Nursing Elites

1. Which statement by a patient indicates an understanding of cognitive-behavioral therapy (CBT)?

• A. CBT will help me understand and change my thought patterns.
• B. CBT focuses on resolving past trauma.
• C. CBT will help me avoid my problems.
• D. CBT involves taking medication to manage symptoms.

Correct answer: A

Rationale: The correct answer is A. Cognitive-behavioral therapy (CBT) is a type of psychotherapy that focuses on helping patients understand and change their thought patterns to improve their mental health. This therapy aims to identify and modify negative or harmful thoughts and behaviors. Option A correctly reflects this fundamental concept of CBT, emphasizing the role of thought patterns in mental health improvement. Choices B and C are incorrect because CBT does not primarily focus on resolving past trauma or avoiding problems; instead, it concentrates on changing cognitive patterns. Choice D is also inaccurate as CBT does not involve medication management but rather focuses on cognitive and behavioral interventions.

2. What is the most appropriate nursing diagnosis for a patient with agoraphobia who reports not having left their house in months?

• A. Social isolation
• B. Ineffective coping
• C. Risk for injury
• D. Impaired social interaction

Correct answer: A

Rationale: The nursing diagnosis 'Social isolation' is most appropriate for a patient with agoraphobia who has not left their house in months. Agoraphobia often leads to the avoidance of situations or places perceived as unsafe, resulting in social isolation. This diagnosis reflects the patient's limited social interactions and confinement to the home environment, which can impact their overall well-being and mental health. The other options are not as relevant in this scenario: 'Ineffective coping' does not directly address the social withdrawal aspect, 'Risk for injury' is not the primary concern presented, and 'Impaired social interaction' does not capture the extent of isolation described.

3. Gilbert, age 19, is described by his parents as a 'moody child' with an onset of odd behavior at age 14, which caused Gilbert to suffer academically and socially. Gilbert has lost the ability to complete household chores, is reluctant to leave the house, and is obsessed with the locks on the windows and doors. Due to Gilbert’s early and slow onset of what is now recognized as schizophrenia, his prognosis is considered:

• A. Favorable with medication
• B. In the relapse stage
• C. Improvable with psychosocial interventions
• D. To have a less positive outcome

Correct answer: D

Rationale: Individuals with an early and slow onset of schizophrenia typically have a less positive outcome or prognosis. This is because early onset schizophrenia is often associated with a more severe form of the illness and can lead to greater functional impairment in various aspects of life, including academic and social functioning. Therefore, the prognosis for Gilbert, given his presentation and age of onset, would be considered to have a less positive outcome.

4. When developing a care plan for a patient with generalized anxiety disorder (GAD), which long-term goal is most appropriate?

• A. The patient will experience no episodes of anxiety.
• B. The patient will recognize and modify anxiety-provoking thoughts.
• C. The patient will avoid situations that cause anxiety.
• D. The patient will take medication as prescribed.

Correct answer: B

Rationale: The most appropriate long-term goal for managing generalized anxiety disorder is for the patient to recognize and modify anxiety-provoking thoughts. By addressing and modifying these thoughts, the patient can develop coping mechanisms and strategies to manage their anxiety more effectively in the long term. Choices A and C are not ideal long-term goals as complete elimination of anxiety episodes or avoidance of anxiety-provoking situations may not be realistic or sustainable. Choice D focuses solely on medication adherence, which is important but does not address the core cognitive-behavioral aspects of managing anxiety in GAD.

5. 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.

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