Nursing Elites

1. A patient with obsessive-compulsive disorder (OCD) is prescribed fluvoxamine. What is a common side effect of this medication?

• A. Increased appetite
• B. Dry mouth
• C. Weight gain
• D. Nausea

Correct answer: D

Rationale: Nausea is a common side effect of fluvoxamine, a selective serotonin reuptake inhibitor (SSRI) commonly used in the treatment of OCD. Patients should be advised to monitor and report any gastrointestinal disturbances, including nausea, to their healthcare provider.

2. 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.

3. Which intervention is most appropriate to promote the self-esteem of a patient with severe depression?

• A. Encouraging the patient to spend time alone for self-reflection.
• B. Involving the patient in simple, achievable activities to ensure success.
• C. Allowing the patient to rest and avoid responsibilities.
• D. Providing frequent reassurances and compliments.

Correct answer: B

Rationale: Involving the patient in simple, achievable activities is a constructive approach to promote self-esteem by fostering a sense of accomplishment and success. This method encourages positive reinforcement and helps the patient regain confidence and self-worth, which are essential in managing depression. Choice A could potentially lead to rumination and worsen depressive symptoms. Choice C might reinforce avoidance behaviors and hinder progress. Choice D, while supportive, may not address the core need for building self-esteem through personal achievements.

4. In planning care for the termination phase of a nurse-client relationship, which of the following actions should the nurse include in the plan of care?

• A. Discussing ways to use new behaviors
• B. Practicing new problem-solving skills
• C. Developing goals
• D. Establishing boundaries

Correct answer: A

Rationale: During the termination phase of a nurse-client relationship, it is crucial to discuss ways to use new behaviors. This helps the client integrate and apply the skills and strategies they have acquired during the therapeutic process into their daily life. By focusing on the application of new behaviors, the client can maintain progress and continue to grow even after the professional relationship has ended. Practicing new problem-solving skills, developing goals, and establishing boundaries are important aspects of the therapeutic process but are more commonly addressed in earlier phases of the nurse-client relationship. Therefore, the correct action to include in the plan of care during the termination phase is discussing ways to use new behaviors.

5. Which nursing response provides accurate information to discuss with the female patient diagnosed with bipolar disorder and her support system?

• A. Remember that alcohol and caffeine can trigger a relapse of your symptoms.
• B. Antidepressant therapy should be carefully monitored due to the risk of a manic episode in bipolar disorder.
• C. It’s crucial to inform your healthcare provider promptly if you experience sleep disturbances.
• D. Are your family members prepared to play an active role in helping manage this disorder?

Correct answer: A

Rationale: Choice A is the correct answer as it emphasizes the importance of avoiding triggers like alcohol and caffeine that can lead to symptom relapse in patients with bipolar disorder. Educating the patient and their support system about these triggers is essential for managing the condition effectively and preventing exacerbations of symptoms. Choice B is incorrect as it overly focuses on antidepressant therapy, which is not the primary concern related to triggers for symptom relapse. Choice C, while important, does not directly address triggers for symptom relapse in bipolar disorder. Choice D is also relevant but does not provide immediate information on managing triggers for symptom relapse.

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