Nursing Elites

1. Which of the following interventions is most effective in managing a patient with obsessive-compulsive disorder (OCD)?

• A. Encouraging the patient to engage in repetitive behaviors.
• B. Helping the patient to understand that their thoughts are irrational.
• C. Providing the patient with a structured daily routine.
• D. Allowing the patient to avoid situations that trigger their obsessions.

Correct answer: B

Rationale: The most effective intervention in managing a patient with obsessive-compulsive disorder (OCD) is helping the patient to understand that their thoughts are irrational. This cognitive-behavioral approach can assist in reducing the frequency and intensity of obsessive thoughts and compulsive behaviors by challenging and reframing maladaptive beliefs and thought patterns associated with OCD. Encouraging the patient to engage in repetitive behaviors (choice A) reinforces the compulsive behavior rather than addressing the underlying issue. Providing a structured daily routine (choice C) may help in some cases but does not directly target the irrational thoughts and beliefs. Allowing the patient to avoid trigger situations (choice D) can provide temporary relief but does not address the core problem of irrational thoughts and behaviors.

2. 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.

3. Which of the following medications is commonly used to treat attention deficit hyperactivity disorder (ADHD)?

• A. Sertraline
• B. Diazepam
• C. Methylphenidate
• D. Clozapine

Correct answer: C

Rationale: Methylphenidate is the correct answer. It is a stimulant medication commonly used to treat ADHD. Methylphenidate works by increasing the activity of certain chemicals in the brain that are involved in attention and impulse control. Sertraline is an antidepressant used for depression, anxiety, and other conditions, not ADHD. Diazepam is a benzodiazepine mainly prescribed for anxiety, muscle spasms, and seizures, not ADHD. Clozapine is an antipsychotic medication used for schizophrenia when other medications are ineffective, not for ADHD.

4. Which medication is often prescribed for patients with bipolar disorder to help stabilize mood?

• A. Sertraline
• B. Lithium
• C. Haloperidol
• D. Diazepam

Correct answer: B

Rationale: Lithium is the medication frequently prescribed to stabilize mood in patients with bipolar disorder. It helps to reduce the frequency and severity of manic episodes, making it a cornerstone in the treatment of bipolar disorder. Sertraline is an antidepressant commonly used for depression, while haloperidol and diazepam are not typically first-line treatments for bipolar disorder.

5. A patient with major depressive disorder has been prescribed sertraline (Zoloft). Which statement by the patient indicates a need for further teaching?

• A. I should take my medication with food to avoid stomach upset.
• B. I should avoid alcohol while taking this medication.
• C. I can stop taking my medication once I feel better.
• D. I might experience some improvement in mood within a few weeks.

Correct answer: C

Rationale: Choice C is the correct answer. It is crucial for patients to understand that they should not stop taking their medication once they feel better. Discontinuing antidepressants abruptly can lead to a relapse of depressive symptoms. Patients should continue taking their medication as prescribed by their healthcare provider, even if they start feeling better, to ensure the best outcomes in managing major depressive disorder. Choices A, B, and D are all accurate statements. Taking medication with food can help reduce stomach upset, avoiding alcohol is essential while on sertraline to prevent interactions, and experiencing some improvement in mood within a few weeks is a common expectation when starting an antidepressant like sertraline.

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