Nursing Elites

1. 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.

2. A client is discussing free associations as a therapeutic tool with a nurse. Which of the following client statements indicates an understanding of this technique?

• A. “I will write down my dreams as soon as I wake up.”
• B. “I might begin to associate my therapist with important people in my life.”
• C. “I can learn to express myself in a nonaggressive manner.”
• D. “I should say the first thing that comes to my mind.”

Correct answer: D

Rationale: Free association is a psychoanalytic technique where the client is encouraged to say the first thing that comes to their mind without censoring or filtering. This technique helps uncover unconscious thoughts and emotions. Choice D, “I should say the first thing that comes to my mind,” indicates an understanding of free association as it aligns with the principle of allowing thoughts to flow freely without inhibition. Choices A, B, and C do not reflect an understanding of free association and its purpose, making them incorrect. A, focusing on writing down dreams, does not relate to the immediate expression of thoughts. B, associating the therapist with important people, and C, learning to express oneself nonaggressively, do not capture the essence of free association as a technique for exploring unconscious processes.

3. Which patient statement suggests the presence of dissociative amnesia?

• A. I keep forgetting where I put my keys.
• B. I don’t remember the accident that brought me here or the past two days.
• C. Sometimes I feel like I’m watching myself from outside my body.
• D. I often lose track of time when I’m reading.

Correct answer: B

Rationale: The correct answer is B because the statement reflects a significant gap in memory related to a traumatic event, which is characteristic of dissociative amnesia. Choice A is more indicative of normal forgetfulness and absentmindedness. Choice C suggests depersonalization or dissociative identity disorder rather than dissociative amnesia. Choice D describes a common experience related to concentration while reading, not memory loss as seen in dissociative amnesia.

4. 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.

5. A patient with bipolar disorder is prescribed lithium. What is a common side effect the nurse should monitor for?

• A. Increased energy
• B. Constipation
• C. Weight gain
• D. Dry mouth

Correct answer: C

Rationale: Weight gain is a common side effect associated with lithium therapy. It is essential for the nurse to monitor the patient for changes in weight as it can impact the individual's overall health and well-being. Patients on lithium should be advised on dietary and lifestyle modifications to manage potential weight gain and maintain a healthy weight.

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