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 an important aspect of patient education regarding buspirone when prescribed for generalized anxiety disorder (GAD)?

• A. Buspirone is an as-needed medication for anxiety.
• B. Buspirone has a high risk of addiction and dependence.
• C. Buspirone may not become effective until 2-4 weeks after starting the medication.
• D. Buspirone should be taken with food to increase absorption.

Correct answer: C

Rationale: The correct answer is C. When educating a patient about buspirone for generalized anxiety disorder, it is crucial to highlight that buspirone may take 2-4 weeks to become effective. Patients need to be aware of this delayed onset of action to manage their expectations and continue the medication as prescribed. This information helps patients understand that they may not experience immediate relief and should not discontinue the medication prematurely. Choices A, B, and D are incorrect because buspirone is typically taken regularly, not as-needed, it has a lower risk of addiction compared to other anxiety medications, and it does not need to be taken with food for increased absorption.

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. What is the most appropriate intervention for a patient experiencing severe anxiety?

• A. Encourage the patient to talk about their anxiety.
• B. Teach the patient deep breathing exercises.
• C. Remain with the patient and provide a calm presence.
• D. Suggest the patient engage in physical activity.

Correct answer: C

Rationale: When a patient is experiencing severe anxiety, remaining with the patient and providing a calm presence is the most appropriate intervention. This approach can help the patient feel supported and safe, which can help in reducing their anxiety levels. Encouraging the patient to talk about their anxiety may not be suitable during a severe anxiety episode, as it can potentially escalate their distress. Teaching deep breathing exercises can be helpful, but in cases of severe anxiety, the patient may find it challenging to focus on such techniques. Suggesting physical activity may not be suitable as the patient might not be in a state to engage in such activities when experiencing severe anxiety.

5. A patient is experiencing a manic episode. Which intervention is most effective?

• A. Encouraging the patient to participate in group activities
• B. Providing a low-stimulation environment
• C. Allowing the patient to move freely around the unit
• D. Engaging the patient in competitive games

Correct answer: B

Rationale: During a manic episode, individuals may be overwhelmed by stimuli. Providing a low-stimulation environment can help reduce excessive sensory input and minimize exacerbation of manic behaviors. This intervention aims to create a calm and structured setting that supports the individual in managing their symptoms effectively.

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