Nursing Elites

1. Which mental health disorder is most likely to be treated with electroconvulsive therapy (ECT)?

• A. Clinical depression
• B. Substance abuse disorder
• C. Antisocial personality disorder
• D. Psychosis occurring in schizophrenia

Correct answer: A

Rationale: Electroconvulsive therapy (ECT) is commonly used to treat severe cases of clinical depression in individuals who have not responded well to psychotropic medications or when immediate intervention is necessary due to the severity of the depression. ECT is not typically a first-line treatment for substance abuse disorders, antisocial personality disorder, or psychosis occurring in schizophrenia. Clients with clinical depression who meet specific criteria and have not benefited from other treatments may be considered for ECT to alleviate symptoms and improve overall functioning.

2. What action would the nurse take for a 4-year-old child who is called to the operating room for a planned myringotomy?

• A. Removing the child's undergarments
• B. Placing the child's toys on the bedside table
• C. Allowing the child to climb onto the stretcher
• D. Having the parents accompany the child to the operating suite

Correct answer: D

Rationale: The correct action is to have the parents accompany the child to the operating suite. Current practice encourages parents to stay with the child as long as possible to reduce stress related to a frightening experience. Removing the child's undergarments is usually not necessary for a myringotomy procedure. Placing the child's toys on the bedside table is important, especially a favorite one, for comfort until sedation is induced. Allowing the child to climb onto the stretcher may not be safe or appropriate as the child is too young to do so independently.

3. Which parameter would be assessed to determine the degree of anxiety being experienced by the client?

• A. Memory state
• B. Creativity level
• C. Perceptual field
• D. Delusional system

Correct answer: C

Rationale: The correct parameter to assess the degree of anxiety experienced by a client is the perceptual field. As anxiety increases, perceptual fields tend to narrow. Memory state, creativity level, and delusional system are not directly related to the level of anxiety and are not appropriate parameters for determining the degree of anxiety. Memory state refers to the ability to remember, creativity level to the ability to generate new ideas or solutions, and delusional system to a set of false beliefs.

4. Which approach would the healthcare provider use when managing the care of a client diagnosed with generalized anxiety disorder (GAD)?

• A. Creating an anxiety-free environment for the client
• B. Assisting the client with the development of healthy, adaptive coping mechanisms
• C. Avoiding triggers that produce anxiety in the client
• D. Providing reinforcement that the client's anxiety issues can be eliminated

Correct answer: B

Rationale: The healthcare provider would assist the client with the development of healthy, adaptive coping mechanisms. GAD is characterized by the maladaptive use of worrying as a coping mechanism. The ultimate goal is for the healthcare provider to help the client replace the ineffective worrying with effective, healthy coping mechanisms. Creating an anxiety-free environment is not feasible or recommended; the goal is to help the client learn to deal with anxiety in a healthy manner. While identifying triggers is important, avoiding all triggers that produce anxiety is often impractical. Providing reinforcement that anxiety issues can be eliminated is not appropriate as anxiety is a normal human experience that needs to be managed effectively rather than eliminated completely.

5. A parent of a young child says, 'I'm so upset! The doctor prescribed an antidepressant!' Which response is best?

• A. Tell me more about what's bothering you.'
• B. Weren't you told about the need for the medication?'
• C. I'll notify the healthcare provider about your concerns.'
• D. 'Maybe the medication is for attention deficit disorder.'

Correct answer: A

Rationale: The best response in this situation is to express empathy and encourage the parent to share more about their concerns. Option A ('Tell me more about what's bothering you.') allows the nurse to show understanding and gather more information to address the parent's distress effectively. Option B ('Weren't you told about the need for the medication?') is confrontational and may make the parent defensive, hindering effective communication. Option C ('I'll notify the healthcare provider about your concerns.') is premature; the nurse should first assess the parent's feelings before deciding on further actions. Option D ('Maybe the medication is for attention deficit disorder.') assumes without clarification, which is not appropriate; the nurse should validate the prescription before suggesting alternative reasons.

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