Nursing Elites

1. A client has a new prescription for disulfiram for the treatment of alcohol use disorder. The nurse informs the client that this medication can cause nausea and vomiting when alcohol is consumed. Which of the following types of treatment is this method an example of?

• A. Aversion therapy
• B. Flooding
• C. Biofeedback
• D. Dialectical behavior therapy

Correct answer: A

Rationale: Aversion therapy is a form of behavioral therapy that aims to create a negative response to a stimulus, in this case, alcohol consumption. Disulfiram is used in aversion therapy to induce unpleasant effects when alcohol is consumed, such as nausea and vomiting, to deter the individual from drinking. Therefore, the use of disulfiram in this context exemplifies aversion therapy. Flooding involves exposing an individual to a feared object or situation to overcome anxiety; biofeedback teaches self-regulation techniques, and dialectical behavior therapy is a type of cognitive-behavioral therapy focusing on acceptance and change strategies, which are not directly related to the use of disulfiram for alcohol use disorder.

2. When caring for a patient with dissociative identity disorder, which nursing intervention is a priority?

• A. Providing detailed education about the condition
• B. Monitoring for signs of self-harm or suicidal ideation
• C. Encouraging the patient to recall traumatic events
• D. Helping the patient develop a strong sense of identity

Correct answer: B

Rationale: When caring for a patient with dissociative identity disorder, the priority nursing intervention is to monitor for signs of self-harm or suicidal ideation. Ensuring patient safety is crucial, as individuals with this disorder may be at increased risk of self-harm or suicidal behaviors. Providing education about the condition is beneficial but ensuring immediate safety takes precedence. Encouraging the patient to recall traumatic events can be detrimental and should be done cautiously under professional guidance. While helping the patient develop a strong sense of identity is important in the long term, it is not the immediate priority when safety is a concern.

3. What is the primary benefit of using exposure therapy for patients with phobias?

• A. To eliminate the phobia completely
• B. To gradually reduce the patient’s fear and anxiety
• C. To teach the patient relaxation techniques
• D. To provide immediate relief from anxiety

Correct answer: B

Rationale: The primary benefit of using exposure therapy for patients with phobias is to gradually reduce the patient's fear and anxiety. Exposure therapy involves exposing the individual to the feared object or situation in a controlled manner to help them confront their fears and learn that the perceived threat is not as harmful as initially believed. Over time, repeated exposure can lead to a decrease in anxiety and fear responses, helping the individual manage and overcome their phobia. Choice A is incorrect because exposure therapy aims to reduce fear and anxiety, not necessarily eliminate the phobia completely. Choice C is incorrect as although relaxation techniques might be part of the therapy, the primary goal is fear reduction. Choice D is incorrect as exposure therapy typically involves gradual exposure rather than providing immediate relief.

4. 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.

5. A 33-year-old female diagnosed with bipolar I disorder has been functioning well on lithium for 11 months. At her most recent checkup, the psychiatric nurse practitioner states, ‘You are ready to enter the maintenance therapy stage, so at this time I am going to adjust your dosage by prescribing:'

• A. A higher dosage
• B. Once-a-week dosing
• C. A lower dosage
• D. A different drug

Correct answer: C

Rationale: As the patient transitions to maintenance therapy, the typical approach involves decreasing the dosage to a lower level. This adjustment is made to find the minimum effective dose needed for symptom control while reducing the potential side effects associated with long-term use. Choosing a higher dosage (A) would not align with the goal of maintenance therapy, as it may increase the risk of adverse effects. Once-a-week dosing (B) is not a common adjustment for lithium, which is usually prescribed daily for bipolar disorder. Switching to a different drug (D) is typically considered if the current medication is ineffective or intolerable, not as a routine step in transitioning to maintenance therapy.

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