Nursing Elites

1. Which therapeutic approach is most effective for a patient with generalized anxiety disorder (GAD)?

• A. Psychoanalytic therapy
• B. Cognitive-behavioral therapy (CBT)
• C. Humanistic therapy
• D. Gestalt therapy

Correct answer: B

Rationale: Cognitive-behavioral therapy (CBT) is the most effective therapeutic approach for generalized anxiety disorder (GAD). CBT helps individuals identify and modify negative thought patterns and behaviors that contribute to anxiety. It focuses on changing cognitive distortions and maladaptive behaviors, providing practical strategies to manage anxiety symptoms effectively. Numerous studies have shown the effectiveness of CBT in treating GAD by helping patients develop coping mechanisms and skills to address their anxiety. Choice A, Psychoanalytic therapy, is not the most effective for GAD as it primarily focuses on exploring unconscious conflicts and childhood experiences rather than providing immediate coping strategies. Choice C, Humanistic therapy, emphasizes personal growth and self-improvement, which may not directly target the specific symptoms of GAD. Choice D, Gestalt therapy, focuses on increasing self-awareness and personal responsibility, which might not address the cognitive distortions and behavioral patterns associated with GAD as directly as CBT does.

2. A patient with major depressive disorder is started on fluoxetine. What is a common side effect the nurse should monitor for?

• A. Weight gain
• B. Increased appetite
• C. Nausea
• D. Dry mouth

Correct answer: C

Rationale: Nausea is a common side effect of fluoxetine and should be monitored.

3. A patient with obsessive-compulsive disorder (OCD) is under the care of a nurse. Which intervention is most appropriate?

• A. Encourage the patient to suppress their compulsive behaviors.
• B. Allow the patient to perform their rituals, then gradually limit the time spent on these rituals.
• C. Discourage the patient from discussing their obsessions.
• D. Avoid setting limits on the patient’s compulsive behaviors.

Correct answer: B

Rationale: In managing a patient with OCD, it is crucial to allow them to perform their rituals while gradually limiting the time spent on these rituals. This approach helps the patient feel supported while working towards reducing the compulsive behaviors. Choice A is incorrect because suppressing compulsive behaviors can increase anxiety and distress. Choice C is inappropriate as discussing obsessions is part of therapy. Choice D is not recommended as setting limits on compulsive behaviors is essential for treatment.

4. Carolina is surprised when her patient does not show for a regularly scheduled appointment. When contacted, the patient states, ‘I don’t need to come see you anymore. I have found a therapy app on my phone that I love.’ How should Carolina respond to this news?

• A. That sounds exciting; would you be willing to visit and show me the app?
• B. At this time, there is no real evidence that the app can replace our therapy.
• C. I am not sure that is a good idea right now; we are so close to progress.
• D. Why would you think that is a better option than meeting with me?

Correct answer: A

Rationale: Carolina should respond with openness and curiosity to maintain a positive therapeutic relationship. By showing interest in the patient's new therapy method and inviting them to share the app, Carolina demonstrates a willingness to explore alternative approaches while also ensuring the patient feels heard and valued in their decision-making process. Choice B is incorrect because it dismisses the patient's choice without exploring it further. Choice C focuses more on Carolina's concerns rather than engaging with the patient's decision. Choice D comes off as defensive and may make the patient feel misunderstood or judged.

5. 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.

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