Nursing Elites

1. When assessing a patient with generalized anxiety disorder (GAD), which symptom would the nurse most likely observe?

• A. Flashbacks
• B. Excessive worry
• C. Hallucinations
• D. Compulsive behaviors

Correct answer: B

Rationale: Excessive worry is a characteristic feature of generalized anxiety disorder (GAD). Patients with GAD experience persistent and excessive worry about various aspects of their life, such as work, health, or family, even when there is little or no reason for concern. This chronic worrying can significantly impact their daily functioning and quality of life. Flashbacks are more commonly associated with post-traumatic stress disorder (PTSD), hallucinations are more typical in conditions like schizophrenia, while compulsive behaviors are seen in obsessive-compulsive disorder (OCD). Therefore, in the context of GAD, excessive worry is the symptom that the nurse is most likely to observe.

2. Which statement indicates an understanding of the DSM-5 diagnosis?

• A. The DSM-5 includes information on cultural considerations.
• B. The DSM-5 is a tool for healthcare providers.
• C. The DSM-5 is not used for legal purposes.
• D. The DSM-5 includes information on the prevalence of mental disorders.

Correct answer: A

Rationale: Option A is the correct answer as the DSM-5 not only provides specific criteria for diagnosing mental disorders but also includes information on cultural considerations. Understanding cultural factors is crucial in making accurate diagnoses and providing appropriate care, highlighting the comprehensive nature of the DSM-5 for healthcare providers. Choices B, C, and D are incorrect because while the DSM-5 is indeed a tool for healthcare providers, it is also used in legal settings, and it focuses on diagnostic criteria and not just the prevalence of mental disorders.

3. The client recently survived a plane crash and is assessed by the nurse. Which client statement would cause the nurse to suspect that the client may be experiencing PTSD?

• A. I believe that I was meant to survive this accident so that I can focus on the important things in life
• B. Although I have nightmares sometimes, I have started going to church to show gratitude for surviving the crash
• C. I am so afraid that I will never be able to fly again, but I know that it will take a while
• D. I keep having these thoughts about the crash that just pop into my mind at random times

Correct answer: D

Rationale: Experiencing intrusive thoughts about a traumatic event, such as a plane crash, that occur unexpectedly and repeatedly is a common symptom of Post-Traumatic Stress Disorder (PTSD). These thoughts can be distressing and are often a key indicator of PTSD. Options A, B, and C demonstrate coping mechanisms and fears related to the traumatic event but do not specifically address the hallmark symptom of intrusive thoughts. Therefore, option D is the correct choice as it aligns with a potential symptom of PTSD.

4. Which intervention focuses on managing a common characteristic of major depressive disorder associated with the older population?

• A. Conducting routine suicide screenings at a senior center.
• B. Identifying depression as a natural, but treatable outcome of aging.
• C. Identifying males as at a greater risk for developing depression.
• D. Stressing that most individuals experience only a single episode of major depression in a lifetime.

Correct answer: A

Rationale: Conducting routine suicide screenings at senior centers is crucial in managing major depressive disorder in the older population. Screening helps identify individuals at risk, allows for timely intervention, and contributes to the overall well-being of older adults.

5. A client with schizophrenia is experiencing auditory hallucinations. Which nursing intervention should the nurse implement to address this symptom?

• A. Encourage the client to express feelings about the hallucinations.
• B. Distract the client from the hallucinations.
• C. Provide reality-based feedback about the hallucinations.
• D. Encourage the client to ignore the hallucinations.

Correct answer: C

Rationale: The correct intervention for a client experiencing auditory hallucinations in schizophrenia is to provide reality-based feedback about the hallucinations. By providing reality-based feedback, the nurse helps the client differentiate between what is real and what is not, which can help decrease the distress and impact of the hallucinations on the client's perception of reality. Encouraging the client to express feelings (Choice A) may not directly address the hallucinations. Distracting the client (Choice B) may temporarily alleviate the symptoms but does not help the client differentiate reality from hallucinations. Encouraging the client to ignore the hallucinations (Choice D) may not be effective as the client may struggle to do so without appropriate guidance.

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