Nursing Elites

1. Which assessment question will provide information regarding the effects of a woman’s circadian rhythms on her quality of life?

• A. How much sleep do you usually get each night?
• B. Does your heart ever seem to skip a beat?
• C. When was the last time you had a fever?
• D. Do you have problems urinating?

Correct answer: A

Rationale: The correct answer is A: 'How much sleep do you usually get each night?' Asking about sleep patterns is essential to understand the impact of circadian rhythms on an individual's quality of life. Adequate sleep is closely linked to circadian rhythms, and disturbances in sleep patterns can significantly affect a person's well-being and daily functioning. Choices B, C, and D are not directly related to circadian rhythms and would not provide information specifically about how circadian rhythms affect quality of life.

2. 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.

3. Which medication is commonly used to treat obsessive-compulsive disorder (OCD)?

• A. Lorazepam
• B. Fluoxetine
• C. Lithium
• D. Haloperidol

Correct answer: B

Rationale: The correct answer is Fluoxetine (Choice B). Fluoxetine, an SSRI (Selective Serotonin Reuptake Inhibitor), is commonly used in the treatment of obsessive-compulsive disorder (OCD). SSRIs like Fluoxetine are considered first-line medications for managing OCD symptoms by helping to increase serotonin levels in the brain, which plays a role in mood regulation and anxiety reduction. Choice A, Lorazepam, is a benzodiazepine primarily used for anxiety disorders but is not a first-line treatment for OCD. Choice C, Lithium, is typically used in conditions like bipolar disorder, not OCD. Choice D, Haloperidol, is an antipsychotic medication and is not commonly used to treat OCD.

4. 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.

5. The school nurse has been alerted to the fact that an 8-year-old boy routinely playacts as a police officer, 'locking up' other children on the playground to the point where the children get scared. The nurse recognizes that this behavior is most likely an indication of:

• A. The need to dominate others
• B. Inventing traumatic events
• C. A need to develop close relationships
• D. A potential symptom of traumatization

Correct answer: D

Rationale: When an 8-year-old boy engages in playacting as a police officer that instills fear in other children, it can be indicative of a potential symptom of traumatization. This behavior may reflect the child's attempt to process or express experiences of trauma, leading to a manifestation of such distress in his play interactions with others.

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