A nurse is working with a patient diagnosed with generalized anxiety disorder. Which of the following interventions is most appropriate to help the patient manage their anxiety?

Correct Answer: B

Rationale: The most appropriate intervention for a patient diagnosed with generalized anxiety disorder is to provide relaxation techniques such as deep breathing (Option B). This is because deep breathing exercises are a widely recognized evidence-based strategy for managing anxiety. Deep breathing helps activate the body's relaxation response, which can counter the physiological arousal associated with anxiety. Encouraging the patient to confront their fears directly (Option A) may actually exacerbate their anxiety and lead to increased distress. It is important not to push individuals with anxiety disorders into situations that may trigger overwhelming anxiety. Reassuring the patient that their anxiety is not warranted (Option C) is not helpful as it may invalidate their feelings and experiences. Anxiety disorders are real and valid mental health conditions that require understanding and appropriate interventions. Encouraging the patient to avoid stressful situations whenever possible (Option D) can contribute to the perpetuation of anxiety and limit the individual's ability to cope and adapt to challenging circumstances. Avoidance can lead to increased fear and avoidance behaviors, ultimately worsening the anxiety symptoms. In an educational context, it is crucial for healthcare providers, including nurses, to be well-versed in evidence-based interventions for anxiety disorders. By understanding the most effective strategies like deep breathing techniques, nurses can provide optimal care and support to patients with generalized anxiety disorder, promoting their overall well-being and mental health.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Nutritional deficiencies and electrolyte imbalances. This is the priority concern for the nurse because individuals with bulimia nervosa often engage in binge eating followed by purging behaviors like self-induced vomiting, which can lead to severe consequences such as electrolyte imbalances (e.g., hypokalemia) and nutritional deficiencies (e.g., low levels of vitamins and minerals). These complications can have serious implications on the patient's physical health, potentially leading to cardiac arrhythmias, muscle weakness, and other life-threatening conditions. Option B) Impulsivity and emotional dysregulation, while important factors in understanding and treating bulimia nervosa, are not the immediate priority in this case. Addressing nutritional deficiencies and electrolyte imbalances takes precedence due to their acute and potentially life-threatening nature. Option C) Distorted body image and low self-esteem are common psychosocial issues in individuals with bulimia nervosa but do not pose an immediate threat to the patient's physical health compared to the risks associated with electrolyte imbalances and nutritional deficiencies. Option D) Excessive exercise and weight loss are more commonly associated with anorexia nervosa rather than bulimia nervosa. While these behaviors can co-occur in some cases, they are not the primary concern in a patient presenting with binge eating and purging behaviors. Educationally, it is crucial for nurses and healthcare providers to prioritize the management of acute physical health concerns in individuals with eating disorders to prevent serious complications. Understanding the hierarchy of concerns allows for appropriate triaging and intervention to address the most critical issues first, ensuring the safety and well-being of the patient.

Correct Answer: B

Rationale: In behavioral nursing, after formulating nursing diagnoses for a new patient, the nurse's next action should be determining the goals and outcome criteria (Option B). This step is crucial as it sets the direction for the plan of care. By establishing clear goals and outcome criteria, the nurse can develop a targeted and effective care plan that addresses the patient's specific needs and helps in evaluating the success of the interventions over time. Option A, designing interventions, is premature without clearly defined goals. Without specific goals, interventions may not be aligned with the desired outcomes, leading to ineffective care. Option C, implementing the nursing plan of care, should only occur after goals are established to ensure that interventions are purposeful and tailored to the patient's needs. Option D, completing the spiritual assessment, is important but typically falls within the assessment phase and may not be the immediate next step after formulating nursing diagnoses. It is essential for holistic care but may not directly follow the formulation of nursing diagnoses in the care planning process. Understanding the sequential nature of the nursing process is essential for providing efficient and effective care. By prioritizing goal setting after formulating nursing diagnoses, nurses can ensure that their interventions are focused, measurable, and aligned with the patient's needs, ultimately leading to better patient outcomes.

Correct Answer: D

Rationale: The correct answer is D) Differing values are reflected in the two statements. In this scenario, it is essential to understand that both the patient and the nurse are expressing their personal values and beliefs regarding the sensitive topic of suicide. The patient's perspective advocates for autonomy and individual choice over one's life, while the nurse's response reflects a perspective that values life preservation and intervention to prevent harm. The patient's viewpoint emphasizes the importance of respecting an individual's autonomy and right to make decisions about their own life, even in situations as complex as suicide. On the other hand, the nurse's response reflects a duty to uphold the sanctity of life and intervene to prevent harm, aligning with the ethical principle of beneficence in nursing. This interchange highlights the significance of recognizing and respecting diverse perspectives and values in healthcare settings. Nurses must navigate these differences with empathy, respect, and understanding while upholding professional ethics and standards of care. It also underscores the importance of effective communication and active listening in addressing sensitive and challenging topics with patients to provide holistic and patient-centered care.

Correct Answer: B

Rationale: In this scenario, the correct priority nursing intervention is option B: Assess the patient for suicidal thoughts and ideation. This is the most critical action because the patient's expression of hopelessness raises concerns about their safety and risk of harm to themselves. Suicidal ideation is a serious symptom in major depressive disorder that requires immediate attention to ensure the patient's safety. Option A is incorrect because encouraging the patient to engage in mood-improving activities may not be effective or safe if the patient is experiencing suicidal thoughts. Option C, providing positive affirmations, though supportive, does not address the immediate safety concerns raised by the patient's statement. Option D, suggesting medication, may be part of the treatment plan but is not the most urgent intervention in this situation. From an educational perspective, it is crucial for nurses to prioritize safety in mental health assessments. Assessing for suicidal ideation is a fundamental skill in psychiatric nursing to ensure that appropriate interventions are implemented promptly. Understanding the hierarchy of nursing interventions based on the patient's presenting symptoms is essential for providing quality care in behavioral health settings.