A nurse is working with a patient diagnosed with generalized anxiety disorder. The patient states, 'I can't stop worrying about everything, even things that don't matter.' Which of the following interventions is most appropriate?

Correct Answer: B

Rationale: In this scenario, the most appropriate intervention is option B) Teach the patient relaxation techniques to help manage anxiety. Generalized anxiety disorder is characterized by excessive and uncontrollable worry about various aspects of life. Teaching the patient relaxation techniques such as deep breathing, progressive muscle relaxation, or mindfulness can help them cope with their anxiety symptoms effectively. Option A) Encouraging the patient to confront their anxieties head-on may exacerbate their anxiety and lead to increased distress. Patients with generalized anxiety disorder often find it challenging to confront their worries directly without proper coping mechanisms in place. Option C) Reassuring the patient that their worries are unfounded and unimportant may invalidate their feelings and experiences, potentially worsening the therapeutic relationship and diminishing the patient's trust in the nurse. Option D) Encouraging the patient to avoid stressful situations whenever possible is not a recommended approach as it promotes avoidance behavior, which can further reinforce anxiety in the long term. It is essential to empower patients with coping strategies rather than avoidance tactics. Educationally, it is crucial for nurses to understand the evidence-based interventions for managing generalized anxiety disorder. By teaching relaxation techniques, nurses empower patients to take an active role in managing their symptoms and promote self-care practices that can enhance their overall well-being. This rationale highlights the importance of individualized, patient-centered care in addressing mental health challenges like generalized anxiety disorder.

Correct Answer: C

Rationale: In this scenario, the most appropriate nursing intervention is option C: Set firm limits on the patient's behavior to prevent harm. When working with a patient in the manic phase of bipolar disorder, setting firm limits is crucial to ensure their safety and the safety of others. Manic episodes can lead individuals to engage in risky behaviors that may result in harm or consequences. By establishing clear boundaries, the nurse can help manage the situation and prevent any potential negative outcomes. Option A, providing a calm and quiet environment, may not be sufficient in addressing the risky behaviors associated with mania. While a calming environment can be beneficial in some cases, it may not effectively manage the impulsivity and poor judgment often seen in manic episodes. Encouraging the patient to express their feelings and talk about their behavior (option B) may not be appropriate during a manic phase as the patient's judgment and insight may be impaired. Engaging in such discussions could potentially reinforce or escalate the risky behaviors. Option D, allowing the patient to engage in whatever activities they choose without interference, is not recommended as it could further exacerbate the situation and increase the risk of harm. Patients in a manic phase may not be able to make sound decisions, making it necessary for the nurse to intervene and provide structure and boundaries. In an educational context, understanding the importance of setting firm limits during manic episodes is crucial for nurses working in behavioral health settings. It showcases the significance of safety measures and the role of the nurse in managing challenging behaviors associated with bipolar disorder. By choosing the correct intervention, nurses can effectively support patients in crisis and promote their overall well-being.

Correct Answer: C

Rationale: Asking, 'Am I correct in understanding that "¦' permits clarification to ensure that both the nurse and patient share mutual understanding of the communication. Asking about common elements encourages comparison rather than clarification. The remaining responses are implied questions that suggest the nurse was not listening.

Correct Answer: C

Rationale: Silence can be helpful to both participants by giving each an opportunity to contemplate what has transpired, weigh alternatives, and formulate ideas. A nurse breaking silences is not a principle related to silences. It is inaccurate to say that patients withdraw during long silences or that silence helps patients know that they are understood. Feedback helps patients know they have been understood.

Correct Answer: B

Rationale: The correct answer is B) The patient's speech is fragmented and difficult to understand. Disorganized thinking is a hallmark symptom of schizophrenia, characterized by incoherent and fragmented speech patterns that make it challenging to follow the patient's thoughts. This can include rapid shifts in topics, tangential responses, or even word salad where words are strung together without logical connection. Option A is incorrect because speaking in a logical, coherent manner with clear thoughts does not demonstrate disorganized thinking, which is a specific symptom of schizophrenia. Option C describes delusional thinking, which is a different symptom associated with schizophrenia but not synonymous with disorganized thinking. Option D mentions well-organized thoughts with concentration difficulties, which is more indicative of attention deficits rather than disorganized thinking. In an educational context, understanding the nuances of symptoms like disorganized thinking in schizophrenia is crucial for nurses to provide appropriate care and support for patients. Recognizing these symptoms helps in developing effective nursing care plans tailored to the individual's needs, promoting better outcomes and quality of life for patients with schizophrenia.