Nursing Elites

1. A healthcare professional is assessing a client with major depressive disorder. Which of the following findings should the professional expect? Select one that does not apply.

• A. Anhedonia
• B. Hypersomnia
• C. Fatigue
• D. Flight of ideas

Correct answer: D

Rationale: In major depressive disorder, common findings include anhedonia (loss of interest or pleasure), hypersomnia (excessive sleepiness), fatigue, and feelings of worthlessness. Flight of ideas, characterized by racing thoughts and rapid speech, is more commonly associated with bipolar disorder, particularly during manic episodes. Therefore, 'Flight of ideas' does not apply to the expected findings in major depressive disorder.

2. A client has been diagnosed with obsessive-compulsive personality disorder. Which of the following behaviors should the nurse expect?

• A. Perfectionism
• B. Flexibility
• C. Generosity
• D. Spontaneity

Correct answer: A

Rationale: Individuals with obsessive-compulsive personality disorder commonly exhibit perfectionism, a need for orderliness, and a preoccupation with details. This behavior often interferes with task completion and can impact interpersonal relationships. Choice A is correct because perfectionism is a key characteristic of this disorder. Choices B, C, and D are incorrect because individuals with obsessive-compulsive personality disorder typically lack flexibility, may not display generosity, and tend to avoid spontaneity.

3. Which therapeutic approach is most effective for managing borderline personality disorder?

• A. Dialectical behavior therapy
• B. Cognitive-behavioral therapy
• C. Psychoanalysis
• D. Supportive therapy

Correct answer: A

Rationale: Dialectical behavior therapy (DBT) is considered the most effective therapeutic approach for managing borderline personality disorder. DBT is a specialized form of cognitive-behavioral therapy that focuses on providing skills to cope with intense emotions, improve relationships, and regulate behavior. It has been extensively studied and shown to be effective in reducing self-harm, suicidal behaviors, and improving overall functioning in individuals with borderline personality disorder. Cognitive-behavioral therapy (Choice B) is a common and effective treatment for many mental health conditions but is not as specifically tailored to address the core symptoms of borderline personality disorder as DBT. Psychoanalysis (Choice C) is a more intensive and long-term therapy that focuses on exploring unconscious patterns and early life experiences, which may not be as practical or effective for the impulsive and emotional dysregulation seen in borderline personality disorder. Supportive therapy (Choice D) provides emotional support but lacks the structured skills training and strategies that are essential in managing borderline personality disorder.

4. What information should the nurse include in patient education for a patient prescribed fluoxetine for obsessive-compulsive disorder (OCD)?

• A. Take the medication in the morning to avoid insomnia.
• B. The medication may take several weeks to achieve the full effect.
• C. It is safe to consume alcohol while taking this medication.
• D. Report any side effects to the healthcare provider immediately.

Correct answer: B

Rationale: Patients prescribed fluoxetine should be educated that the medication may take several weeks to achieve its full therapeutic effect. This information helps manage patient expectations and ensures they do not discontinue the medication prematurely due to lack of immediate results. Taking the medication in the morning to avoid insomnia is not a specific requirement for fluoxetine. Consuming alcohol while taking fluoxetine is not safe and can lead to adverse effects. It is crucial to report any side effects to the healthcare provider promptly for timely management and adjustment of the treatment plan.

5. Which response demonstrates accurate information that should be discussed with the female patient diagnosed with bipolar disorder and her support system? Select the incorrect one.

• A. Remember that alcohol and caffeine can trigger a relapse of your symptoms.
• B. Due to the risk of a manic episode, antidepressant therapy is never used with bipolar disorder.
• C. It's critical to inform your healthcare provider immediately if you are experiencing sleep disturbances.
• D. Is your family prepared to be actively involved in helping manage this disorder?

Correct answer: B

Rationale: In managing bipolar disorder, it is vital to educate the patient and their support system about triggers like alcohol and caffeine, the significance of good sleep, and the need for family involvement. However, the statement in choice B is incorrect. While antidepressants need to be carefully monitored in bipolar disorder, they can be used in conjunction with mood stabilizers to manage depression in some cases.

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