Nursing Elites

1. Which of the following is an example of a mood stabilizer used to treat bipolar disorder?

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

Correct answer: B

Rationale: Lithium is a widely recognized mood stabilizer used in the treatment of bipolar disorder. It helps to control mood swings, prevent manic episodes, and reduce the risk of suicidal behavior in individuals with bipolar disorder. Fluoxetine is an antidepressant, Haloperidol is an antipsychotic, and Lorazepam is a benzodiazepine used for anxiety and insomnia, none of which are primary mood stabilizers for bipolar disorder.

2. A client is discussing free associations as a therapeutic tool with a nurse. Which of the following client statements indicates an understanding of this technique?

• A. “I will write down my dreams as soon as I wake up.”
• B. “I might begin to associate my therapist with important people in my life.”
• C. “I can learn to express myself in a nonaggressive manner.”
• D. “I should say the first thing that comes to my mind.”

Correct answer: D

Rationale: Free association is a psychoanalytic technique where the client is encouraged to say the first thing that comes to their mind without censoring or filtering. This technique helps uncover unconscious thoughts and emotions. Choice D, “I should say the first thing that comes to my mind,” indicates an understanding of free association as it aligns with the principle of allowing thoughts to flow freely without inhibition. Choices A, B, and C do not reflect an understanding of free association and its purpose, making them incorrect. A, focusing on writing down dreams, does not relate to the immediate expression of thoughts. B, associating the therapist with important people, and C, learning to express oneself nonaggressively, do not capture the essence of free association as a technique for exploring unconscious processes.

3. What is a priority intervention for a patient with severe anxiety?

• A. Encouraging the patient to discuss their feelings in detail.
• B. Providing a calm and quiet environment.
• C. Encouraging the patient to participate in group activities.
• D. Providing detailed information about their treatment plan.

Correct answer: B

Rationale: When dealing with a patient experiencing severe anxiety, providing a calm and quiet environment is a priority intervention. This approach helps reduce stimuli and anxiety levels, creating a more soothing atmosphere for the individual. Encouraging the patient to discuss their feelings in detail or participate in group activities may be beneficial in certain situations, but establishing a peaceful setting takes precedence when managing severe anxiety. Providing detailed information about their treatment plan, although important, may not be the immediate priority when the patient is in a state of severe anxiety and needs a calming environment first.

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: The most therapeutic response acknowledges the patient's emotional state and invites further discussion about their experience. By saying, 'You seem very upset. Please tell me more about what you experienced last night,' the nurse shows empathy and openness, providing a supportive environment for the patient to express their feelings and perceptions.

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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