Nursing Elites

1. In treating a patient with generalized anxiety disorder (GAD) using cognitive-behavioral therapy (CBT), what is the most appropriate goal of this therapy?

• A. To explore the patient's childhood experiences.
• B. To reduce the patient's symptoms through medication.
• C. To change the patient's negative thought patterns.
• D. To improve the patient's social skills.

Correct answer: C

Rationale: The most appropriate goal of cognitive-behavioral therapy (CBT) in treating generalized anxiety disorder (GAD) is to change the patient's negative thought patterns. This therapy focuses on identifying and modifying distorted thinking patterns that contribute to anxiety. Exploring childhood experiences (Choice A) may be part of therapy, but the primary focus is on present thoughts and behaviors. While medication (Choice B) can help manage symptoms, CBT aims to address the root cause through cognitive restructuring. Improving social skills (Choice D) is not the primary goal of CBT for GAD, although it may be a secondary benefit as confidence improves with reduced anxiety.

2. Which response by a 15-year-old demonstrates a common symptom observed in patients diagnosed with major depressive disorder?

• A. I'm so restless. I can't seem to sit still.
• B. I spend most of my time studying. I have to get into a good college.
• C. I'm not trying to diet, but I've lost about 5 pounds in the past 5 months.
• D. I go to sleep around 11 p.m. but I'm always up by 3 a.m. and can't go back to sleep.

Correct answer: D

Rationale: Sleep disturbances, such as early morning awakening, are common symptoms of major depressive disorder.

3. In what order should the following goals be approached for a client being treated for alcoholism?

• A. Learning about dependence and recovery; abstinence and development of a support system; attaining physiological stabilization; developing alternative coping skills
• B. Developing alternative coping skills; attaining physiological stabilization; learning about dependence and recovery; abstinence and development of a support system
• C. Abstinence and development of a support system; attaining physiological stabilization; learning about dependence and recovery; developing alternative coping skills
• D. Abstinence and development of a support system; learning about dependence and recovery; attaining physiological stabilization; developing alternative coping skills

Correct answer: B

Rationale: When treating a client for alcoholism, it is important to follow a structured approach to maximize treatment effectiveness. The correct order of approaching goals is to first help the client in developing alternative coping skills to manage triggers and stressors without relying on alcohol. This is followed by attaining physiological stabilization, which involves addressing any physical health issues related to alcoholism. Next, the client should learn about dependence and recovery to understand the nature of their condition and the process of recovery. Finally, the goals of abstinence and developing a support system come into play to ensure long-term sobriety and a reliable network of support. Therefore, the correct order is: Developing alternative coping skills; attaining physiological stabilization; learning about dependence and recovery; abstinence and development of a support system.

4. A patient with schizophrenia is prescribed olanzapine. The nurse should monitor the patient for which common side effect?

• A. Weight gain
• B. Hypotension
• C. Hair loss
• D. Hyperthyroidism

Correct answer: A

Rationale: Weight gain is a common side effect of olanzapine, an atypical antipsychotic. Olanzapine is known to cause metabolic changes that can lead to weight gain. Monitoring weight regularly is essential to detect and manage this side effect to prevent associated health risks such as diabetes and cardiovascular issues. Hypotension (choice B) is not a common side effect of olanzapine. Olanzapine is more likely to cause orthostatic hypotension, which is a sudden drop in blood pressure when changing positions. Hair loss (choice C) and hyperthyroidism (choice D) are not typically associated with olanzapine use.

5. A school nurse is assessing a female high school student who is overly concerned about her appearance. The client's mother states, 'That's not something to be stressed about!' Which is the most appropriate nursing response?

• A. Teenagers! They don't know a thing about real stress.
• B. Stress occurs only when there is a loss.
• C. When you are in poor physical condition, you can't experience psychological well-being.
• D. Stress can be psychological. A threat to self-esteem may result in high stress levels.

Correct answer: D

Rationale: The most appropriate response is D: 'Stress can be psychological. A threat to self-esteem may result in high stress levels.' This response acknowledges the psychological aspect of stress and how a perceived threat to self-esteem can be just as stressful as a physiological change. Choices A, B, and C are incorrect because they do not address the client's concerns or provide a therapeutic response to the situation.

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