. It focuses on long-term use of medications.
• B. It helps patients understand and change their thought patterns.
• C. It primarily addresses childhood traumas.
• D. It encourages patients to avoid anxiety-provoking situations.

Correct answer: B

Rationale: The primary benefit of using cognitive-behavioral therapy (CBT) for treating anxiety disorders is that it helps patients understand and change their thought patterns. By addressing maladaptive thought processes and behaviors, CBT can effectively reduce anxiety symptoms and improve coping mechanisms. This approach empowers individuals to develop healthier responses to anxiety triggers, leading to long-lasting benefits beyond solely relying on medications or avoiding anxiety-provoking situations. Choices A, C, and D are incorrect because CBT does not primarily focus on long-term use of medications, addressing childhood traumas, or encouraging avoidance of anxiety-provoking situations. While medications may be used in conjunction with CBT, the main focus of CBT is on cognitive restructuring and behavioral interventions to alleviate anxiety symptoms.

5. A charge nurse is conducting a class on therapeutic communication with a group of newly licensed nurses. Which of the following aspects of communication should the nurse identify as a component of verbal communication?

• A. Personal space
• B. Posture
• C. Eye contact
• D. Intonation

Correct answer: D

Rationale: Verbal communication involves the use of words, tone, and pitch to convey messages. Intonation refers to the variation of pitch in speech, which can convey emotions, attitudes, and emphasize certain points. Therefore, intonation is a key component of verbal communication, making it the correct choice in this scenario. Choices A, B, and C are aspects of nonverbal communication. Personal space, posture, and eye contact are important nonverbal cues that contribute to effective communication, but they are not components of verbal communication.

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