Nursing Elites

1. A client with bipolar disorder is experiencing a depressive episode. Which nursing intervention is most appropriate?

• A. Encourage the client to avoid physical activity.
• B. Encourage the client to engage in social activities.
• C. Encourage the client to participate in group therapy.
• D. Encourage the client to set realistic goals.

Correct answer: C

Rationale: Encouraging the client to participate in group therapy is the most appropriate nursing intervention for a client with bipolar disorder experiencing a depressive episode. Group therapy provides a supportive environment where the client can share experiences, learn coping strategies, and receive emotional support from peers and mental health professionals. It can help reduce feelings of isolation, improve social skills, and enhance overall well-being. Group therapy also promotes a sense of belonging and understanding, which are essential for individuals dealing with bipolar disorder and depressive symptoms. Choices A, B, and D are not the most appropriate interventions for a client experiencing a depressive episode in bipolar disorder. Encouraging the client to avoid physical activity may worsen their symptoms, promoting social activities may not address the underlying issues effectively, and setting goals may be overwhelming during a depressive episode.

2. Which therapeutic approach is most effective for managing obsessive-compulsive disorder (OCD)?

• A. Cognitive-behavioral therapy
• B. Psychoanalysis
• C. Medication management
• D. Group therapy

Correct answer: A

Rationale: Cognitive-behavioral therapy (CBT), especially exposure and response prevention, is considered the most effective therapeutic approach for managing obsessive-compulsive disorder (OCD). CBT helps individuals identify and modify their distorted beliefs and behaviors related to OCD, while exposure and response prevention specifically target the core symptoms of OCD by gradually exposing the individual to feared stimuli and preventing compulsive responses. While medication management can be used as an adjunct to therapy, CBT has shown to have long-lasting benefits in reducing OCD symptoms and improving the overall quality of life. Psychoanalysis focuses more on exploring unconscious conflicts and childhood experiences, which may not be as effective for OCD. Group therapy can be beneficial as a supplemental treatment but is not typically as effective as individual CBT tailored to the specific needs of the individual with OCD.

3. A client with schizophrenia is experiencing auditory hallucinations. Which intervention should the nurse implement to address this symptom?

• A. Encourage the client to discuss the voices.
• B. Tell the client that the voices are not real.
• C. Provide reality-based feedback to the client.
• D. Distract the client from the voices.

Correct answer: C

Rationale: When a client with schizophrenia is experiencing auditory hallucinations, providing reality-based feedback is a therapeutic intervention. This helps the client differentiate between what is real and what is not, aiding in reducing the impact of hallucinations. Encouraging the client to discuss the voices may validate the hallucinations, telling the client that the voices are not real dismisses their experience, and distracting the client may not address the underlying issue of the hallucinations.

4. A client with bipolar disorder is experiencing a manic episode. Which of the following interventions should the nurse implement? Select one that does not apply.

• A. Provide a structured environment
• B. Encourage rest periods
• C. Limit setting on inappropriate behaviors
• D. Allow the client to engage in stimulating activities

Correct answer: D

Rationale: During a manic episode, it is essential to provide a structured environment to help the client maintain stability. Encouraging rest periods is crucial as excessive activity during mania can lead to exhaustion. Setting limits on inappropriate behaviors helps ensure the client's safety and the safety of others. Allowing the client to engage in stimulating activities can exacerbate manic symptoms by further increasing their energy levels and impulsivity. This can lead to a worsening of the manic episode and potentially risky behaviors. Therefore, allowing the client to engage in stimulating activities is not an appropriate intervention during a manic episode.

5. A client prescribed sertraline for depression is receiving discharge instructions. Which statement by the client indicates an accurate understanding of the medication?

• A. I should take this medication at bedtime to avoid nausea.
• B. I should avoid drinking alcohol while taking this medication.
• C. I should take this medication with food to avoid stomach upset.
• D. It may take several weeks for this medication to be effective.

Correct answer: D

Rationale: The correct answer is D because sertraline, used for depression, typically takes several weeks to become effective. It is important for clients to understand this delayed onset of action to manage their expectations and continue taking the medication as prescribed despite not seeing immediate results.

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