Nursing Elites

1. Cognitive-behavioral therapy (CBT) is often used to treat which of the following conditions?

• A. Schizophrenia
• B. Bipolar disorder
• C. Posttraumatic stress disorder
• D. Generalized anxiety disorder

Correct answer: D

Rationale: Cognitive-behavioral therapy (CBT) is a widely used therapeutic approach effective in treating various mental health conditions. While CBT can be beneficial for different disorders, it is particularly well-suited for anxiety-related conditions like generalized anxiety disorder. CBT focuses on identifying and modifying negative thought patterns and behaviors contributing to anxiety, making it a suitable choice for treating generalized anxiety disorder. Therefore, the correct answer is D. Choices A, B, and C are incorrect because CBT is not typically the first-line treatment for schizophrenia, bipolar disorder, or posttraumatic stress disorder, although it may be used as a part of a comprehensive treatment plan.

2. A healthcare professional is assessing a client's use of defense mechanisms. Which statement would indicate to the healthcare professional that the client is using the defense mechanism of projection?

• A. The client accuses others of being angry when it is the client who is angry.
• B. The client refuses to acknowledge a problem despite evidence to the contrary.
• C. The client attributes his own feelings of hostility to others.
• D. The client avoids dealing with painful feelings by focusing on something else.

Correct answer: C

Rationale: Projection is a defense mechanism where individuals attribute their own unacceptable feelings, thoughts, or impulses onto others. In this case, the client is projecting his own feelings of hostility onto others by assuming they possess these feelings instead.

3. A client with obsessive-compulsive disorder (OCD) spends several hours each day washing her hands. Which intervention should the nurse implement?

• A. Encourage the client to wash her hands less frequently.
• B. Set a time limit for hand washing.
• C. Teach the client relaxation techniques.
• D. Discourage the client from washing her hands.

Correct answer: B

Rationale: Setting a time limit for hand washing is an appropriate intervention for a client with OCD who spends excessive time on this compulsive behavior. By setting a time limit, the nurse can help the client gradually reduce the compulsive behavior, promoting a more manageable approach to hand washing without completely discouraging it. Encouraging the client to wash her hands less frequently (Choice A) may not address the root of the issue and could lead to increased anxiety. Teaching relaxation techniques (Choice C) may be helpful for overall anxiety management but may not directly address the excessive hand washing behavior. Discouraging the client from washing her hands (Choice D) may increase anxiety and resistance, making it a less effective intervention.

4. When patients diagnosed with schizophrenia suffer from anosognosia, they often refuse medication, believing that:

• A. Medications provided are ineffective.
• B. Nurses are trying to control their minds.
• C. The medications will make them sick.
• D. They are not actually ill.

Correct answer: D

Rationale: Anosognosia is a lack of insight that affects patients with schizophrenia, leading them to deny or lack awareness of their illness. This lack of awareness often results in patients refusing medication because they genuinely believe they are not ill and do not need treatment. It is crucial for healthcare providers to approach such situations with understanding and empathy, recognizing the impact of anosognosia on treatment adherence.

5. 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.

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