Nursing Elites

1. A patient with borderline personality disorder is admitted to the psychiatric unit. Which behavior is most characteristic of this disorder?

• A. Avoiding social interactions due to fear of rejection.
• B. Engaging in impulsive and self-destructive behaviors.
• C. Having a grandiose sense of self-importance.
• D. Exhibiting a pattern of unstable relationships.

Correct answer: B

Rationale: Borderline personality disorder is characterized by impulsivity and self-destructive behaviors, such as substance abuse, reckless driving, and self-harm. These behaviors are often used to cope with intense emotional distress and are a key feature of this disorder. While individuals with borderline personality disorder may also struggle with unstable relationships, the hallmark feature that sets it apart is the impulsivity and self-destructive behaviors. Avoiding social interactions due to fear of rejection is more characteristic of avoidant personality disorder. Having a grandiose sense of self-importance is a feature of narcissistic personality disorder.

2. What is an important aspect of patient education regarding buspirone when prescribed for generalized anxiety disorder (GAD)?

• A. Buspirone is an as-needed medication for anxiety.
• B. Buspirone has a high risk of addiction and dependence.
• C. Buspirone may not become effective until 2-4 weeks after starting the medication.
• D. Buspirone should be taken with food to increase absorption.

Correct answer: C

Rationale: The correct answer is C. When educating a patient about buspirone for generalized anxiety disorder, it is crucial to highlight that buspirone may take 2-4 weeks to become effective. Patients need to be aware of this delayed onset of action to manage their expectations and continue the medication as prescribed. This information helps patients understand that they may not experience immediate relief and should not discontinue the medication prematurely. Choices A, B, and D are incorrect because buspirone is typically taken regularly, not as-needed, it has a lower risk of addiction compared to other anxiety medications, and it does not need to be taken with food for increased absorption.

3. What is the priority intervention for a patient admitted for an overdose of sedatives and diagnosed with dissociative identity disorder?

• A. Conducting a suicide assessment
• B. Arranging for placement in a group home
• C. Providing a low-stimulation environment
• D. Establishing trust and rapport

Correct answer: A

Rationale: Conducting a suicide assessment is the priority intervention for a patient admitted for an overdose of sedatives and diagnosed with dissociative identity disorder. In this scenario, the immediate concern is to assess the risk of harm to the patient's life. It is crucial to determine if the overdose was intentional and if the patient has suicidal ideation or intent. Arranging for placement in a group home (choice B) may be necessary at a later stage depending on the patient's needs, but it is not the priority in this urgent situation. Providing a low-stimulation environment (choice C) and establishing trust and rapport (choice D) are important aspects of care but addressing the immediate risk of suicide takes precedence in this case.

4. Which medication is commonly used to treat both major depressive disorder and neuropathic pain?

• A. Gabapentin
• B. Duloxetine
• C. Amitriptyline
• D. Tramadol

Correct answer: B

Rationale: Duloxetine, also known as Cymbalta, is a medication commonly used to treat both major depressive disorder and neuropathic pain. It is a serotonin-norepinephrine reuptake inhibitor (SNRI) that helps alleviate symptoms associated with these conditions. Gabapentin is primarily used for neuropathic pain, Amitriptyline is commonly used as an antidepressant, and Tramadol is an opioid analgesic often used for pain relief but not typically indicated for major depressive disorder.

5. Which symptom is most commonly associated with obsessive-compulsive disorder (OCD)?

• A. Frequent mood swings
• B. Intrusive, repetitive thoughts
• C. Hallucinations
• D. Flashbacks

Correct answer: B

Rationale: The correct answer is B: Intrusive, repetitive thoughts. Intrusive, repetitive thoughts are the hallmark symptom of obsessive-compulsive disorder (OCD). Individuals with OCD experience persistent, unwanted thoughts or obsessions that lead to repetitive behaviors or compulsions. These thoughts are intrusive and difficult to control, causing significant distress and interfering with daily activities. While mood swings, hallucinations, and flashbacks can be present in other mental health conditions, they are not the primary symptoms associated with OCD.

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