Nursing Elites

1. What is a primary goal of treatment for a patient with obsessive-compulsive disorder (OCD)?

• A. To eliminate all obsessive thoughts and compulsive behaviors
• B. To reduce the frequency and intensity of obsessive thoughts
• C. To increase the patient’s social interactions
• D. To improve the patient’s sleep quality

Correct answer: B

Rationale: The primary goal of treating obsessive-compulsive disorder (OCD) is to reduce the frequency and intensity of obsessive thoughts and compulsive behaviors. While complete elimination of all obsessive thoughts and compulsive behaviors may be an ideal outcome, it is often unrealistic. Focusing on reducing the impact of these symptoms on the patient's daily life and functioning is more achievable and practical. Choices C and D are incorrect as they are not primary goals in the treatment of OCD. Increasing social interactions and improving sleep quality may be beneficial as part of a comprehensive treatment plan, but they are not the primary focus when managing OCD.

2. A healthcare professional is assessing a patient with major depressive disorder. Which finding is most concerning?

• A. Decreased interest in activities
• B. Feelings of worthlessness
• C. Difficulty sleeping
• D. Changes in appetite

Correct answer: C

Rationale: Among the symptoms listed, difficulty sleeping is particularly concerning in patients with major depressive disorder. Insomnia or other sleep disturbances can exacerbate depressive symptoms and increase the risk of suicidal ideation. Healthcare professionals should address sleep issues promptly to provide appropriate interventions and prevent further complications.

3. 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.

4. Gilbert, age 19, is described by his parents as a ‘moody child’ with an onset of odd behavior at age 14, which caused Gilbert to suffer academically and socially. Gilbert has lost the ability to complete household chores, is reluctant to leave the house, and is obsessed with the locks on the windows and doors. Due to Gilbert’s early and slow onset of what is now recognized as schizophrenia, his prognosis is considered:

• A. Favorable with medication
• B. In the relapse stage
• C. Improvable with psychosocial interventions
• D. To have a less positive outcome

Correct answer: D

Rationale: A person like Gilbert, with an early and slow onset of schizophrenia along with severe symptoms such as loss of daily functioning and obsessions, is likely to have a less positive outcome. Early and severe symptoms are often associated with a more chronic and debilitating course of schizophrenia, which can make treatment and recovery more challenging. Therefore, Gilbert's prognosis is considered to have a less positive outcome. Choices A, B, and C are incorrect because Gilbert's condition, with its early onset and severe symptoms impacting daily life, suggests a more challenging prognosis that is less likely to be favorable with just medication or psychosocial interventions. Being in the relapse stage is not the primary concern here; the focus is on the overall outcome which is expected to be less positive given the early and severe nature of Gilbert's symptoms.

5. What medication is frequently prescribed for patients with generalized anxiety disorder (GAD)?

• A. Fluoxetine
• B. Sertraline
• C. Buspirone
• D. Diazepam

Correct answer: C

Rationale: Buspirone is a medication commonly prescribed for generalized anxiety disorder (GAD) due to its effectiveness and lower risk of dependency compared to benzodiazepines like diazepam. While fluoxetine and sertraline are selective serotonin reuptake inhibitors (SSRIs) often used for various anxiety disorders, buspirone is specifically indicated for GAD.

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