Nursing Elites

1. A client is being treated for obsessive-compulsive disorder (OCD). Which intervention should be included in the care plan?

• A. Discourage the client from performing rituals.
• B. Allow the client to perform rituals in the early stages of treatment.
• C. Encourage the client to focus on their compulsions.
• D. Isolate the client to prevent performance of rituals.

Correct answer: B

Rationale: Allowing the client to perform rituals in the early stages of treatment is a common therapeutic approach for obsessive-compulsive disorder (OCD). Allowing the client to engage in rituals can help reduce anxiety by providing temporary relief. It is a part of exposure therapy, where the individual is gradually exposed to anxiety-provoking situations. As treatment progresses, the focus shifts to gradually reducing the frequency and intensity of rituals through interventions like exposure and response prevention therapy. Discouraging the client from performing rituals (Choice A) is not recommended as it may increase anxiety and resistance to treatment. Encouraging the client to focus on their compulsions (Choice C) may reinforce the behavior rather than helping to decrease it. Isolating the client (Choice D) is not therapeutic and can lead to feelings of abandonment and worsen symptoms.

2. Which approach involves surgically implanting electrodes into specific areas of the brain to stimulate regions identified as underactive in depression?

• A. Transcranial magnetic stimulation
• B. Deep brain stimulation
• C. Vagus nerve stimulation
• D. Electroconvulsive therapy

Correct answer: B

Rationale: Deep brain stimulation is a treatment approach that involves the surgical implantation of electrodes into specific areas of the brain to stimulate regions identified as underactive in depression. This method aims to modulate brain activity and has shown effectiveness in treating certain cases of depression.

3. A client with a history of alcohol use disorder is admitted to the hospital for detoxification. Which of the following symptoms shouldn't the nurse expect to observe during withdrawal?

• A. Tremors
• B. Hallucinations
• C. Diaphoresis
• D. Bradycardia

Correct answer: D

Rationale: During alcohol withdrawal, the nurse should expect to observe symptoms such as tremors, hallucinations, and diaphoresis. Seizures may also occur during severe withdrawal. Bradycardia is not typically associated with alcohol withdrawal; instead, tachycardia (an increased heart rate) is more commonly observed due to the stimulant effects of alcohol withdrawal on the sympathetic nervous system.

4. Which of the following symptoms shouldn't one expect to assess in a client diagnosed with major depressive disorder?

• A. Loss of interest or pleasure
• B. Decreased ability to concentrate
• C. Significant weight loss or gain
• D. Increased energy

Correct answer: D

Rationale: Symptoms commonly associated with major depressive disorder include a loss of interest or pleasure, decreased ability to concentrate, significant weight loss or gain, and feelings of worthlessness or excessive guilt. Increased energy is not a typical symptom of major depressive disorder; individuals with this condition often experience fatigue rather than increased energy.

5. During cognitive-behavioral therapy, a 12-year-old patient reports to the nurse practitioner:

• A. I was so mad I wanted to hit my mother.
• B. I thought that everyone at school hated me. That's not true. Most people like me and I have a friend named Todd.
• C. I forgot that you told me to breathe when I become angry.
• D. I scream as loud as I can when the train goes by the house.

Correct answer: B

Rationale: In cognitive-behavioral therapy, recognizing and challenging negative thoughts is crucial for progress. Choice B demonstrates the patient's ability to identify and correct distorted thoughts, indicating positive advancement in therapy. This cognitive restructuring is a key component of cognitive-behavioral therapy, helping individuals develop healthier thinking patterns and coping strategies.

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