Nursing Elites

1. What is the most appropriate intervention for a patient experiencing severe anxiety?

• A. Encourage the patient to talk about their anxiety.
• B. Teach the patient deep breathing exercises.
• C. Remain with the patient and provide a calm presence.
• D. Suggest the patient engage in physical activity.

Correct answer: C

Rationale: When a patient is experiencing severe anxiety, remaining with the patient and providing a calm presence is the most appropriate intervention. This approach can help the patient feel supported and safe, which can help in reducing their anxiety levels. Encouraging the patient to talk about their anxiety may not be suitable during a severe anxiety episode, as it can potentially escalate their distress. Teaching deep breathing exercises can be helpful, but in cases of severe anxiety, the patient may find it challenging to focus on such techniques. Suggesting physical activity may not be suitable as the patient might not be in a state to engage in such activities when experiencing severe anxiety.

2. A healthcare professional is assessing a patient with bipolar disorder. Which finding suggests the patient is experiencing a manic episode?

• A. Decreased need for sleep
• B. Feelings of worthlessness
• C. Increased need for sleep
• D. Avoidance of social interactions

Correct answer: A

Rationale: During a manic episode in patients with bipolar disorder, they often experience a decreased need for sleep. This symptom is characterized by feeling rested after only a few hours of sleep, or even feeling like they can go without sleep for extended periods without feeling tired. The increased energy levels and racing thoughts during a manic episode contribute to the decreased need for sleep.

3. A patient is being discharged with a prescription for an antidepressant for their depression. Which instruction is most important?

• A. Take the medication with food to prevent stomach upset.
• B. Refrain from driving until you understand the effects of the medication.
• C. Do not discontinue the medication suddenly.
• D. Avoid alcohol consumption while taking this medication.

Correct answer: C

Rationale: The most critical instruction is to not discontinue the antidepressant medication suddenly. Abrupt discontinuation can lead to withdrawal symptoms and potentially trigger a relapse of depression. Options A, B, and D are important but not as crucial as ensuring the patient follows the prescribed regimen and consults with a healthcare provider before making any changes to the medication routine.

4. A patient with obsessive-compulsive disorder (OCD) frequently washes their hands. Which nursing intervention is most appropriate?

• A. Allow the patient to wash their hands, then gradually limit the time spent on this behavior.
• B. Discourage the patient from discussing their obsessions.
• C. Encourage the patient to suppress their compulsive behaviors.
• D. Avoid setting limits on the patient's compulsive behaviors.

Correct answer: A

Rationale: In managing a patient with OCD who frequently washes their hands, it is important to understand that compulsive behaviors provide temporary relief from anxiety. Allowing the patient to engage in their rituals initially and then gradually setting limits on the time spent can help them gain control over their compulsions. This approach supports the patient without causing undue distress, ultimately assisting in managing OCD symptoms effectively. Choice B is incorrect as discouraging the patient from discussing their obsessions can hinder therapeutic communication and understanding of their condition. Choice C is wrong because encouraging the patient to suppress their compulsive behaviors may increase their anxiety and lead to worsening symptoms. Choice D is also incorrect as avoiding setting limits on the patient's compulsive behaviors does not help the patient in gaining control over their OCD symptoms.

5. A patient with obsessive-compulsive disorder (OCD) is prescribed fluvoxamine. What is a common side effect of this medication?

• A. Increased appetite
• B. Dry mouth
• C. Weight gain
• D. Nausea

Correct answer: D

Rationale: Nausea is a common side effect of fluvoxamine, a selective serotonin reuptake inhibitor (SSRI) commonly used in the treatment of OCD. Patients should be advised to monitor and report any gastrointestinal disturbances, including nausea, to their healthcare provider.

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