The PMHNP is working with a client who says he is anxious today. Which of the following is an example of a scaling question?
“Was there a time when you didn't have anxiety?”
“On a scale of 1-10, with 10 being the most anxious and 1 being the least, how would you rate your anxiety today?”
“Is this the most anxiety you have ever felt in your life?”
“If you woke up tomorrow and your anxiety was completely gone, what would that look like?”
The Correct Answer is B
Choice A reason: This is a qualitative, exploratory question about past experiences, not a numeric scaling question.
Choice B reason: This is correct. It asks the client to quantify their anxiety on a numerical scale, which is the essence of a scaling question.
Choice C reason: This is a comparative question about intensity, not a numeric rating, and does not establish a scale for monitoring progress.
Choice D reason: This is a miracle question exploring desired outcomes, not a scaling measure of current symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Atrial fibrillation typically presents with a rapid and irregular heartbeat. A pulse rate of 157 beats per minute is tachycardic and may indicate AF, especially in the context of palpitations, dyspnea, and syncope.
Choice B reason: Low blood pressure may be associated with multiple cardiac conditions but is not specific for AF.
Choice C reason: Bradycardia is generally not associated with typical atrial fibrillation unless there is a conduction defect or medication effect.
Choice D reason: Elevated blood pressure alone is not diagnostic of atrial fibrillation. It may be a chronic condition or a comorbidity.
Correct Answer is B
Explanation
Choice A reason: Discontinuing the medication after only two weeks is premature. SSRIs like escitalopram typically require 4–6 weeks to achieve full therapeutic effect, so discontinuation at this point could prevent the patient from benefiting from treatment.
Choice B reason: Making no changes is appropriate because the patient is within the early stages of treatment. Her HAM-A score decreased slightly, and she reports no adverse effects, indicating she is tolerating the medication and may continue to improve with time. Monitoring and follow-up are the correct next steps.
Choice C reason: Adding an augmenting agent is unnecessary at this stage because the patient has only just begun therapy, and insufficient time has passed to determine the full effect of the SSRI. Augmentation is considered after an adequate trial of the primary medication.
Choice D reason: Switching to a different antidepressant is not indicated because there has been some improvement in her symptoms and she is tolerating the medication well. A switch is premature before completing an adequate trial period.
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