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. A healthcare professional is conducting education on anxiety and stress management. Which of the following should be identified as the most important initial step in learning how to manage anxiety?

• A. Diagnostic blood tests
• B. Awareness of factors creating stress
• C. Relaxation exercises
• D. Identifying support systems

Correct answer: B

Rationale: The correct answer is B: Awareness of factors creating stress. In managing anxiety, the first crucial step is recognizing and being aware of the factors that contribute to stress. Without this awareness, it becomes challenging to effectively address and manage anxiety. Diagnostic blood tests are not typically the initial step in managing anxiety; they may be used to rule out other medical conditions but are not the primary focus. While relaxation exercises can be helpful in managing anxiety, understanding the root causes of stress takes precedence. Identifying support systems is important but comes after recognizing the stress factors to develop a comprehensive management plan.

3. A patient with schizophrenia is prescribed olanzapine. The nurse should monitor the patient for which common side effect?

• A. Weight gain
• B. Hypotension
• C. Hair loss
• D. Hyperthyroidism

Correct answer: A

Rationale: Weight gain is a common side effect of olanzapine, an atypical antipsychotic. Olanzapine is known to cause metabolic changes that can lead to weight gain. Monitoring weight regularly is essential to detect and manage this side effect to prevent associated health risks such as diabetes and cardiovascular issues. Hypotension (choice B) is not a common side effect of olanzapine. Olanzapine is more likely to cause orthostatic hypotension, which is a sudden drop in blood pressure when changing positions. Hair loss (choice C) and hyperthyroidism (choice D) are not typically associated with olanzapine use.

4. Which client statement should alert a nurse that a client may be responding maladaptively to stress?

• A. I've found that avoiding contact with others helps me cope.
• B. I really enjoy journaling; it's my private time.
• C. I signed up for a yoga class this week.
• D. I made an appointment to meet with a therapist.

Correct answer: A

Rationale: The correct answer is A. Reliance on social isolation as a coping mechanism is maladaptive and can hinder the development of appropriate coping skills and access to support systems. It may indicate a lack of healthy coping strategies and social connections, which are important for managing stress effectively. Choice B is a positive coping strategy that promotes self-reflection and emotional expression. Choice C reflects a proactive approach to managing stress through physical activity. Choice D shows a willingness to seek professional help, which is a healthy coping mechanism.

5. A nurse is caring for a client who has been diagnosed with schizoaffective disorder. The client states, 'I am the president of the United States.' Which of the following responses should the nurse make?

• A. You are not the president. You are a client in the hospital.
• B. Tell me more about being the president.
• C. Why do you think you are the president?
• D. Let's talk about something else.

Correct answer: C

Rationale: The nurse should avoid challenging the client's delusions directly. Asking for more information can help the nurse understand the client's experience and build rapport.

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