Nursing Elites

1. Which behavior is most characteristic of agoraphobia?

• A. Avoiding crowded places and public transportation
• B. Excessively washing hands to prevent contamination
• C. Experiencing unexpected panic attacks
• D. Having a fear of gaining weight

Correct answer: A

Rationale: Agoraphobia is characterized by the avoidance of situations where escape might be difficult or help unavailable in the event of a panic attack. Avoiding crowded places and public transportation aligns with this fear of being in situations where escape might be challenging, making choice A the most characteristic behavior of agoraphobia. Choices B, C, and D do not directly relate to the core feature of agoraphobia, which is the avoidance of situations perceived as difficult to escape from.

2. Luc’s family comes home one evening to find him extremely agitated, and they suspect he is in a full manic episode. The family calls emergency medical services. While one medic is talking with Luc and his family, the other medic is counting something on his desk. What is the medic most likely counting?

• A. Hypodermic needles
• B. Fast food wrappers
• C. Empty soda cans
• D. Energy drink containers

Correct answer: D

Rationale: The medic is most likely counting energy drink containers. Energy drink containers could indicate high caffeine intake, which can exacerbate manic episodes by increasing agitation and exacerbating symptoms in individuals with mood disorders.

3. A patient diagnosed with panic disorder asks the nurse about the purpose of deep breathing exercises. Which explanation by the nurse is most accurate?

• A. Deep breathing helps distract you from your anxiety.
• B. Deep breathing can prevent future panic attacks.
• C. Deep breathing helps reduce physical symptoms of anxiety.
• D. Deep breathing increases your overall lung capacity.

Correct answer: C

Rationale: Deep breathing helps reduce the physical symptoms of anxiety, such as rapid heartbeat and shortness of breath.

4. James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for the day shift and anxiously reports, ‘Last night, demons came to my room and tried to rape me.’ Which response would be most therapeutic?

• A. There are no such things as demons. What you saw were hallucinations.
• B. It is not possible for anyone to enter your room at night. You are safe here.
• C. You seem very upset. Please tell me more about what you experienced last night.
• D. That must have been very frightening, but we’ll check on you at night and you’ll be safe.

Correct answer: C

Rationale: Choice C is the most therapeutic response as it acknowledges the patient’s feelings, shows empathy, and encourages further expression of his experiences. By actively listening and inviting the patient to share more details, the healthcare provider provides a supportive environment that can help the patient feel understood and validated. Option A dismisses the patient's experience and can make him feel unheard. Option B denies the patient's reality and can increase his distress. Option D, while offering reassurance, does not address the patient's emotional state or encourage further communication.

5. Ted, a former executive, is now unemployed due to manic episodes at work. He was diagnosed with bipolar I 8 years ago. Ted has a history of IV drug abuse, which resulted in hepatitis C. He is taking his lithium exactly as scheduled, a fact that both Ted’s wife and his blood tests confirm. To reduce Ted’s mania, the psychiatric nurse practitioner recommends:

• A. Clonazepam (Klonopin)
• B. Fluoxetine (Prozac)
• C. Electroconvulsive therapy (ECT)
• D. Lurasidone (Latuda)

Correct answer: D

Rationale: Lurasidone (Latuda) is an atypical antipsychotic medication commonly used in the treatment of bipolar disorder. It can help manage symptoms of mania by stabilizing mood and reducing the intensity of manic episodes. Given Ted's history of bipolar I disorder and the need to address his manic symptoms, Lurasidone (Latuda) is a suitable recommendation by the psychiatric nurse practitioner to aid in managing Ted's condition effectively.

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