Nursing Elites

1. Which of the following are therapeutic communication techniques that a healthcare professional can use when interacting with clients?

• A. Using silence
• B. Discouraging the client from washing their hands
• C. Giving advice
• D. Providing reassurance

Correct answer: A

Rationale: Therapeutic communication techniques aim to establish a trusting and supportive relationship between the healthcare professional and the client. Using silence is a valid therapeutic technique that allows the client to reflect and express their thoughts. On the other hand, discouraging the client from washing their hands goes against good hygiene practices and is not therapeutic. Giving advice and providing reassurance can be non-therapeutic if not used appropriately, as they may undermine the client's autonomy and problem-solving abilities.

2. When interviewing a distressed client who was fired after 15 years of loyal employment, which of the following questions would best assist in determining the client's appraisal of the situation? Select all that apply.

• A. What caused the stressful situation?
• B. Have you ever experienced a similar stressful situation?
• C. Who do you think is to blame for this situation?
• D. Why do you think you were fired from your job?

Correct answer: B

Rationale: The question 'Have you ever experienced a similar stressful situation?' is the most appropriate as it assesses the client's coping resources and encourages reflection on past experiences. This question can help the client consider alternative ways to deal with stress. Asking about the cause of the stressful situation may provide insight into the current situation but does not directly assess coping abilities. Inquiring about blame does not focus on coping strategies but may encourage negative thinking and a sense of victimization. Questioning why the client was fired is a nontherapeutic approach that can hinder communication by putting the client on the defensive.

3. During a mental health assessment on an adult client, which client action would demonstrate the highest achievement in terms of mental health according to Maslow's hierarchy of needs?

• A. Maintaining a long-term, faithful, intimate relationship
• B. Achieving a sense of self-confidence
• C. Possessing a feeling of self-fulfillment and realizing full potential
• D. Developing a sense of purpose and the ability to direct activities

Correct answer: C

Rationale: In Maslow's hierarchy of needs, self-actualization is the highest level. Possessing a feeling of self-fulfillment and realizing full potential reflects self-actualization. This level represents achieving personal growth, self-improvement, and reaching one's full potential, indicating optimal mental health. Choices A, B, and D represent lower levels of needs according to Maslow's hierarchy. Maintaining a long-term relationship indicates belongingness and love needs, achieving self-confidence pertains to esteem needs, and developing a sense of purpose relates to self-esteem and self-actualization needs, but they are not at the pinnacle of self-actualization as in choice C.

4. A healthcare professional is assessing a client who is experiencing severe anxiety. Which of the following symptoms should the healthcare professional expect to observe?

• A. Restlessness
• B. Rapid heart rate
• C. Sweating
• D. Dry mouth

Correct answer: B

Rationale: Rapid heart rate is a characteristic symptom of severe anxiety due to the body's fight-or-flight response being activated. This physiological response leads to an increased heart rate to prepare the body to deal with perceived threats. Healthcare professionals should be vigilant in monitoring and managing this symptom in clients experiencing severe anxiety.

5. When a patient with major depressive disorder is prescribed escitalopram, what potential side effect should the healthcare provider educate the patient about?

• A. Weight gain
• B. Insomnia
• C. Diarrhea
• D. Hypertension

Correct answer: B

Rationale: The correct answer is B: Insomnia. Escitalopram, a selective serotonin reuptake inhibitor (SSRI), commonly causes insomnia as a side effect. Patients should be informed about the possibility of experiencing difficulty falling or staying asleep when starting this medication. Choices A, C, and D are incorrect because weight gain, diarrhea, and hypertension are not typically associated with escitalopram use.

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