Nursing Elites

1. When assessing a patient with major depressive disorder, which of the following is a common cognitive symptom?

• A. Hallucinations
• B. Delusions
• C. Lack of appetite
• D. Negative self-talk

Correct answer: D

Rationale: Negative self-talk is a common cognitive symptom of major depressive disorder. It involves a pattern of negative thoughts and beliefs about oneself, which can significantly impact a patient's self-esteem and overall outlook on life. Hallucinations and delusions are more commonly associated with other mental health conditions like schizophrenia, while lack of appetite is typically considered a physical symptom of depression rather than a cognitive one.

2. Which of the following is an example of a mood stabilizer used to treat bipolar disorder?

• A. Fluoxetine
• B. Lithium
• C. Haloperidol
• D. Lorazepam

Correct answer: B

Rationale: Lithium is a widely recognized mood stabilizer used in the treatment of bipolar disorder. It helps to control mood swings, prevent manic episodes, and reduce the risk of suicidal behavior in individuals with bipolar disorder. Fluoxetine is an antidepressant, Haloperidol is an antipsychotic, and Lorazepam is a benzodiazepine used for anxiety and insomnia, none of which are primary mood stabilizers for bipolar disorder.

3. A client with anxiety disorder is scheduled to begin classical psychoanalysis. Which client statement indicates an understanding of this form of therapy?

• A. “Even if my anxiety improves, I will need to continue this therapy for 6 weeks”
• B. “The therapist will focus on my past relationships during our sessions”
• C. “Psychoanalysis will help me reduce my anxiety by changing my behaviors”
• D. “This therapy will address my conscious feelings about stressful experiences”

Correct answer: B

Rationale: In classical psychoanalysis, the therapist delves into the client's past relationships, childhood experiences, and unconscious thoughts to uncover underlying issues contributing to the client's current symptoms. Understanding that the therapist will focus on past relationships aligns with the core principles of classical psychoanalysis. Choice A is incorrect because the duration of classical psychoanalysis is typically longer than 6 weeks. Choice C is incorrect as changing behaviors is more aligned with behavioral therapy than classical psychoanalysis. Choice D is incorrect as classical psychoanalysis primarily focuses on unconscious thoughts rather than conscious feelings about stressful experiences.

4. 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.

5. A patient with panic disorder is prescribed selective serotonin reuptake inhibitors (SSRIs). What should the nurse include in the patient’s education?

• A. SSRIs are fast-acting medications that can relieve anxiety immediately.
• B. It may take several weeks for the full therapeutic effects of SSRIs to be felt.
• C. SSRIs have a high potential for abuse and dependence.
• D. The patient should discontinue the medication once they feel better.

Correct answer: B

Rationale: Patients prescribed with SSRIs need to be educated that it may take several weeks for the full therapeutic effects of the medication to be experienced. This delay is important for patient understanding and compliance with the treatment plan. Choice A is incorrect because SSRIs do not provide immediate relief and may take weeks to show significant improvement. Choice C is inaccurate as SSRIs are not known for having a high potential for abuse and dependence. Choice D is incorrect as patients should never discontinue medication abruptly without consulting their healthcare provider.

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