Nursing Elites

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

• A. Encourage deep, slow breathing.
• B. Encourage the patient to talk about their feelings.
• C. Leave the patient alone to calm down.
• D. Engage the patient in a physical activity.

Correct answer: A

Rationale: Encouraging deep, slow breathing is the most appropriate intervention for a patient experiencing a panic attack. This technique can help the patient regulate their breathing, reduce hyperventilation, and promote relaxation, which are essential in managing the symptoms of a panic attack. Choice B, encouraging the patient to talk about their feelings, may not be effective during an acute panic attack as the focus should be on calming the patient down. Choice C, leaving the patient alone, can lead to increased feelings of fear and isolation during a panic attack. Choice D, engaging the patient in physical activity, may exacerbate symptoms as it can increase the feeling of being out of control.

2. During an assessment, a nurse observes a client showing signs of moderate anxiety. Which symptom is not typically associated with moderate anxiety?

• A. Fidgeting
• B. Laughing inappropriately
• C. Palpitations
• D. Nail biting

Correct answer: C

Rationale: When assessing a client with moderate anxiety, the nurse should anticipate signs such as fidgeting, laughing inappropriately, and nail biting. These behaviors are common manifestations of increased stress levels. Palpitations, on the other hand, are more commonly associated with severe anxiety or panic attacks. Other symptoms of severe anxiety may include restlessness, difficulty concentrating, muscle tension, and sleep disturbances.

3. A client has experienced the death of a close family member and at the same time becomes unemployed. This situation has resulted in a 6-month score of 110 on the Recent Life Changes Questionnaire. How should the nurse evaluate this client data?

• A. The client is experiencing severe distress and is at risk for physical and psychological illness.
• B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant threat of stress-related illness.
• C. Susceptibility to stress-related physical or psychological illness cannot be estimated without knowledge of coping resources and available supports.
• D. The client may view these losses as challenges and perceive them as opportunities.

Correct answer: C

Rationale: The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences and the Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a year-score total of 500 or more, indicates high stress in a client's life. However, susceptibility to stress-related physical or psychological illness cannot be accurately estimated without considering the individual's coping resources and available support systems. Positive coping mechanisms and strong social support can mitigate the risk of stress-related illnesses even in the face of significant life changes and losses. Choice A is incorrect because it makes a definitive statement about the client's state without considering individual coping mechanisms and support. Choice B is incorrect because a score of 110 does not necessarily mean no threat of stress-related illness, as individual factors play a crucial role. Choice D is incorrect as it assumes a positive outlook without acknowledging the potential impact of the experienced losses on stress levels.

4. After fasting from 10 p.m. the previous evening, a client finds out that the blood test has been canceled. The client swears at the nurse and states, 'You are incompetent!' Which is the nurse's best response?

• A. Do you believe that I was the cause of your blood test being canceled?
• B. I see that you are upset, but I feel uncomfortable when you swear at me.
• C. Have you ever thought about ways to express anger appropriately?
• D. I'll give you some space. Let me know if you need anything.

Correct answer: B

Rationale: In this scenario, the most appropriate response for the nurse is option B. By acknowledging the client's feelings and setting a boundary regarding inappropriate behavior, the nurse addresses the situation with empathy. This response demonstrates understanding of the client's emotions while also maintaining a professional standard by expressing discomfort with swearing. Option A could come off as defensive and may escalate the situation. Option C may be perceived as condescending and not immediately address the client's behavior. Option D, although offering space, does not directly address the inappropriate behavior and misses an opportunity to set a professional boundary.

5. In a patient with schizophrenia, which of the following symptoms would indicate a poor prognosis?

• A. Auditory hallucinations
• B. Paranoia
• C. Flat affect
• D. Delusions of grandeur

Correct answer: C

Rationale: A flat affect, characterized by a lack of emotional expression, is often linked to a poorer prognosis in schizophrenia. It can hinder social interactions and affect the individual's ability to engage in therapy or express emotions, thereby impacting the overall treatment outcomes. Auditory hallucinations (Choice A) and delusions of grandeur (Choice D) are common symptoms in schizophrenia but may not always indicate a poor prognosis. Paranoia (Choice B) can also vary in its impact on prognosis depending on the individual and the severity of the symptom.

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