Nursing Elites

1. Which of the following is an example of a cognitive-behavioral therapy (CBT) technique?

• A. Free association
• B. Thought stopping
• C. Dream analysis
• D. Systematic desensitization

Correct answer: B

Rationale: Thought stopping is a specific cognitive-behavioral therapy (CBT) technique aimed at helping individuals manage and interrupt negative or intrusive thoughts. This technique involves identifying and stopping negative thought patterns to promote healthier thinking and emotional well-being. Free association and dream analysis are associated with psychoanalytic therapy, while systematic desensitization is a technique commonly used in behavior therapy.

2. 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.

3. A client is undergoing systematic desensitization for an extreme fear of elevators. Which of the following actions should be implemented with this form of therapy?

• A. Demonstrate riding in an elevator, then ask the client to imitate the behavior.
• B. Advise the client to say “stop” out loud every time they begin to feel an anxiety response related to an elevator.
• C. Gradually expose the client to an elevator while practicing relaxation techniques.
• D. Stay with the client in an elevator until the anxiety response diminishes.

Correct answer: C

Rationale: Systematic desensitization is a type of therapy used to help individuals overcome phobias or anxieties. It involves gradually exposing the client to the feared object or situation, in this case, an elevator, while simultaneously practicing relaxation techniques. This process helps the client associate relaxation with the previously feared stimulus, gradually reducing anxiety levels over time. Choice A is incorrect as it involves imitation rather than gradual exposure. Choice B is incorrect as it focuses on a verbal response rather than the systematic process of exposure and relaxation. Choice D is incorrect as it does not involve the systematic approach of gradually exposing the client while teaching relaxation techniques.

4. A patient with borderline personality disorder is admitted to the psychiatric unit. Which behavior is most characteristic of this disorder?

• A. Avoiding social interactions due to fear of rejection.
• B. Engaging in impulsive and self-destructive behaviors.
• C. Having a grandiose sense of self-importance.
• D. Exhibiting a pattern of unstable relationships.

Correct answer: B

Rationale: Borderline personality disorder is characterized by impulsivity and self-destructive behaviors, such as substance abuse, reckless driving, and self-harm. These behaviors are often used to cope with intense emotional distress and are a key feature of this disorder. While individuals with borderline personality disorder may also struggle with unstable relationships, the hallmark feature that sets it apart is the impulsivity and self-destructive behaviors. Avoiding social interactions due to fear of rejection is more characteristic of avoidant personality disorder. Having a grandiose sense of self-importance is a feature of narcissistic personality disorder.

5. What assessment question will provide insight into 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: Inquiring about the amount of sleep a woman gets each night is crucial in understanding how her circadian rhythms may be affecting her quality of life. Circadian rhythms play a significant role in regulating sleep-wake cycles, and disruptions in these rhythms can impact overall well-being and quality of life.

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