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. In cognitive processing therapy for PTSD, what is the primary goal for the patient?

• A. To help the patient process the trauma and reduce avoidance behaviors.
• B. To help the patient confront and process the trauma in a safe environment.
• C. To help the patient understand the impact of the trauma on their current thoughts and behaviors.
• D. To help the patient avoid triggers that remind them of the trauma.

Correct answer: C

Rationale: The primary goal of cognitive processing therapy for PTSD is to help the patient understand the impact of the trauma on their current thoughts and behaviors. Through this therapy, individuals learn to identify and challenge maladaptive beliefs related to the traumatic event, ultimately helping them to process the trauma and develop healthier coping mechanisms. This approach aims to address the cognitive distortions and negative thoughts that have resulted from the trauma, facilitating healing and recovery.

3. A patient with a diagnosis of panic disorder is prescribed an SSRI. Which side effect should the nurse monitor for when the patient starts this medication?

• A. Increased heart rate
• B. Increased appetite
• C. Gastrointestinal disturbances
• D. Dry mouth

Correct answer: C

Rationale: When a patient with panic disorder is prescribed an SSRI, the nurse should monitor for gastrointestinal disturbances as a common side effect. SSRIs can cause gastrointestinal symptoms such as nausea, diarrhea, or abdominal discomfort, especially at the beginning of treatment. Increased heart rate (Choice A) is not a common side effect of SSRIs; it is more commonly associated with medications like stimulants. Increased appetite (Choice B) is not a typical side effect of SSRIs, as they are more likely to cause weight loss or appetite suppression. Dry mouth (Choice D) is a side effect seen more commonly with medications that have anticholinergic properties, not typically with SSRIs.

4. A patient with social anxiety disorder is learning cognitive-behavioral therapy (CBT) techniques. Which skill is most likely being taught?

• A. Avoiding social situations that cause anxiety
• B. Challenging and changing negative thoughts
• C. Using deep breathing exercises during social interactions
• D. Taking anti-anxiety medication before social events

Correct answer: B

Rationale: The correct answer is B. In cognitive-behavioral therapy (CBT) for social anxiety disorder, the focus is on challenging and changing negative thoughts that contribute to anxiety. This process involves identifying distorted thought patterns and replacing them with more balanced and realistic thoughts, helping individuals develop healthier perspectives on social situations. Choices A, C, and D are incorrect because avoiding social situations, using deep breathing exercises, and taking medication are not the primary skills taught in CBT for social anxiety disorder. CBT aims to address the underlying thought patterns and behaviors that maintain anxiety, rather than avoidance or temporary relief.

5. A patient with posttraumatic stress disorder (PTSD) is experiencing nightmares. Which intervention should the nurse include in the care plan?

• A. Encouraging the patient to journal before bedtime
• B. Teaching relaxation techniques
• C. Avoiding discussing the nightmares directly
• D. Developing a safety plan

Correct answer: B

Rationale: Teaching relaxation techniques is an appropriate intervention for a patient with PTSD experiencing nightmares. Relaxation techniques can help the patient manage anxiety and improve sleep quality, potentially decreasing the frequency and intensity of nightmares. By teaching relaxation techniques, the nurse empowers the patient to actively cope with and reduce the distressing symptoms of PTSD, contributing to overall therapeutic outcomes.

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