Nursing Elites

1. Which of the following is a hallmark symptom of generalized anxiety disorder (GAD)?

• A. Flashbacks
• B. Excessive worry
• C. Hallucinations
• D. Compulsive behaviors

Correct answer: B

Rationale: Excessive worry is a hallmark symptom of generalized anxiety disorder (GAD). Individuals with GAD often experience persistent and excessive worry or anxiety about a variety of situations or activities, even when there is little or no reason to worry. This chronic worrying can significantly impact their daily functioning and quality of life, distinguishing it as a key feature of GAD. Flashbacks are more commonly associated with post-traumatic stress disorder (PTSD), not GAD. Hallucinations are not typically seen in GAD but may be present in conditions like schizophrenia. Compulsive behaviors are characteristic of obsessive-compulsive disorder (OCD), not GAD.

2. A client is being taught relaxation techniques to manage anxiety. Which of the following techniques should the instructor include in the teaching? Select one that doesn't apply.

• A. Deep breathing exercises
• B. Progressive muscle relaxation
• C. Mindfulness meditation
• D. Cognitive restructuring

Correct answer: D

Rationale: Relaxation techniques commonly used to manage anxiety include deep breathing exercises, progressive muscle relaxation, mindfulness meditation, and guided imagery. Cognitive restructuring, on the other hand, is a cognitive-behavioral technique aimed at identifying and changing negative thought patterns rather than a specific relaxation technique. Therefore, cognitive restructuring does not fall under the category of relaxation techniques and is not typically used to manage anxiety.

3. Which of the following are potential side effects of electroconvulsive therapy (ECT)? Select one that does not apply.

• A. Short-term memory loss
• B. Headache
• C. Confusion
• D. Tardive dyskinesia

Correct answer: D

Rationale: Potential side effects of ECT include short-term memory loss, headache, confusion, and nausea. Tardive dyskinesia is not a side effect of ECT; it is associated with long-term use of antipsychotic medications, particularly antipsychotics that block dopamine receptors over time. ECT is primarily used for severe depression, bipolar disorder, and certain psychotic disorders. The other choices, short-term memory loss, headache, and confusion, are known side effects of ECT and are usually short-term and manageable.

4. A healthcare professional is planning care for a client with borderline personality disorder. Which of the following interventions should not be included in the plan of care?

• A. Set clear and consistent boundaries
• B. Encourage dependency on the healthcare professional
• C. Avoid discussing the client's feelings
• D. Use a firm, authoritative approach

Correct answer: B

Rationale: In caring for a client with borderline personality disorder, it is essential to set clear and consistent boundaries, use a firm, authoritative approach, and provide opportunities for the client to express feelings. Encouraging dependency can reinforce maladaptive behaviors, while avoiding discussing feelings can hinder therapeutic progress in addressing underlying issues. Building a sense of dependency may exacerbate the client's difficulties in developing autonomy and self-reliance, which are crucial for their progress and recovery. Therefore, encouraging dependency is not a recommended intervention in the plan of care for clients with borderline personality disorder.

5. You have been working closely with a patient for the past month. Today he tells you he is looking forward to meeting with his new psychiatrist but frowns and avoids eye contact while reporting this to you. Which of the following responses would most likely be therapeutic?

• A. A new psychiatrist is a chance to start fresh; I'm sure it will go well for you.
• B. You say you look forward to the meeting, but you appear anxious or unhappy.
• C. I notice that you frowned and avoided eye contact just now. Don't you feel well?
• D. I get the impression you don't really want to see your psychiatrist—can you tell me why?

Correct answer: B

Rationale: Choice B is the most therapeutic response as it acknowledges the discrepancy between the patient's verbal statement and nonverbal cues. By addressing both the patient's expressed anticipation and the conflicting nonverbal cues of frowning and avoiding eye contact, the responder demonstrates attentiveness to the patient's emotional state and encourages further exploration of underlying feelings. This approach fosters open communication and helps the patient feel understood and supported.

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