Nursing Elites

1. A client has been diagnosed with dependent personality disorder. Which of the following behaviors should the nurse expect?

• A. Difficulty making decisions
• B. Preoccupation with orderliness
• C. Attention-seeking behavior
• D. Aggression

Correct answer: A

Rationale: Individuals with dependent personality disorder typically struggle with making decisions independently and rely heavily on others for guidance and reassurance. This can manifest as difficulty in initiating or making choices without the input of others. Clients with this disorder often display clingy, submissive behaviors and fear being alone, which aligns with the characteristic of difficulty making decisions seen in option A. Choices B, C, and D are not typically associated with dependent personality disorder. Preoccupation with orderliness may be seen in obsessive-compulsive personality disorder, attention-seeking behavior in histrionic personality disorder, and aggression in other disorders such as antisocial personality disorder.

2. Which therapeutic approach is considered most effective for treating posttraumatic stress disorder (PTSD)?

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

Correct answer: A

Rationale: Cognitive processing therapy is a specialized form of cognitive-behavioral therapy that has been shown to be highly effective in treating posttraumatic stress disorder (PTSD). This therapy focuses on helping individuals process and make sense of their traumatic experiences, leading to symptom reduction and improved coping mechanisms. Psychoanalysis, medication management, and group therapy can be beneficial in some cases, but cognitive processing therapy is specifically tailored for addressing the symptoms and underlying causes of PTSD. Psychoanalysis may not be as effective for PTSD due to its focus on unconscious conflicts rather than trauma processing. Medication management can be useful as an adjunct to therapy but does not address the core issues of PTSD. Group therapy can provide support but may not offer the individualized approach that cognitive processing therapy provides.

3. 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.

4. Which of the following symptoms should a healthcare provider expect to assess in a client diagnosed with generalized anxiety disorder (GAD)? Select one that doesn't apply.

• A. Excessive worry
• B. Muscle tension
• C. Increased energy
• D. Restlessness

Correct answer: C

Rationale: Symptoms of generalized anxiety disorder include excessive worry, muscle tension, restlessness, and irritability. Increased energy is not typically associated with GAD; clients often experience fatigue instead. This heightened energy level is more commonly seen in conditions like mania or hypomania, rather than in GAD. Therefore, the correct answer is 'Increased energy.' Choices A, B, and D are all symptoms commonly observed in individuals with generalized anxiety disorder.

5. Which of the following would be the most appropriate intervention for a patient experiencing severe anxiety?

• A. Encourage the patient to talk about their feelings.
• B. Use a firm, authoritative approach.
• C. Stay with the patient and provide a quiet environment.
• D. Suggest the patient watch TV to distract themselves.

Correct answer: C

Rationale: During a severe anxiety episode, it's crucial to stay with the patient and create a quiet environment. This approach helps reduce anxiety by providing a sense of safety and support. Encouraging the patient to talk about their feelings may not be effective during an acute episode of severe anxiety. Using a firm, authoritative approach can escalate the situation and worsen the anxiety. Suggesting distractions like watching TV may not address the root cause of the anxiety or provide the necessary support.

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