Nursing Elites

1. Which intervention would be appropriate for assisting a client diagnosed with major depressive disorder?

• A. Encourage discussion of feelings
• B. Offer family therapy sessions
• C. Discuss childhood events
• D. Teach alternate coping skills

Correct answer: B

Rationale: Offering family therapy sessions would be the most appropriate intervention for a client diagnosed with major depressive disorder. Family therapy can be beneficial as it addresses interpersonal relationships within the family system, which is crucial in managing major depressive disorder effectively. This approach aligns with Sullivan's interpersonal theory, which emphasizes the impact of interpersonal relationships on individual behavior and personality development. In contrast, encouraging discussion of feelings, discussing childhood events, or teaching alternate coping skills may not directly address the interpersonal dynamics contributing to the client's major depressive disorder.

2. A client with bipolar disorder is in the manic phase. Which nursing intervention should the nurse implement to ensure the client's safety?

• A. Provide a structured environment with minimal stimuli.
• B. Encourage the client to participate in group activities.
• C. Monitor the client closely for signs of exhaustion.
• D. Encourage the client to rest and sleep as needed.

Correct answer: A

Rationale: During the manic phase of bipolar disorder, individuals may engage in impulsive behaviors that can put them at risk of harm. Providing a structured environment with minimal stimuli can help reduce the risk of injury by minimizing triggers for impulsive actions. This intervention promotes a safe and controlled setting for the client, which is crucial in managing the symptoms of mania. Encouraging the client to participate in group activities (Choice B) may increase stimuli and potentially exacerbate manic symptoms. Monitoring for signs of exhaustion (Choice C) is important but does not directly address the safety concerns related to impulsive behaviors during mania. Encouraging the client to rest and sleep as needed (Choice D) may be challenging during the manic phase when individuals typically experience decreased need for sleep.

3. April, a 10-year-old admitted to inpatient pediatric care, has been getting more and more wound up and is losing self-control in the day room. Time-out does not appear to be an effective tool for April to engage in self-reflection. April's mother admits to putting her in time-out up to 20 times a day. The nurse recognizes that:

• A. Time-out is an important part of April's baseline discipline.
• B. Time-out is no longer an effective therapeutic measure.
• C. April enjoys time-out, and acts out to get some alone time.
• D. Time-out will need to be replaced with seclusion and restraint.

Correct answer: B

Rationale: Frequent use of time-out has reduced its effectiveness as a therapeutic measure for April.

4. The healthcare provider is preparing to provide medication instruction for a patient. Which of the following understandings about anxiety will be essential to effective instruction?

• A. Learning is best when anxiety is moderate to severe.
• B. Learning is enhanced when anxiety is mild.
• C. Panic-level anxiety helps the provider teach better.
• D. Severe anxiety is characterized by intense concentration and enhances the attention span.

Correct answer: B

Rationale: Mild anxiety sharpens the senses, increases the perceptual field, and results in heightened awareness of the environment, which enhances learning. As anxiety increases, attention span decreases, making learning more difficult. Therefore, mild anxiety is more conducive to effective instruction compared to moderate to severe anxiety, panic-level anxiety, or severe anxiety. Choice A is incorrect because moderate to severe anxiety impairs learning. Choice C is incorrect as panic-level anxiety can be overwhelming and hinder the learning process. Choice D is incorrect because severe anxiety typically leads to impaired attention span rather than enhancing it.

5. A nursing instructor is discussing diseases of adaptation with students and when they are likely to occur. Which student response indicates that learning has occurred?

• A. When an individual has limited experience managing stress
• B. When an individual inherits adaptive genes
• C. When an individual faces pre-existing conditions that worsen stress
• D. When an individual's physiological and psychological resources are depleted

Correct answer: D

Rationale: The correct answer is D. During the stage of exhaustion in the general adaptation syndrome, an individual's physiological and psychological resources become depleted, leading to a reduced capacity to adapt effectively. This depletion of resources is when diseases of adaptation, such as stress-related disorders, are more likely to occur. Choices A, B, and C do not reflect an accurate understanding of diseases of adaptation. Limited experience managing stress, inheriting adaptive genes, and facing pre-existing conditions that worsen stress do not directly relate to the concept of physiological and psychological resource depletion leading to diseases of adaptation.

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