Nursing Elites

1. A healthcare professional is assessing a patient with anorexia nervosa. Which finding is most concerning?

• A. Mild bradycardia
• B. Electrolyte imbalances
• C. Slight hypotension
• D. Lanugo

Correct answer: B

Rationale: Electrolyte imbalances are a critical concern in patients with anorexia nervosa due to the potential for severe complications such as cardiac arrhythmias, muscle weakness, and neurological disturbances. Prompt identification and management of electrolyte imbalances are essential to prevent life-threatening outcomes.

2. Ted, a former executive, is now unemployed due to manic episodes at work. He was diagnosed with bipolar I 8 years ago. Ted has a history of IV drug abuse, which resulted in hepatitis C. He is taking his lithium exactly as scheduled, a fact that both Ted’s wife and his blood tests confirm. To reduce Ted’s mania, the psychiatric nurse practitioner recommends:

• A. Clonazepam (Klonopin)
• B. Fluoxetine (Prozac)
• C. Electroconvulsive therapy (ECT)
• D. Lurasidone (Latuda)

Correct answer: D

Rationale: Lurasidone (Latuda) is an atypical antipsychotic medication commonly used in the treatment of bipolar disorder. It can help manage symptoms of mania by stabilizing mood and reducing the intensity of manic episodes. Given Ted's history of bipolar I disorder and the need to address his manic symptoms, Lurasidone (Latuda) is a suitable recommendation by the psychiatric nurse practitioner to aid in managing Ted's condition effectively.

3. What must be considered when preparing the teaching plan for a patient diagnosed with bipolar disorder who is being prescribed lithium therapy?

• A. Caffeine and alcohol can affect lithium levels.
• B. Lithium should be taken with meals to avoid gastrointestinal distress.
• C. Regular blood tests are required to monitor lithium levels.
• D. Lithium can cause weight gain.

Correct answer: C

Rationale: When preparing a teaching plan for a patient prescribed lithium therapy for bipolar disorder, it is crucial to emphasize the need for regular blood tests to monitor lithium levels. Monitoring levels is essential to ensure the drug's effectiveness and to manage potential side effects. While factors like caffeine and alcohol intake, taking lithium with meals, and the risk of weight gain may be relevant considerations, the primary focus should be on the necessity of regular blood tests for effective management of lithium therapy. Therefore, option C is the correct choice as it addresses a critical aspect of lithium therapy management.

4. What is the primary goal of exposure therapy for a patient with specific phobia?

• A. To eliminate the phobic response completely
• B. To increase the patient's exposure to the feared object
• C. To help the patient confront and reduce their fear gradually
• D. To provide immediate relief from anxiety symptoms

Correct answer: C

Rationale: The primary goal of exposure therapy for a patient with a specific phobia is to help them confront their fear gradually, leading to a reduction in their fear response over time. This gradual exposure helps the individual learn to manage and cope with their phobia, ultimately reducing the intensity of their fear reactions. Choice A is incorrect because while the goal is to reduce the fear response, complete elimination may not always be feasible. Choice B is incorrect as the focus is not solely on increasing exposure but on gradual confrontation. Choice D is incorrect as the therapy aims for long-term reduction rather than immediate relief.

5. James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for the day shift and anxiously reports, “Last night, demons came to my room and tried to rape me.” Which response would be most therapeutic?

• A. There are no such things as demons. What you saw were hallucinations.
• B. It is not possible for anyone to enter your room at night. You are safe here.
• C. You seem very upset. Please tell me more about what you experienced last night.
• D. That must have been very frightening, but we’ll check on you at night and you’ll be safe.

Correct answer: C

Rationale: The most therapeutic response acknowledges the patient's emotional state and invites further discussion about their experience. By saying, 'You seem very upset. Please tell me more about what you experienced last night,' the nurse shows empathy and openness, providing a supportive environment for the patient to express their feelings and perceptions.

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