A nurse is providing information to a client about risk factors for developing an anxiety-related disorder. Which of the following clients is at greatest risk for developing an anxiety-related disorder?

Correct Answer: B

Rationale: In this scenario, option B is the correct answer because it presents a client with multiple adverse childhood experiences and a family history of anxiety disorders. Adverse childhood experiences, such as trauma, neglect, or abuse, are known risk factors for developing anxiety-related disorders. Additionally, a genetic predisposition to anxiety disorders further increases the likelihood of developing such conditions. Option A is incorrect because having a family history of cancer and being recently unemployed are not directly linked to an increased risk of anxiety-related disorders. Option C is incorrect as not completing high school or GED may impact opportunities and socioeconomic status but does not necessarily correlate with a higher risk of anxiety-related disorders. Option D is incorrect because although a family history of anxiety disorders is a risk factor, having several positive childhood experiences may actually serve as protective factors against developing anxiety-related disorders. Educationally, understanding the interplay between genetic predispositions, adverse childhood experiences, and environmental factors is crucial for nurses to provide comprehensive care to clients with anxiety-related disorders. Recognizing these risk factors allows nurses to tailor interventions and support strategies to effectively address the client's needs.

Correct Answer: D

Rationale: In this scenario, the correct answer is option D: Exploring alternative options with a patient regarding medications. This choice aligns with the ethical principle of autonomy, which emphasizes the right of individuals to make their own decisions about their healthcare. By engaging in a collaborative discussion with the patient about medication options, the psychiatric nurse respects the patient's autonomy and empowers them to actively participate in their treatment plan. Option A is incorrect because intervening when a self-mutilating patient attempts to harm themselves may be necessary for patient safety, but it may not always align with promoting autonomy as it involves overriding the patient's actions without their input. Option B is incorrect because staying with a patient who is anxious is a supportive measure but does not directly address the ethical principle of autonomy or involve the patient in decision-making about their care. Option C is incorrect as suggesting that two fighting patients be restricted to the unit is more about maintaining a safe environment and managing behavior rather than promoting autonomy through collaborative decision-making. In an educational context, it is crucial for nurses to understand the ethical principles that guide their practice, including autonomy. By selecting the correct answer, nurses can learn how to respect and promote their patients' autonomy while providing high-quality care that is patient-centered and empowering. This question highlights the importance of involving patients in decisions about their care to uphold ethical standards and foster positive patient outcomes.

Correct Answer: A

Rationale: The correct answer is option A because it demonstrates the most concrete evidence of treatment effectiveness. The patient being abstinent for 10 days indicates immediate compliance with the treatment plan. Additionally, stating "I can maintain sobriety one day at a time" reflects a key principle of Alcoholics Anonymous and recovery programs, showing the patient's understanding of their journey. Moreover, the fact that the employer is willing to allow the patient to return to work in 3 weeks suggests positive progress and support from the external environment. Options B, C, and D are incorrect as they each have red flags indicating potential relapse or misalignment with effective treatment outcomes. Option B's statement of "My problems are under control" may indicate overconfidence or denial of ongoing issues. Option C's focus on helping others and finding jobs for them instead of personal recovery suggests a lack of self-awareness. Option D's statement about being able to handle one or two drinks raises concerns about boundaries and potential relapse triggers. In an educational context, this question assesses the nurse's ability to interpret patient progress and treatment effectiveness based on documentation. It highlights the importance of looking for concrete evidence of compliance with treatment plans, understanding of recovery principles, and integration of support systems in evaluating patient outcomes in alcohol treatment programs. By understanding these nuances, nurses can provide more effective care and support to individuals struggling with addiction.

Correct Answer: B

Rationale: In this scenario, option B is the most appropriate response for the nurse to assist the patient in reframing their overgeneralization. By suggesting to explore a specific event to identify alternative explanations, the nurse is guiding the patient towards critical thinking and challenging their automatic negative thoughts. This approach helps the patient recognize that not all bad outcomes are solely their fault, promoting a more balanced perspective. Option A is incorrect because it simply dismisses the patient's belief without offering a constructive alternative. This response may come off as invalidating and not supportive of the patient's feelings. Option C, while showing empathy, does not actively engage the patient in challenging their negative thought pattern. It acknowledges the patient's self-criticism but does not provide a strategy for cognitive restructuring. Option D is unrelated to the patient's statement and does not address the overgeneralization presented. Bringing up the patient's belief in fate or cultural heritage does not directly assist in reframing the negative thought pattern the patient is experiencing. Educationally, this question highlights the importance of active listening and therapeutic communication skills in nursing practice. It emphasizes the role of nurses in guiding patients towards more adaptive thought processes and promoting mental well-being through cognitive restructuring techniques. By understanding the rationale behind each response, nurses can enhance their ability to support patients with mental health challenges effectively.

Correct Answer: D

Rationale: The correct answer is D) Assess for signs of withdrawal. In this scenario, the priority nursing intervention is to assess for signs of withdrawal because the patient is exhibiting symptoms like agitation, sweating, and hand tremors, which are indicative of alcohol withdrawal. Early identification of withdrawal symptoms is crucial in preventing potential complications such as seizures, delirium tremens, or even death. By assessing the patient for signs of withdrawal, the nurse can determine the severity of the withdrawal symptoms and initiate appropriate interventions promptly. Option A) Provide a quiet, calm environment, is important in managing withdrawal symptoms, but it is not the priority at this moment. Option B) Encourage the patient to drink fluids may be beneficial, but it does not address the immediate concern of assessing for withdrawal symptoms. Option C) Administer medications as prescribed may be necessary, but without a thorough assessment of withdrawal symptoms, the nurse may not know which medications are most appropriate for the patient's condition. In an educational context, this question highlights the importance of recognizing and managing alcohol withdrawal in patients. Nurses need to be able to prioritize interventions based on the patient's condition and assess for potential complications. This question reinforces the critical thinking skills required in nursing practice to ensure patient safety and well-being.