Nursing Elites

1. What is the priority nursing intervention for a patient experiencing a panic attack?

• A. Encourage the patient to talk about their feelings.
• B. Provide a safe, calm environment.
• C. Administer prescribed anti-anxiety medication.
• D. Teach the patient deep breathing exercises.

Correct answer: B

Rationale: The priority nursing intervention for a patient experiencing a panic attack is to provide a safe, calm environment. This action is crucial as it helps reduce the patient's anxiety and creates a sense of security, which can aid in managing the panic attack effectively. Encouraging the patient to talk about their feelings, administering medication, or teaching deep breathing exercises can be beneficial interventions, but creating a safe and calm environment takes precedence in addressing the immediate needs of the patient during a panic attack.

2. Carolina is surprised when her patient does not show for a regularly scheduled appointment. When contacted, the patient states, ‘I don’t need to come see you anymore. I have found a therapy app on my phone that I love.’ How should Carolina respond to this news?

• A. That sounds exciting; would you be willing to visit and show me the app?
• B. At this time, there is no real evidence that the app can replace our therapy.
• C. I am not sure that is a good idea right now; we are so close to progress.
• D. Why would you think that is a better option than meeting with me?

Correct answer: A

Rationale: Carolina should respond with openness and curiosity to maintain a positive therapeutic relationship. By showing interest in the patient's new therapy method and inviting them to share the app, Carolina demonstrates a willingness to explore alternative approaches while also ensuring the patient feels heard and valued in their decision-making process. Choice B is incorrect because it dismisses the patient's choice without exploring it further. Choice C focuses more on Carolina's concerns rather than engaging with the patient's decision. Choice D comes off as defensive and may make the patient feel misunderstood or judged.

3. What principle about patient communication should guide a nurse's fear of 'saying the wrong thing' to a patient?

• A. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation.
• B. Patients are more interested in talking to you than listening to what you have to say, so they are not likely to be offended.
• C. Considering the patient's history, there is little chance that the comment will do any actual harm.
• D. Most people with a mental illness have, by necessity, developed a high tolerance for forgiveness.

Correct answer: A

Rationale: Effective patient communication is guided by the principle that patients value genuine acceptance, respect, and concern from their caregivers. This approach helps to build trust and fosters effective communication, enhancing the nurse-patient relationship. Choice B is incorrect because patients value both talking and listening in effective communication. Choice C is incorrect because a nurse should always consider the impact of their words on the patient, regardless of the patient's history. Choice D is incorrect as it generalizes about people with mental illness and forgiveness, which is not directly relevant to patient communication.

4. The school nurse has been alerted to the fact that an 8-year-old boy routinely playacts as a police officer, 'locking up' other children on the playground to the point where the children get scared. The nurse recognizes that this behavior is most likely an indication of:

• A. The need to dominate others
• B. Inventing traumatic events
• C. A need to develop close relationships
• D. A potential symptom of traumatization

Correct answer: D

Rationale: When an 8-year-old boy engages in playacting as a police officer that instills fear in other children, it can be indicative of a potential symptom of traumatization. This behavior may reflect the child's attempt to process or express experiences of trauma, leading to a manifestation of such distress in his play interactions with others.

5. In schizophrenia, a patient is experiencing negative symptoms. Which of the following is a negative symptom?

• A. Hallucinations
• B. Delusions
• C. Apathy
• D. Disorganized speech

Correct answer: C

Rationale: In schizophrenia, negative symptoms refer to deficits in normal emotional responses or other thought processes. Apathy is a negative symptom characterized by a lack of interest, enthusiasm, or concern. Hallucinations (seeing or hearing things that aren't there), delusions (false beliefs), and disorganized speech are positive symptoms, which involve the presence of abnormal behaviors or thoughts.

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