Nursing Elites

1. For a patient with obsessive-compulsive disorder (OCD) who spends several hours a day washing her hands, which type of therapy is most appropriate?

• A. Exposure and response prevention
• B. Dialectical behavior therapy
• C. Family therapy
• D. Interpersonal therapy

Correct answer: A

Rationale: Exposure and response prevention (ERP) is the most appropriate therapy for managing OCD. ERP involves exposing the patient to anxiety-provoking stimuli (such as touching dirty objects) and preventing the compulsive response (hand washing), thus helping the patient learn to tolerate the anxiety without performing the ritualistic behavior. Dialectical behavior therapy (DBT) focuses more on emotional regulation and interpersonal skills, making it less suitable for directly addressing OCD symptoms. Family therapy and interpersonal therapy may be beneficial for other conditions or relationship issues but are not specifically designed to target OCD symptoms like ERP.

2. The client recently survived a plane crash and is assessed by the nurse. Which client statement would cause the nurse to suspect that the client may be experiencing PTSD?

• A. I believe that I was meant to survive this accident so that I can focus on the important things in life
• B. Although I have nightmares sometimes, I have started going to church to show gratitude for surviving the crash
• C. I am so afraid that I will never be able to fly again, but I know that it will take a while
• D. I keep having these thoughts about the crash that just pop into my mind at random times

Correct answer: D

Rationale: Experiencing intrusive thoughts about a traumatic event, such as a plane crash, that occur unexpectedly and repeatedly is a common symptom of Post-Traumatic Stress Disorder (PTSD). These thoughts can be distressing and are often a key indicator of PTSD. Options A, B, and C demonstrate coping mechanisms and fears related to the traumatic event but do not specifically address the hallmark symptom of intrusive thoughts. Therefore, option D is the correct choice as it aligns with a potential symptom of PTSD.

3. A client is being taught relaxation techniques to manage anxiety. Which of the following techniques should the instructor include in the teaching? Select one that doesn't apply.

• A. Deep breathing exercises
• B. Progressive muscle relaxation
• C. Mindfulness meditation
• D. Cognitive restructuring

Correct answer: D

Rationale: Relaxation techniques commonly used to manage anxiety include deep breathing exercises, progressive muscle relaxation, mindfulness meditation, and guided imagery. Cognitive restructuring, on the other hand, is a cognitive-behavioral technique aimed at identifying and changing negative thought patterns rather than a specific relaxation technique. Therefore, cognitive restructuring does not fall under the category of relaxation techniques and is not typically used to manage anxiety.

4. Which medication is commonly prescribed for the treatment of bipolar disorder?

• A. Sertraline
• B. Valproic acid
• C. Clozapine
• D. Haloperidol

Correct answer: B

Rationale: Valproic acid is commonly prescribed as a mood stabilizer for the treatment of bipolar disorder. It helps in controlling mood swings, preventing manic episodes, and reducing the risk of depressive episodes in individuals with bipolar disorder. Sertraline is an antidepressant typically used for major depressive disorder and other anxiety disorders, not for bipolar disorder. Clozapine and Haloperidol are antipsychotic medications primarily used in schizophrenia and other psychotic disorders, not as first-line treatments for bipolar disorder.

5. A client has been diagnosed with paranoid personality disorder. Which of the following behaviors should the nurse expect?

• A. Distrust of others
• B. Reluctance to confide in others
• C. Suspiciousness of others
• D. Jealousy of others

Correct answer: A

Rationale: Individuals with paranoid personality disorder commonly display a pervasive distrust of others. They often interpret benign actions of others as hostile or malicious, leading to suspicion and a belief that others have malevolent intentions. While choices B, C, and D may be present in individuals with different personality disorders or issues, distrust of others is a hallmark feature of paranoid personality disorder, making it the correct behavior to expect in these clients.

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