Nursing Elites

1. A patient with panic disorder is prescribed a benzodiazepine. The nurse should educate the patient that this medication is typically used for:

• A. For long-term maintenance therapy.
• B. As a first-line treatment.
• C. For short-term use due to the risk of dependence.
• D. To treat depression symptoms.

Correct answer: C

Rationale: The correct answer is C: 'For short-term use due to the risk of dependence.' Benzodiazepines are usually prescribed for short-term relief of anxiety symptoms due to the risk of dependence. Prolonged use can lead to tolerance, dependence, and other adverse effects, so they are not typically used for long-term maintenance therapy (choice A). They are not considered first-line treatments for panic disorder (choice B) and are not primarily used to treat depression symptoms (choice D), as their main indication is for anxiety and panic disorders.

2. A healthcare provider is evaluating the effectiveness of medication therapy for a client diagnosed with bipolar disorder. Which outcome should indicate that the medication has been effective?

• A. The client reports a decrease in manic episodes.
• B. The client experiences fewer mood swings.
• C. The client sleeps for 8 hours each night.
• D. The client maintains a stable weight.

Correct answer: A

Rationale: A decrease in manic episodes is a key indicator of the effectiveness of medication therapy for bipolar disorder. Manic episodes are a hallmark of bipolar disorder, and a decrease in their frequency or intensity suggests that the medication is helping to stabilize the client's mood and manage their symptoms. While choices B, C, and D are important aspects of overall health and well-being, they are not specific indicators of the effectiveness of medication therapy for bipolar disorder. Choice B focuses on mood swings in general, which may include depressive episodes as well, while choice C addresses sleep patterns and choice D relates to weight stability, which can be influenced by various factors unrelated to bipolar disorder treatment.

3. Which of the following is not a cultural aspect related to mental illness?

• A. Local or cultural norms define pathological behavior.
• B. The higher the social class, the greater the recognition of mental illness behaviors.
• C. Psychiatrists typically see patients when the family can no longer deny the illness.
• D. The greater the cultural distance from the mainstream of society, the greater the likelihood that the illness will be treated with sensitivity and compassion.

Correct answer: D

Rationale: The statement in option D is incorrect. The greater the cultural distance from the mainstream of society, the more likely there will be negative responses to mental illness. In such cases, coercive treatments and involuntary hospitalizations are more common, rather than sensitivity and compassion.

4. Tammy, a 28-year-old with major depressive disorder and bulimia nervosa, is ready for discharge from the county hospital after 2 weeks of inpatient therapy. Tammy is taking citalopram (Celexa) and reports that it has made her feel more hopeful. With a secondary diagnosis of bulimia nervosa, what is an alternative antidepressant to consider?

• A. Fluoxetine (Prozac)
• B. Isocarboxazid (Marplan)
• C. Amitriptyline
• D. Duloxetine (Cymbalta)

Correct answer: A

Rationale: Fluoxetine (Prozac) is a suitable alternative antidepressant for Tammy due to its approval for the treatment of bulimia nervosa. It belongs to the selective serotonin reuptake inhibitor (SSRI) class of antidepressants, similar to citalopram, which Tammy is already taking. Fluoxetine has shown efficacy in treating bulimia nervosa and can be a beneficial choice for individuals with this condition.

5. A client with obsessive-compulsive disorder (OCD) spends hours each day washing her hands. Which intervention should the nurse implement to help the client reduce this behavior?

• A. Encourage the client to set a time limit for washing hands.
• B. Encourage the client to wash hands only when necessary.
• C. Encourage the client to use hand sanitizer instead of washing.
• D. Encourage the client to explore the reasons behind the hand washing.

Correct answer: A

Rationale: Setting a time limit for hand washing is an effective intervention in managing obsessive-compulsive disorder (OCD) symptoms. By establishing boundaries around the behavior, the client can gradually work towards reducing the excessive hand washing and regaining control over the compulsion. Choice B is not as effective because it does not address the underlying compulsion. Choice C may not be helpful as it may not satisfy the client's need for cleanliness and could reinforce the behavior. Choice D, while important in therapy, may not be the most immediate intervention needed to address the excessive hand washing behavior.

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