Nursing Elites

1. A client diagnosed with major depressive disorder is receiving cognitive-behavioral therapy (CBT). Which outcome indicates that the therapy is effective?

• A. The client identifies and challenges negative thoughts.
• B. The client reports an increase in suicidal thoughts.
• C. The client experiences an increase in anxiety.
• D. The client shows no change in behavior.

Correct answer: A

Rationale: In cognitive-behavioral therapy (CBT), one of the primary objectives is to help clients identify and challenge their negative thoughts. This process allows the individual to reframe their thinking patterns and develop more adaptive coping strategies. Reporting an increase in suicidal thoughts (Choice B) or experiencing an increase in anxiety (Choice C) are not desired outcomes and may indicate a need for further intervention. Showing no change in behavior (Choice D) suggests that the therapy has not been effective. Therefore, the correct indicator of effective therapy in this context is the client's ability to identify and challenge negative thoughts (Choice A).

2. A client has been prescribed sertraline (Zoloft) and is receiving education from a healthcare provider. Which statement by the client indicates an accurate understanding of the medication?

• A. I should take this medication at the same time every day.
• B. It may take several weeks for this medication to be effective.
• C. I should take this medication on an empty stomach.
• D. I should avoid eating aged cheeses and processed meats.

Correct answer: B

Rationale: The correct answer is B. Sertraline (Zoloft) may take several weeks to be effective, so it is important for the client to be informed about this timeframe. This medication does not need to be taken on an empty stomach, but it can be taken with or without food. Choice A is a good practice for many medications but not specifically related to sertraline (Zoloft). Choice D is not directly related to sertraline (Zoloft) but pertains to dietary restrictions when taking MAOIs due to potential interactions with tyramine.

3. A patient with major depressive disorder is being treated with electroconvulsive therapy (ECT). The nurse should monitor the patient for which common side effect?

• A. Memory loss
• B. Hypertension
• C. Weight gain
• D. Hyperglycemia

Correct answer: A

Rationale: Memory loss, especially short-term memory loss, is a common side effect associated with electroconvulsive therapy (ECT). During ECT treatment, the electrical currents passed through the brain can disrupt short-term memory formation. This side effect is usually temporary, but patients should be closely monitored for any changes in memory function during and after the treatment. Choices B, C, and D are incorrect because they are not commonly associated with ECT. Hypertension, weight gain, and hyperglycemia are not typically observed as side effects of ECT.

4. A client with schizophrenia is experiencing auditory hallucinations. Which nursing intervention should the nurse implement to address this symptom?

• A. Encourage the client to express feelings about the hallucinations.
• B. Distract the client from the hallucinations.
• C. Provide reality-based feedback about the hallucinations.
• D. Encourage the client to ignore the hallucinations.

Correct answer: C

Rationale: The correct intervention for a client experiencing auditory hallucinations in schizophrenia is to provide reality-based feedback about the hallucinations. By providing reality-based feedback, the nurse helps the client differentiate between what is real and what is not, which can help decrease the distress and impact of the hallucinations on the client's perception of reality. Encouraging the client to express feelings (Choice A) may not directly address the hallucinations. Distracting the client (Choice B) may temporarily alleviate the symptoms but does not help the client differentiate reality from hallucinations. Encouraging the client to ignore the hallucinations (Choice D) may not be effective as the client may struggle to do so without appropriate guidance.

5. Which should the healthcare provider recognize as a DSM-5 disorder?

• A. Obesity
• B. Generalized anxiety disorder
• C. Hypertension
• D. Grief

Correct answer: B

Rationale: The DSM-5 categorizes mental health disorders for diagnostic purposes. Generalized anxiety disorder is one of the disorders listed in the DSM-5, characterized by persistent and excessive worry about various events or activities. This disorder falls under the category of anxiety disorders, which also include panic disorder, phobias, and others. Choices A, C, and D are not DSM-5 disorders. Obesity and hypertension are medical conditions, while grief, though a significant emotional response, is not classified as a mental health disorder in the DSM-5.

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