Nursing Elites

1. During cognitive-behavioral therapy, a 12-year-old patient reports to the nurse practitioner:

• A. I was so mad I wanted to hit my mother.
• B. I thought that everyone at school hated me. That's not true. Most people like me and I have a friend named Todd.
• C. I forgot that you told me to breathe when I become angry.
• D. I scream as loud as I can when the train goes by the house.

Correct answer: B

Rationale: In cognitive-behavioral therapy, recognizing and challenging negative thoughts is crucial for progress. Choice B demonstrates the patient's ability to identify and correct distorted thoughts, indicating positive advancement in therapy. This cognitive restructuring is a key component of cognitive-behavioral therapy, helping individuals develop healthier thinking patterns and coping strategies.

2. During a panic attack, what is the nurse's priority intervention for a patient with panic disorder?

• A. Encourage the patient to verbalize their feelings.
• B. Provide reassurance and stay with the patient.
• C. Leave the patient alone to calm down.
• D. Distract the patient with a task.

Correct answer: B

Rationale: During a panic attack, the priority intervention for the nurse is to provide reassurance and stay with the patient. This action helps reduce fear and provides a sense of safety, which can aid in calming the patient and preventing further escalation of the panic attack. Encouraging the patient to verbalize their feelings (Choice A) may be beneficial after the acute phase of the panic attack. Leaving the patient alone (Choice C) may increase feelings of abandonment and escalate the panic attack. Distracting the patient with a task (Choice D) is not recommended during a panic attack as it may divert attention but not address the underlying anxiety and fear.

3. Which assessment question asked by the nurse demonstrates an understanding of comorbid mental health conditions associated with major depressive disorder? Select one that doesn't apply.

• A. Do rules apply to you?
• B. What do you do to manage anxiety?
• C. Do you have a history of disordered eating?
• D. Do you think that you drink too much?

Correct answer: A

Rationale: Questions about anxiety management, disordered eating, and alcohol use are relevant to identifying comorbid conditions with major depressive disorder, but the question 'Do rules apply to you?' does not directly address common comorbid mental health conditions associated with major depressive disorder.

4. Which characteristic identified during an assessment serves to support a diagnosis of disruptive mood dysregulation disorder? Select one that doesn't apply.

• A. Female
• B. 7 years old
• C. Comorbid autism diagnosis
• D. Outbursts occur at least once a week

Correct answer: C

Rationale: Characteristics such as age, frequency of outbursts, and occurrence in multiple settings support a diagnosis of disruptive mood dysregulation disorder. While comorbid conditions like autism can coexist with disruptive mood dysregulation disorder, it is not a characteristic that serves to support a diagnosis of this specific disorder.

5. A client is being taught relaxation techniques to manage anxiety. Which of the following techniques should be included in the teaching? Select one that does not apply.

• A. Deep breathing exercises
• B. Progressive muscle relaxation
• C. Mindfulness meditation
• D. Cognitive restructuring

Correct answer: D

Rationale: Relaxation techniques commonly used to manage anxiety include deep breathing exercises, progressive muscle relaxation, mindfulness meditation, and guided imagery. Cognitive restructuring, on the other hand, is a cognitive-behavioral technique used to challenge and change negative thought patterns, not specifically a relaxation technique. Therefore, choice D, cognitive restructuring, does not apply to relaxation techniques for managing anxiety.

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