Nursing Elites

1. In treating PTSD, which type of therapy is most commonly recommended?

• A. Cognitive-behavioral therapy (CBT)
• B. Psychoanalytic therapy
• C. Humanistic therapy
• D. Gestalt therapy

Correct answer: A

Rationale: Cognitive-behavioral therapy (CBT) is the most commonly recommended therapy for PTSD due to its effectiveness in helping patients identify and change negative thoughts and behaviors associated with trauma. This therapy focuses on providing practical coping strategies to manage symptoms and process traumatic experiences. Psychoanalytic therapy, humanistic therapy, and gestalt therapy are less commonly used for PTSD as they may not target the specific symptoms and cognitive distortions associated with this disorder.

2. What assessment findings would indicate lithium toxicity in a patient hospitalized for an acute manic episode?

• A. Shortness of breath, gastrointestinal distress, chronic cough
• B. Ataxia, severe hypotension, large volume of dilute urine
• C. Gastrointestinal distress, thirst, nystagmus
• D. Electroencephalographic changes, chest pain, dizziness

Correct answer: B

Rationale: In a patient suspected of lithium toxicity, the presence of ataxia, severe hypotension, and a large volume of dilute urine are key assessment findings. Ataxia is a sign of central nervous system involvement, severe hypotension indicates cardiovascular effects, and a large volume of dilute urine suggests renal impairment, all of which are commonly seen in severe lithium toxicity. Options A, C, and D do not align with typical signs of lithium toxicity.

3. A patient with schizophrenia is prescribed risperidone. Which statement by the patient indicates understanding of the medication?

• A. I should take this medication at the same time every day.
• B. I can stop taking this medication once I feel better.
• C. I should avoid drinking alcohol while taking this medication.
• D. I should take this medication on an as-needed basis.

Correct answer: A

Rationale: The correct answer is A because taking the medication at the same time every day helps maintain consistent blood levels and effectiveness. Consistency in dosing is crucial for the medication to work optimally in managing symptoms of schizophrenia. Option B is incorrect because stopping the medication abruptly can lead to a worsening of symptoms. Option C is important as alcohol can interact with the medication and cause adverse effects. Option D is incorrect because risperidone is typically taken regularly, not on an as-needed basis, to manage symptoms effectively.

4. Child protective services have removed 10-year-old Christopher from his parents’ home due to neglect. Christopher reveals to the nurse that he considers the woman next door his “nice” mom, that he loves school, and gets above-average grades. The strongest explanation for this response is:

• A. Temperament
• B. Genetic factors
• C. Resilience
• D. Paradoxical effects of neglect

Correct answer: C

Rationale: Resilience is the ability to adapt well despite adversity, which is demonstrated by Christopher's positive relationships and school performance. Despite the challenging situation of being removed from his parents' home, Christopher's ability to form a positive bond with the neighbor, enjoy school, and excel academically showcases his resilience in coping with the circumstances.

5. In dissociative identity disorder, a patient exhibits different personalities, each with distinct behaviors and memories. The nurse recognizes that this fragmentation of identity serves as a coping mechanism for:

• A. Current stressors
• B. Developmental issues
• C. Traumatic experiences
• D. Family dynamics

Correct answer: C

Rationale: In dissociative identity disorder, the fragmentation of identity serves as a coping mechanism for traumatic experiences. Individuals may develop different identities to help them manage and cope with overwhelming and traumatic events from their past. These distinct personalities often emerge as a way to protect the individual from the emotional pain associated with their traumatic experiences. Choices A, B, and D are incorrect because dissociative identity disorder is primarily associated with coping mechanisms related to past traumatic experiences, rather than current stressors, developmental issues, or family dynamics.

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