Nursing Elites

1. Which of the following is a positive symptom of schizophrenia?

• A. Apathy
• B. Social withdrawal
• C. Delusions
• D. Flat affect

Correct answer: C

Rationale: The correct answer is 'C: Delusions.' Positive symptoms of schizophrenia involve an excess or distortion of normal functions. Delusions are fixed false beliefs that are not based in reality and are considered positive symptoms because they represent an addition of abnormal behavior or thoughts.

2. A patient diagnosed with dissociative identity disorder has been undergoing therapy for several months. Which outcome indicates that the patient is progressing in therapy?

• A. The patient has developed a strong therapeutic relationship with the therapist.
• B. The patient’s different personalities are beginning to merge.
• C. The patient is able to recall traumatic events without dissociating.
• D. The patient reports fewer gaps in memory.

Correct answer: B

Rationale: In dissociative identity disorder, the merging of different personalities is a crucial indicator of progress in therapy. As the different identities merge, it signifies that the patient is integrating fragmented aspects of their self, leading to a more cohesive sense of identity and a reduction in dissociative symptoms. This process is a significant therapeutic milestone in the treatment of dissociative identity disorder as it promotes internal cohesion and decreases internal conflict. Choices A, C, and D are incorrect because while developing a strong therapeutic relationship, recalling traumatic events without dissociating, and reporting fewer gaps in memory are important aspects of therapy, the merging of different personalities is specifically indicative of substantial progress in treating dissociative identity disorder.

3. A patient with social anxiety disorder is learning cognitive-behavioral therapy (CBT) techniques. Which skill is most likely being taught?

• A. Avoiding social situations that cause anxiety
• B. Challenging and changing negative thoughts
• C. Using deep breathing exercises during social interactions
• D. Taking anti-anxiety medication before social events

Correct answer: B

Rationale: The correct answer is B. In cognitive-behavioral therapy (CBT) for social anxiety disorder, the focus is on challenging and changing negative thoughts that contribute to anxiety. This process involves identifying distorted thought patterns and replacing them with more balanced and realistic thoughts, helping individuals develop healthier perspectives on social situations. Choices A, C, and D are incorrect because avoiding social situations, using deep breathing exercises, and taking medication are not the primary skills taught in CBT for social anxiety disorder. CBT aims to address the underlying thought patterns and behaviors that maintain anxiety, rather than avoidance or temporary relief.

4. April, a 10-year-old admitted to inpatient pediatric care, has been becoming increasingly agitated and losing control in the day room. Time-out has proven to be ineffective for April to engage in self-reflection. April’s mother mentions using time-out up to 20 times a day. The nurse acknowledges that:

• A. Time-out is a crucial aspect of April’s baseline discipline.
• B. Time-out is no longer an effective intervention.
• C. April finds enjoyment in time-out and misbehaves to seek solitude.
• D. Time-out will have to be replaced with seclusion and restraint.

Correct answer: B

Rationale: The scenario describes how April's behavior is not improving with the frequent use of time-out, indicating that it is no longer an effective intervention. When a strategy such as time-out loses its effectiveness due to overuse, it is crucial to explore alternative therapeutic measures to address the underlying issues effectively.

5. A patient with obsessive-compulsive disorder (OCD) performs hand washing repeatedly. Which nursing intervention is most appropriate?

• A. Restricting the patient from washing hands
• B. Setting strict limits on the patient's hand washing
• C. Allowing the patient to wash hands at specified times
• D. Ignoring the patient's behavior

Correct answer: C

Rationale: Allowing the patient to wash hands at specified times is the most appropriate nursing intervention for a patient with OCD who repetitively performs hand washing. This intervention provides structure by allowing the patient to engage in the behavior at designated times, helping to reduce the compulsion gradually. Restricting or setting strict limits may increase anxiety and worsen the condition, while ignoring the behavior does not address the underlying issue of OCD.

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