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. Which of the following is a hallmark symptom of generalized anxiety disorder (GAD)?

• A. Flashbacks
• B. Excessive worry
• C. Hallucinations
• D. Compulsive behaviors

Correct answer: B

Rationale: Excessive worry is a hallmark symptom of generalized anxiety disorder (GAD). Individuals with GAD often experience persistent and excessive worry or anxiety about a variety of situations or activities, even when there is little or no reason to worry. This chronic worrying can significantly impact their daily functioning and quality of life, distinguishing it as a key feature of GAD. Flashbacks are more commonly associated with post-traumatic stress disorder (PTSD), not GAD. Hallucinations are not typically seen in GAD but may be present in conditions like schizophrenia. Compulsive behaviors are characteristic of obsessive-compulsive disorder (OCD), not GAD.

3. When interviewing a distressed client who was fired after 15 years of loyal employment, which of the following questions would best assist the nurse in determining the client's appraisal of the situation? Select the one that does not apply.

• A. What coping resources have you used previously in stressful situations?
• B. Have you ever faced a similar stressful situation before?
• C. Who do you think is to blame for this situation?
• D. What do you believe led to your termination from your job?

Correct answer: C

Rationale: In this scenario, it is crucial for the nurse to help the client assess their coping mechanisms and perspective on the situation. Questions A and B focus on exploring the client's coping resources and past experiences to guide them towards effective stress management. Asking who is to blame (choice C) is not conducive to evaluating coping abilities; instead, it might elicit a blame-focused response, which can impede progress. Choice D, inquiring about the reason for being fired, is a nontherapeutic approach that does not promote a constructive appraisal of the situation.

4. Which intervention should the nurse implement when caring for a patient demonstrating manic behavior? Select one that doesn't apply.

• A. Monitor the patient's vital signs frequently.
• B. Keep the patient distracted with group-oriented activities.
• C. Provide the patient with frequent milkshakes and protein drinks.
• D. Reduce the volume on the television and dim bright lights in the environment.

Correct answer: B

Rationale: When caring for a patient demonstrating manic behavior, it is crucial to monitor vital signs frequently to ensure the patient's physical health is stable. Providing nutrition, such as milkshakes and protein drinks, is essential to meet the patient's dietary needs. Diminishing environmental stimuli by reducing the volume on the television and dimming bright lights can help create a calmer environment. However, keeping the patient distracted with group-oriented activities may not be the most appropriate intervention as it could potentially exacerbate the manic behavior by overstimulating the patient. Therefore, this choice is the one that doesn't apply in managing manic behavior effectively.

5. In the treatment of a patient with bipolar disorder experiencing a depressive episode, which medication is commonly prescribed?

• A. Valproic acid
• B. Risperidone
• C. Fluoxetine
• D. Lithium

Correct answer: C

Rationale: The correct answer is C, Fluoxetine. Fluoxetine, a commonly prescribed antidepressant, is used to manage depressive episodes in bipolar disorder. It helps alleviate symptoms of depression by increasing the levels of serotonin in the brain, which can improve mood and reduce feelings of sadness and hopelessness. While mood stabilizers like lithium are often used in bipolar disorder, for depressive episodes, antidepressants like fluoxetine are preferred to address the specific symptoms associated with depression. Valproic acid is a mood stabilizer often used in bipolar disorder to manage manic episodes. Risperidone is an atypical antipsychotic that may be used in bipolar disorder to help control manic episodes or as an adjunctive treatment, but it is not a first-line medication for depressive episodes.

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