Nursing Elites

1. A patient diagnosed with dissociative identity disorder has been undergoing therapy for several months. Which outcome indicates that the patient is progressing in therapy?

• A. The patient has developed a strong therapeutic relationship with the therapist.
• B. The patient’s different personalities are beginning to merge.
• C. The patient is able to recall traumatic events without dissociating.
• D. The patient reports fewer gaps in memory.

Correct answer: B

Rationale: In dissociative identity disorder, the merging of different personalities is a crucial indicator of progress in therapy. As the different identities merge, it signifies that the patient is integrating fragmented aspects of their self, leading to a more cohesive sense of identity and a reduction in dissociative symptoms. This process is a significant therapeutic milestone in the treatment of dissociative identity disorder as it promotes internal cohesion and decreases internal conflict. Choices A, C, and D are incorrect because while developing a strong therapeutic relationship, recalling traumatic events without dissociating, and reporting fewer gaps in memory are important aspects of therapy, the merging of different personalities is specifically indicative of substantial progress in treating dissociative identity disorder.

2. Which assessment question, when asked by the nurse, demonstrates an understanding of comorbid mental health conditions associated with major depressive disorder?

• A. Do rules apply to you?
• B. What do you do to manage anxiety?
• C. Do you have a history of disordered eating?
• D. Do you think that you drink too much?

Correct answer: B

Rationale: The correct answer is B. Inquiring about anxiety management demonstrates an understanding of the common comorbid condition of anxiety often seen alongside major depressive disorder. Anxiety and depression frequently coexist, and addressing anxiety management can provide insights into the patient's overall mental health status. Choices A, C, and D are incorrect because they do not directly address comorbid mental health conditions associated with major depressive disorder.

3. What is a primary goal of treatment for a patient with obsessive-compulsive disorder (OCD)?

• A. To eliminate all obsessive thoughts and compulsive behaviors
• B. To reduce the frequency and intensity of obsessive thoughts
• C. To increase the patient’s social interactions
• D. To improve the patient’s sleep quality

Correct answer: B

Rationale: The primary goal of treating obsessive-compulsive disorder (OCD) is to reduce the frequency and intensity of obsessive thoughts and compulsive behaviors. While complete elimination of all obsessive thoughts and compulsive behaviors may be an ideal outcome, it is often unrealistic. Focusing on reducing the impact of these symptoms on the patient's daily life and functioning is more achievable and practical. Choices C and D are incorrect as they are not primary goals in the treatment of OCD. Increasing social interactions and improving sleep quality may be beneficial as part of a comprehensive treatment plan, but they are not the primary focus when managing OCD.

4. What is a common side effect of benzodiazepines prescribed for anxiety?

• A. Weight gain
• B. Insomnia
• C. Drowsiness
• D. Increased appetite

Correct answer: C

Rationale: The correct answer is C: Drowsiness. Benzodiazepines, commonly prescribed for anxiety, often cause drowsiness as a side effect due to their sedative properties. This can lead to impairments in cognitive and motor skills, making it important for individuals on these medications to exercise caution when performing tasks that require alertness, such as driving or operating machinery. Choices A, B, and D are incorrect because weight gain, insomnia, and increased appetite are not typically associated with benzodiazepines; instead, drowsiness and sedation are more commonly reported side effects.

5. A client with anxiety disorder is scheduled to begin classical psychoanalysis. Which client statement indicates an understanding of this form of therapy?

• A. “Even if my anxiety improves, I will need to continue this therapy for 6 weeks”
• B. “The therapist will focus on my past relationships during our sessions”
• C. “Psychoanalysis will help me reduce my anxiety by changing my behaviors”
• D. “This therapy will address my conscious feelings about stressful experiences”

Correct answer: B

Rationale: In classical psychoanalysis, the therapist delves into the client's past relationships, childhood experiences, and unconscious thoughts to uncover underlying issues contributing to the client's current symptoms. Understanding that the therapist will focus on past relationships aligns with the core principles of classical psychoanalysis. Choice A is incorrect because the duration of classical psychoanalysis is typically longer than 6 weeks. Choice C is incorrect as changing behaviors is more aligned with behavioral therapy than classical psychoanalysis. Choice D is incorrect as classical psychoanalysis primarily focuses on unconscious thoughts rather than conscious feelings about stressful experiences.

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