Nursing Elites

1. An unemployed college graduate is experiencing severe anxiety over not finding a teaching position and has difficulty with independent problem-solving. During a routine physical examination, the graduate confides in the clinic nurse. Which is the most appropriate nursing intervention?

• A. Encourage the graduate to use alternative coping mechanisms such as relaxation exercises.
• B. Complete the problem-solving process for the graduate.
• C. Work through the problem-solving process with the graduate.
• D. Encourage the graduate to keep a journal.

Correct answer: C

Rationale: In situations where a client is experiencing severe anxiety and struggles with independent problem-solving, it is essential for the nurse to work through the problem-solving process together with the client. By doing so, the nurse can provide support and guidance to help the client navigate through their challenges effectively. Choice A is not the most appropriate as just encouraging alternative coping mechanisms may not address the root of the problem. Choice B of completing the problem-solving process for the graduate does not promote independence or skill development. Choice D of encouraging the graduate to keep a journal may be helpful but does not directly address the need for assistance in problem-solving during heightened anxiety.

2. During an acute panic attack, which intervention should the nurse implement?

• A. Encourage the client to discuss their feelings
• B. Provide a calm environment
• C. Teach the client deep breathing exercises
• D. Leave the client alone to calm down

Correct answer: C

Rationale: During an acute panic attack, the priority intervention is to create a calm and safe environment. Teaching the client deep breathing exercises is crucial as it promotes relaxation and reduces hyperventilation, helping to manage the panic attack effectively. Encouraging the client to discuss their feelings may exacerbate the panic by increasing emotional distress. Providing a busy environment can escalate stress levels rather than alleviate them. Leaving the client alone may lead to feelings of abandonment or worsen the panic attack. Therefore, the most appropriate intervention is to teach deep breathing exercises to help the client regain control and manage the panic attack.

3. What intervention should the nurse implement for a client with obsessive-compulsive disorder (OCD) performing ritualistic handwashing?

• A. Allow the client to continue the ritualistic behavior initially
• B. Immediately stop the client from performing the ritual
• C. Encourage the client to perform the ritual more quickly
• D. Provide a distraction to interrupt the ritual

Correct answer: A

Rationale: For a client with OCD performing ritualistic handwashing, the nurse should initially allow the client to continue the behavior. Abruptly stopping the behavior or providing a distraction can heighten the client's anxiety. Encouraging the client to perform the ritual more quickly does not address the underlying issue of OCD and may exacerbate their anxiety. Providing a distraction to interrupt the ritual may not be effective in the long term and could lead to increased distress. Gradual limits should be established over time to help the client manage and reduce the ritualistic behavior effectively.

4. A healthcare provider is assessing a client who has been diagnosed with factitious disorder. Which of the following behaviors should the healthcare provider expect?

• A. Intentional production of false symptoms
• B. Lack of concern about symptoms
• C. Fear of gaining weight
• D. Unintentional production of false symptoms

Correct answer: A

Rationale: Individuals with factitious disorder deliberately fabricate or exaggerate symptoms to assume the sick role and garner attention. They may show a lack of concern about their symptoms, a phenomenon known as la belle indifférence. Fear of gaining weight is not typically associated with factitious disorder. Therefore, the correct behavior to expect in a client with factitious disorder is the intentional production of false symptoms. Choices B, C, and D are incorrect as lack of concern about symptoms and fear of gaining weight are not characteristic of factitious disorder. Additionally, factitious disorder involves the intentional, not unintentional, production of false symptoms.

5. When developing a care plan for a client with generalized anxiety disorder (GAD), which of the following interventions should not be included?

• A. Encourage the client to avoid anxiety-provoking situations.
• B. Teach the client relaxation techniques.
• C. Encourage the client to express their feelings.
• D. Provide a structured daily routine.

Correct answer: A

Rationale: When caring for a client with generalized anxiety disorder (GAD), it is essential to consider therapeutic interventions. Encouraging the client to avoid anxiety-provoking situations is not recommended as it can reinforce their anxiety. Teaching relaxation techniques, encouraging the expression of feelings, and providing a structured daily routine are beneficial strategies in managing generalized anxiety disorder by promoting coping skills and emotional expression while fostering stability and predictability.

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