Nursing Elites

1. Which statement made by the patient demonstrates an understanding of the treatment of choice for patients managing the effects of traumatic events?

• A. I attend my therapy sessions regularly.
• B. Those intrusive memories are hidden for a reason and should stay hidden.
• C. Keeping busy is the key to achieving mental health.
• D. I've agreed to move in with my parents so I'll get the support I need.

Correct answer: A

Rationale: Regular attendance at therapy sessions is a crucial aspect of the recommended treatment for managing the effects of traumatic events. Therapy provides a safe space for individuals to process their experiences, develop coping strategies, and work towards healing and recovery. Consistent participation in therapy sessions can help patients address and overcome the impact of trauma on their mental health.

2. Which assessment question asked by the nurse demonstrates an understanding of comorbid mental health conditions associated with major depressive disorder? Select one that doesn't apply.

• A. Do rules apply to you?
• B. What do you do to manage anxiety?
• C. Do you have a history of disordered eating?
• D. Do you think that you drink too much?

Correct answer: A

Rationale: Questions about anxiety management, disordered eating, and alcohol use are relevant to identifying comorbid conditions with major depressive disorder, but the question 'Do rules apply to you?' does not directly address common comorbid mental health conditions associated with major depressive disorder.

3. A patient with bipolar disorder has been prescribed lithium. Which dietary advice is important for the nurse to include?

• A. Avoid foods high in tyramine.
• B. Maintain a consistent salt intake.
• C. Increase protein intake.
• D. Avoid foods high in fat.

Correct answer: B

Rationale: Patients prescribed lithium should maintain a consistent salt intake to prevent fluctuations in lithium levels. Salt intake can impact lithium levels, and sudden changes in salt intake can affect how the body absorbs and excretes lithium. Therefore, advising the patient to maintain a stable salt intake is crucial for the effectiveness and safety of lithium therapy. Choices A, C, and D are incorrect. Avoiding foods high in tyramine is more relevant for patients taking MAOIs, not lithium. Increasing protein intake or avoiding foods high in fat are not specific dietary recommendations for patients on lithium therapy.

4. 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.

5. A client has generalized anxiety disorder (GAD), and a nurse is providing care. Which of the following interventions should the nurse avoid implementing?

• A. Encourage the client to express their feelings
• B. Monitor daily caloric intake and weight
• C. Promote regular physical activity
• D. Discourage the use of caffeine

Correct answer: B

Rationale: In caring for a client with generalized anxiety disorder (GAD), it is important to encourage the client to express their feelings, promote regular physical activity, and discourage the use of caffeine. Addressing weight and caloric intake monitoring may exacerbate anxiety related to body image, and focusing on these aspects can be distressing for the client. Therefore, monitoring daily caloric intake and weight should be avoided in this scenario.

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