Nursing Elites

1. Which assessment finding best supports dissociative fugue?

• A. The patient states that he cannot remember important information about himself.
• B. The patient is found to be wandering in a park and cannot remember his name or where he lives.
• C. The patient reports feeling as if she is outside her body and observing herself from a distance.
• D. The patient has a sudden onset of symptoms after experiencing a traumatic event.

Correct answer: B

Rationale: The key feature of dissociative fugue is sudden, unexpected travel away from home during which the individual may not be able to recall their identity or past events. Choice B best reflects this by describing a scenario where the patient is found wandering in a park and unable to remember their name or residence, which aligns with the characteristic dissociative amnesia seen in dissociative fugue. Choices A, C, and D do not directly support dissociative fugue. Choice A refers more to general dissociative amnesia, Choice C describes depersonalization/derealization disorder, and Choice D suggests acute stress reaction rather than dissociative fugue.

2. A patient with schizophrenia is prescribed risperidone. Which statement by the patient indicates understanding of the medication?

• A. I should take this medication at the same time every day.
• B. I can stop taking this medication once I feel better.
• C. I should avoid drinking alcohol while taking this medication.
• D. I should take this medication on an as-needed basis.

Correct answer: A

Rationale: The correct answer is A because taking the medication at the same time every day helps maintain consistent blood levels and effectiveness. Consistency in dosing is crucial for the medication to work optimally in managing symptoms of schizophrenia. Option B is incorrect because stopping the medication abruptly can lead to a worsening of symptoms. Option C is important as alcohol can interact with the medication and cause adverse effects. Option D is incorrect because risperidone is typically taken regularly, not on an as-needed basis, to manage symptoms effectively.

3. A patient with generalized anxiety disorder (GAD) is prescribed sertraline. What is a common side effect the nurse should monitor for?

• A. Dry mouth
• B. Weight gain
• C. Insomnia
• D. Nausea

Correct answer: D

Rationale: Nausea is a common side effect associated with sertraline, a medication commonly used in the treatment of generalized anxiety disorder (GAD). It is essential for the nurse to monitor for nausea as it can impact the patient's adherence to the medication regimen. Educating the patient about this potential side effect and advising ways to manage it can enhance treatment compliance and overall therapeutic outcomes.

4. Which therapeutic communication technique involves restating the patient's message to ensure understanding?

• A. Clarification
• B. Reflection
• C. Summarization
• D. Paraphrasing

Correct answer: D

Rationale: Paraphrasing is the correct therapeutic communication technique where the nurse restates the patient's message in their own words to confirm understanding. This technique helps in validating the patient's feelings and ensuring that both parties are in agreement, leading to effective communication and rapport building. Choice A, 'Clarification,' involves seeking further information to enhance understanding rather than restating the message. Choice B, 'Reflection,' involves echoing the patient's feelings to show empathy rather than restating the message. Choice C, 'Summarization,' involves condensing the main points of a conversation rather than restating a specific message.

5. What is the most appropriate intervention for a patient experiencing a panic attack?

• A. Encourage the patient to talk about their feelings.
• B. Provide a quiet and non-stimulating environment.
• C. Administer prescribed medication immediately.
• D. Teach the patient relaxation techniques.

Correct answer: B

Rationale: During a panic attack, it is crucial to provide a quiet and non-stimulating environment to help the patient feel safe and reduce sensory overload. This approach can help the patient focus on calming down and regaining control. Encouraging the patient to talk about their feelings may exacerbate the panic attack by increasing stress and arousal levels. Administering medication should be done following healthcare provider's orders, as it may not be appropriate to give medication immediately without proper assessment. Teaching relaxation techniques might not be effective during the acute phase of a panic attack when the individual is overwhelmed by intense anxiety.

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