Nursing Elites

1. A patient with obsessive-compulsive disorder (OCD) is under the care of a nurse. Which intervention is most appropriate?

• A. Encourage the patient to suppress their compulsive behaviors.
• B. Allow the patient to perform their rituals, then gradually limit the time spent on these rituals.
• C. Discourage the patient from discussing their obsessions.
• D. Avoid setting limits on the patient’s compulsive behaviors.

Correct answer: B

Rationale: In managing a patient with OCD, it is crucial to allow them to perform their rituals while gradually limiting the time spent on these rituals. This approach helps the patient feel supported while working towards reducing the compulsive behaviors. Choice A is incorrect because suppressing compulsive behaviors can increase anxiety and distress. Choice C is inappropriate as discussing obsessions is part of therapy. Choice D is not recommended as setting limits on compulsive behaviors is essential for treatment.

2. Which statement by a patient indicates an understanding of cognitive-behavioral therapy (CBT)?

• A. CBT will help me understand and change my thought patterns.
• B. CBT focuses on resolving past trauma.
• C. CBT will help me avoid my problems.
• D. CBT involves taking medication to manage symptoms.

Correct answer: A

Rationale: The correct answer is A. Cognitive-behavioral therapy (CBT) is a type of psychotherapy that focuses on helping patients understand and change their thought patterns to improve their mental health. This therapy aims to identify and modify negative or harmful thoughts and behaviors. Option A correctly reflects this fundamental concept of CBT, emphasizing the role of thought patterns in mental health improvement. Choices B and C are incorrect because CBT does not primarily focus on resolving past trauma or avoiding problems; instead, it concentrates on changing cognitive patterns. Choice D is also inaccurate as CBT does not involve medication management but rather focuses on cognitive and behavioral interventions.

3. A patient is receiving education about dietary restrictions while taking a monoamine oxidase inhibitor (MAOI). Which food should the patient avoid?

• A. Aged cheese
• B. Fresh vegetables
• C. Grilled chicken
• D. Fruit juices

Correct answer: A

Rationale: Patients taking MAOIs should avoid aged cheese as it contains high levels of tyramine, which can lead to a hypertensive crisis. Monoamine oxidase inhibitors can inhibit the breakdown of tyramine, leading to an excess accumulation in the body and potentially dangerous increases in blood pressure.

4. What is the primary benefit of using cognitive-behavioral therapy (CBT) for treating anxiety disorders?

• A. It focuses on long-term use of medications.
• B. It helps patients understand and change their thought patterns.
• C. It primarily addresses childhood traumas.
• D. It encourages patients to avoid anxiety-provoking situations.

Correct answer: B

Rationale: The primary benefit of using cognitive-behavioral therapy (CBT) for treating anxiety disorders is that it helps patients understand and change their thought patterns. By addressing maladaptive thought processes and behaviors, CBT can effectively reduce anxiety symptoms and improve coping mechanisms. This approach empowers individuals to develop healthier responses to anxiety triggers, leading to long-lasting benefits beyond solely relying on medications or avoiding anxiety-provoking situations. Choices A, C, and D are incorrect because CBT does not primarily focus on long-term use of medications, addressing childhood traumas, or encouraging avoidance of anxiety-provoking situations. While medications may be used in conjunction with CBT, the main focus of CBT is on cognitive restructuring and behavioral interventions to alleviate anxiety symptoms.

5. A healthcare professional is caring for a group of clients. Which of the following clients should the healthcare professional consider for referral to an assertive community treatment (ACT) group?

• A. A client in an acute care mental health facility who has fallen several times while running down the hallway
• B. A client who lives at home and keeps forgetting to come in for a scheduled monthly antipsychotic injection for schizophrenia
• C. A client in a day treatment program who reports increasing anxiety during group therapy
• D. A client in a weekly grief support group who reports still missing a deceased partner who has been dead for 3 months

Correct answer: B

Rationale: The client who lives at home and repeatedly forgets to come in for a scheduled monthly antipsychotic injection for schizophrenia should be considered for referral to an assertive community treatment (ACT) group. ACT teams provide intensive community-based treatment and support for individuals with severe mental illness who may have difficulty adhering to treatment on their own. Choices A, C, and D do not describe individuals with severe mental illness who have difficulty adhering to treatment or need intensive community-based support, which are the typical candidates for referral to an ACT group.

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