Nursing Elites

1. A healthcare provider is evaluating the effectiveness of medication therapy for a client diagnosed with bipolar disorder. Which outcome should indicate that the medication has been effective?

• A. The client reports a decrease in manic episodes.
• B. The client experiences fewer mood swings.
• C. The client sleeps for 8 hours each night.
• D. The client maintains a stable weight.

Correct answer: A

Rationale: A decrease in manic episodes is a key indicator of the effectiveness of medication therapy for bipolar disorder. Manic episodes are a hallmark of bipolar disorder, and a decrease in their frequency or intensity suggests that the medication is helping to stabilize the client's mood and manage their symptoms. While choices B, C, and D are important aspects of overall health and well-being, they are not specific indicators of the effectiveness of medication therapy for bipolar disorder. Choice B focuses on mood swings in general, which may include depressive episodes as well, while choice C addresses sleep patterns and choice D relates to weight stability, which can be influenced by various factors unrelated to bipolar disorder treatment.

2. Which of the following statements should a healthcare provider recognize as true about defense mechanisms? Select all that apply.

• A. They are employed when there is a threat to biological or psychological integrity.
• B. They are controlled by the id and deal with primal urges.
• C. They are used in an effort to increase anxiety.
• D. They are protective devices for the superego.

Correct answer: A

Rationale: Defense mechanisms are employed by the ego, not the id or superego, in response to threats to biological or psychological integrity. They aim to relieve anxiety, not increase it. By redirecting focus, they help manage mild to moderate anxiety and are often self-deceptive in nature.

3. You have been working closely with a patient for the past month. Today he tells you he is looking forward to meeting with his new psychiatrist but frowns and avoids eye contact while reporting this to you. Which of the following responses would most likely be therapeutic?

• A. A new psychiatrist is a chance to start fresh; I'm sure it will go well for you.
• B. You say you look forward to the meeting, but you appear anxious or unhappy.
• C. I notice that you frowned and avoided eye contact just now. Don't you feel well?
• D. I get the impression you don't really want to see your psychiatrist—can you tell me why?

Correct answer: B

Rationale: Choice B is the most therapeutic response as it acknowledges the discrepancy between the patient's verbal statement and nonverbal cues. By addressing both the patient's expressed anticipation and the conflicting nonverbal cues of frowning and avoiding eye contact, the responder demonstrates attentiveness to the patient's emotional state and encourages further exploration of underlying feelings. This approach fosters open communication and helps the patient feel understood and supported.

4. In a client with obsessive-compulsive disorder (OCD) undergoing cognitive-behavioral therapy, which outcome indicates that the therapy is effective?

• A. The client reports a decrease in the frequency of compulsive behaviors.
• B. The client reports a decrease in the intensity of obsessive thoughts.
• C. The client reports an improvement in overall mood.
• D. The client reports an improvement in sleep patterns.

Correct answer: A

Rationale: In clients with OCD undergoing cognitive-behavioral therapy, a decrease in the frequency of compulsive behaviors is a key indicator of treatment effectiveness. This reduction signifies progress in managing and controlling the compulsions associated with OCD, which is a primary goal of the therapy. Choices B, C, and D may also be positive outcomes of therapy, but the most critical aspect in treating OCD with cognitive-behavioral therapy is targeting and reducing the frequency of compulsive behaviors.

5. Which characteristic identified during an assessment serves to support a diagnosis of disruptive mood dysregulation disorder? Select one that doesn't apply.

• A. Female
• B. 7 years old
• C. Comorbid autism diagnosis
• D. Outbursts occur at least once a week

Correct answer: C

Rationale: Characteristics such as age, frequency of outbursts, and occurrence in multiple settings support a diagnosis of disruptive mood dysregulation disorder. While comorbid conditions like autism can coexist with disruptive mood dysregulation disorder, it is not a characteristic that serves to support a diagnosis of this specific disorder.

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