Nursing Elites

1. A client is diagnosed with obsessive-compulsive disorder (OCD), and a nurse is planning care. Which of the following interventions should the nurse exclude from the care plan?

• A. Allowing the client to perform rituals initially
• B. Discouraging the client from washing their hands
• C. Monitoring for suicidal ideation
• D. Providing a structured schedule of activities

Correct answer: C

Rationale: The correct answer is monitoring for suicidal ideation. When caring for a client with OCD, interventions should include allowing the client to perform rituals initially, setting limits on the time allowed for rituals, encouraging the client to verbalize feelings, and providing a structured schedule of activities. Monitoring for suicidal ideation is crucial in assessing the client's safety and mental health status, but it is not a direct intervention specific to managing OCD symptoms.

2. A healthcare professional is caring for a patient with bipolar disorder who is experiencing a manic episode. Which intervention is most appropriate?

• A. Encourage group activities to increase socialization.
• B. Provide a structured environment with limited stimuli.
• C. Allow the patient to engage in physical activities freely.
• D. Give the patient detailed and complex tasks to complete.

Correct answer: B

Rationale: During a manic episode, individuals with bipolar disorder may have heightened sensitivity to stimuli and may struggle with organization and decision-making. Providing a structured environment with limited stimuli can help reduce triggers and maintain a sense of control for the patient. It is essential to create a calm and predictable setting to support the individual in managing their symptoms effectively. Choice A is incorrect as group activities may overwhelm the patient due to increased stimuli. Choice C is not the most appropriate because unstructured physical activities may exacerbate the manic symptoms. Choice D is not recommended as detailed and complex tasks can be overwhelming and may contribute to increased stress and agitation in a manic episode.

3. A client diagnosed with major depressive disorder is receiving cognitive-behavioral therapy (CBT). Which outcome indicates that the therapy is effective?

• A. The client identifies and challenges negative thoughts.
• B. The client reports an increase in suicidal thoughts.
• C. The client experiences an increase in anxiety.
• D. The client shows no change in behavior.

Correct answer: A

Rationale: In cognitive-behavioral therapy (CBT), one of the primary objectives is to help clients identify and challenge their negative thoughts. This process allows the individual to reframe their thinking patterns and develop more adaptive coping strategies. Reporting an increase in suicidal thoughts (Choice B) or experiencing an increase in anxiety (Choice C) are not desired outcomes and may indicate a need for further intervention. Showing no change in behavior (Choice D) suggests that the therapy has not been effective. Therefore, the correct indicator of effective therapy in this context is the client's ability to identify and challenge negative thoughts (Choice A).

4. A healthcare professional is assessing a client with major depressive disorder. Which of the following findings should the professional expect? Select one that does not apply.

• A. Anhedonia
• B. Hypersomnia
• C. Fatigue
• D. Flight of ideas

Correct answer: D

Rationale: In major depressive disorder, common findings include anhedonia (loss of interest or pleasure), hypersomnia (excessive sleepiness), fatigue, and feelings of worthlessness. Flight of ideas, characterized by racing thoughts and rapid speech, is more commonly associated with bipolar disorder, particularly during manic episodes. Therefore, 'Flight of ideas' does not apply to the expected findings in major depressive disorder.

5. A healthcare provider is evaluating a client who is taking selective serotonin reuptake inhibitors (SSRIs) for depression. Which symptom should the healthcare provider identify as an adverse effect that requires immediate attention?

• A. Increased appetite
• B. Weight gain
• C. Blurred vision
• D. Suicidal thoughts

Correct answer: D

Rationale: Suicidal thoughts are a serious adverse effect associated with SSRIs and require immediate attention. This symptom is critical as it can increase the risk of self-harm or suicide in individuals taking these medications. Increased appetite and weight gain are common side effects of SSRIs but do not require immediate attention. Blurred vision is not a typical adverse effect of SSRIs, making it an incorrect choice. Healthcare providers must promptly recognize and address suicidal thoughts to ensure the safety and well-being of the client.

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