Nokea
A patient experiences an episode of severe anxiety. Of these medications in the patient's medical record, which is most appropriate to administer as a short-term therapy?
- A. Buspirone
- B. Lorazepam
- C. Amitriptyline
- D. Desipramine
Correct Answer: B
Rationale: Lorazepam is a benzodiazepine medication used to treat anxiety on a short-term basis only. Buspirone is long acting and not useful as an as-needed drug. Amitriptyline and desipramine are tricyclic antidepressants and considered second- or third-line agents.
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A patient performs ritualistic hand washing. What should the nurse do to help the patient develop more effective coping strategies?
- A. Allow the patient to set a hand-washing schedule.
- B. Encourage the patient to participate in social activities.
- C. Encourage the patient to discuss hand-washing routines.
- D. Focus on the patient's symptoms rather than on the patient.
Correct Answer: B
Rationale: Because patients diagnosed with obsessive-compulsive disorder become overly involved in rituals, promoting involvement with other people and activities is necessary to improve the patient's coping strategies. Daily activities prevent the constant focus on anxiety and its symptoms. The other interventions focus on the compulsive symptom.
Which client statement most supports a diagnosis of agoraphobia?
- A. Being afraid to go out seems ridiculous, but I can't go out the door.
- B. I'm sure I'll get over not wanting to leave home soon. It takes time.
- C. When I have a good incentive to go out, I can do it.
- D. My family says they like it now that I stay home.
Correct Answer: A
Rationale: Individuals who are agoraphobic generally acknowledge that the behavior is not constructive and that they do not really like it. Patients state they are unable to change the behavior. Patients with agoraphobia are not optimistic about change. Most families are dissatisfied when family members refuse to leave the house.
An individual experiencing sexual dysfunction blames it on their partner and suggests the person is both unattractive and unromantic. Which defense mechanism is evident?
- A. Rationalization
- B. Compensation
- C. Introjection
- D. Regression
Correct Answer: A
Rationale: Rationalization involves unconsciously making excuses for one's behavior, inadequacies, or feelings. Regression involves the unconscious use of a behavior from an earlier stage of emotional development. Compensation involves making up for deficits in one area by excelling in another area. Introjection is an unconscious, intense identification with another person.
A nurse encourages an anxious patient to talk about feelings and concerns. What is the rationale for this intervention?
- A. Offering hope allays and defuses the patient's anxiety
- B. Concerns stated aloud become less overwhelming and help decrease feelings of isolation
- C. Anxiety is reduced by focusing on and validating what is occurring in the environment
- D. Encouraging patients to explore alternatives increases the sense of control and lessens anxiety
Correct Answer: B
Rationale: All principles listed are valid, but the only rationale directly related to the intervention of assisting the patient to talk about feelings and concerns is the one that states that concerns spoken aloud become less overwhelming, less socially isolating, and help problem solving to begin.
A patient who is preparing for surgery has moderate anxiety and is unable to understand preoperative information. Which nursing intervention is appropriate?
- A. Reassure the patient that all nurses are skilled in providing postoperative care.
- B. Describe the procedure again in a calm manner, using simple language.
- C. Tell the patient that the staff is prepared to promote recovery.
- D. Encourage the patient to express feelings to his or her family.
Correct Answer: B
Rationale: Providing information in a calm, simple manner helps the patient grasp the important facts. Introducing extraneous topics as described in the incorrect options will further scatter the patient's attention.