Nursing Elites

1. What must be considered when preparing the teaching plan for a patient diagnosed with bipolar disorder who is being prescribed lithium therapy?

• A. Caffeine and alcohol can affect lithium levels.
• B. Lithium should be taken with meals to avoid gastrointestinal distress.
• C. Regular blood tests are required to monitor lithium levels.
• D. Lithium can cause weight gain.

Correct answer: C

Rationale: When preparing a teaching plan for a patient prescribed lithium therapy for bipolar disorder, it is crucial to emphasize the need for regular blood tests to monitor lithium levels. Monitoring levels is essential to ensure the drug's effectiveness and to manage potential side effects. While factors like caffeine and alcohol intake, taking lithium with meals, and the risk of weight gain may be relevant considerations, the primary focus should be on the necessity of regular blood tests for effective management of lithium therapy. Therefore, option C is the correct choice as it addresses a critical aspect of lithium therapy management.

2. When assessing a patient with major depressive disorder, which of the following is a common cognitive symptom?

• A. Hallucinations
• B. Delusions
• C. Lack of appetite
• D. Negative self-talk

Correct answer: D

Rationale: Negative self-talk is a common cognitive symptom of major depressive disorder. It involves a pattern of negative thoughts and beliefs about oneself, which can significantly impact a patient's self-esteem and overall outlook on life. Hallucinations and delusions are more commonly associated with other mental health conditions like schizophrenia, while lack of appetite is typically considered a physical symptom of depression rather than a cognitive one.

3. What is the most effective initial intervention for a patient experiencing a panic attack?

• A. Encourage the patient to discuss their feelings.
• B. Provide a quiet environment and stay with the patient.
• C. Administer prescribed medication immediately.
• D. Teach the patient relaxation techniques.

Correct answer: B

Rationale: During a panic attack, the most effective initial intervention is to provide a quiet environment and stay with the patient. This approach can help the patient feel safe and supported, which may help reduce the intensity and duration of the panic attack. Encouraging the patient to discuss their feelings may not be helpful during the acute phase of a panic attack as it can be overwhelming. Administering prescribed medication immediately is not typically the first-line intervention for panic attacks. Teaching relaxation techniques is beneficial in the long term but may not be the most effective immediate intervention during a panic attack.

4. When working with a patient diagnosed with posttraumatic stress disorder (PTSD), which therapeutic approach is most appropriate?

• A. Encouraging the patient to avoid discussing the traumatic event.
• B. Using exposure therapy to help the patient confront their fears.
• C. Advising the patient to focus on positive thoughts.
• D. Suggesting that the patient keep busy to distract from traumatic memories.

Correct answer: B

Rationale: Exposure therapy is an evidence-based treatment for PTSD that involves gradually exposing the patient to their traumatic memories in a safe and controlled environment. This approach helps individuals confront and process their fears, reducing the impact of the traumatic event over time. Avoiding discussing the trauma (choice A) may lead to avoidance behaviors and hinder recovery. Focusing on positive thoughts (choice C) may provide temporary relief but does not address the underlying trauma. Keeping busy to distract from memories (choice D) is a form of avoidance that does not help in processing the traumatic experiences. Therefore, using exposure therapy (choice B) is the most appropriate approach to effectively treat PTSD.

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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