Nursing Elites

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

• A. Encourage the patient to talk briefly about the traumatic event.
• B. Reassure the patient that they are safe and the event is not happening now.
• C. Administer a sedative medication as prescribed.
• D. Suggest the patient write about their feelings in a journal.

Correct answer: B

Rationale: During a flashback, the patient may feel as though the traumatic event is reoccurring. Reassuring the patient that they are safe and the event is not happening presently can help ground them in reality and reduce anxiety. This approach can provide a sense of safety and security, which is crucial in managing flashbacks associated with PTSD. Encouraging the patient to talk briefly about the traumatic event may worsen the distress during a flashback by intensifying the re-experiencing of the trauma. Administering sedative medication should not be the initial intervention, as non-pharmacological approaches are preferred in managing flashbacks. Suggesting the patient write about their feelings in a journal may be beneficial as part of ongoing therapy, but it is not the most appropriate initial intervention during a flashback.

2. What principle should guide a nurse's fear about 'saying the wrong thing' to a patient in nurse-patient communication?

• A. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation.
• B. The patient is more interested in talking to you than listening to what you have to say and is not likely to be offended.
• C. Considering the patient's history, there is little chance that the comment will do any actual harm.
• D. Most people with a mental illness have, by necessity, developed a high tolerance for forgiveness.

Correct answer: A

Rationale: Effective nurse-patient communication is guided by the principle that patients value sincere and respectful interactions. A nurse's well-meaning approach that conveys acceptance, respect, and concern helps establish trust and rapport with patients, even if the nurse is apprehensive about making mistakes. It is essential for the nurse to focus on genuine intent and respect for the patient's situation rather than being consumed by the fear of saying something wrong.

3. 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.

4. In an outpatient mental health clinic, a nurse is preparing to conduct an initial client interview. Which of the following actions should the nurse identify as a priority?

• A. Coordinate holistic care with social services
• B. Identify the client’s perception of their mental health status
• C. Include the client’s family in the interview
• D. Educate the client about their current mental health disorder

Correct answer: B

Rationale: During an initial client interview in a mental health clinic, it is essential for the nurse to prioritize identifying the client’s perception of their mental health status. Understanding how the client views their mental health can provide valuable insights into their condition, concerns, and needs, facilitating the development of a tailored and effective care plan. Coordinating holistic care with social services, including the client’s family in the interview, and educating the client about their current mental health disorder are important aspects of care but may not be the priority during the initial interview, where understanding the client's own perspective is crucial.

5. 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.

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