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. A patient with bipolar disorder is being educated by a nurse on the importance of medication adherence. Which statement by the patient indicates understanding?

• A. I will take my medication only when I feel manic symptoms.
• B. I understand that I need to take my medication regularly, even if I feel well.
• C. I will stop taking my medication if I experience side effects.
• D. I will take my medication whenever I remember.

Correct answer: B

Rationale: The correct answer is B. Taking medication regularly, even when feeling well, is crucial in managing bipolar disorder. Choice A is incorrect because medication adherence should not be based on symptoms alone. Choice C is incorrect as stopping medication due to side effects should be discussed with a healthcare provider. Choice D is incorrect because relying on memory may lead to missed doses, impacting treatment effectiveness.

3. A patient with obsessive-compulsive disorder (OCD) frequently washes their hands. Which nursing intervention is most appropriate?

• A. Allow the patient to wash their hands, then gradually limit the time spent on this behavior.
• B. Discourage the patient from discussing their obsessions.
• C. Encourage the patient to suppress their compulsive behaviors.
• D. Avoid setting limits on the patient's compulsive behaviors.

Correct answer: A

Rationale: In managing a patient with OCD who frequently washes their hands, it is important to understand that compulsive behaviors provide temporary relief from anxiety. Allowing the patient to engage in their rituals initially and then gradually setting limits on the time spent can help them gain control over their compulsions. This approach supports the patient without causing undue distress, ultimately assisting in managing OCD symptoms effectively. Choice B is incorrect as discouraging the patient from discussing their obsessions can hinder therapeutic communication and understanding of their condition. Choice C is wrong because encouraging the patient to suppress their compulsive behaviors may increase their anxiety and lead to worsening symptoms. Choice D is also incorrect as avoiding setting limits on the patient's compulsive behaviors does not help the patient in gaining control over their OCD symptoms.

4. A patient with posttraumatic stress disorder (PTSD) is experiencing flashbacks. What is the most appropriate initial nursing intervention?

• A. Encourage the patient to talk briefly about the traumatic event.
• B. Reassure the patient that they are safe and the event is not happening now.
• C. Administer a sedative medication as prescribed.
• D. Suggest the patient write about their feelings in a journal.

Correct answer: B

Rationale: During a flashback, the patient may feel as though the traumatic event is reoccurring. Reassuring the patient that they are safe and the event is not happening presently can help ground them in reality and reduce anxiety. This approach can provide a sense of safety and security, which is crucial in managing flashbacks associated with PTSD. Encouraging the patient to talk briefly about the traumatic event may worsen the distress during a flashback by intensifying the re-experiencing of the trauma. Administering sedative medication should not be the initial intervention, as non-pharmacological approaches are preferred in managing flashbacks. Suggesting the patient write about their feelings in a journal may be beneficial as part of ongoing therapy, but it is not the most appropriate initial intervention during a flashback.

5. When discharging a patient with schizophrenia on risperidone, what is an important point to include in the discharge teaching?

• A. Avoiding foods high in tyramine is essential.
• B. Getting blood levels checked regularly is necessary.
• C. Being cautious when driving due to possible drowsiness is crucial.
• D. Taking this medication on an as-needed basis is recommended.

Correct answer: B

Rationale: Regular monitoring of blood levels is crucial for patients taking risperidone to ensure the medication is at therapeutic levels and to prevent potential toxicity. This monitoring helps healthcare providers adjust the dosage as needed to optimize treatment outcomes and minimize adverse effects.

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