Nursing Elites

1. A client 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, identifying and challenging negative thoughts is a fundamental aspect of the treatment process. This cognitive restructuring helps individuals with major depressive disorder to develop healthier thinking patterns and cope more effectively with their emotions, which ultimately leads to improvement in their mental health. Therefore, when a client is able to identify and challenge negative thoughts, it indicates that they are actively engaging in the therapeutic process and making progress towards better mental well-being.

2. A school nurse is assessing a female high school student who is overly concerned about her appearance. The client's mother states, 'That's not something to be stressed about!' Which is the most appropriate nursing response?

• A. Teenagers! They don't know a thing about real stress.
• B. Stress occurs only when there is a loss.
• C. When you are in poor physical condition, you can't experience psychological well-being.
• D. Stress can be psychological. A threat to self-esteem may result in high stress levels.

Correct answer: D

Rationale: The correct answer is D. Stress can manifest as physical or psychological. A perceived threat to self-esteem can be as stressful as a physiological change. Choice A is dismissive of the teenager's concerns and does not address the issue professionally. Choice B is incorrect as stress can result from various factors, not just loss. Choice C oversimplifies the relationship between physical condition and psychological well-being, neglecting the impact of mental stressors on overall health.

3. A healthcare professional is assessing a client who is experiencing severe anxiety. Which of the following is an appropriate intervention?

• A. Encourage the client to talk about their feelings.
• B. Provide a quiet and calm environment.
• C. Encourage the client to exercise vigorously.
• D. Encourage the client to participate in group activities.

Correct answer: B

Rationale: During severe anxiety, it is essential to create a quiet and calm environment to help the client feel safe and reduce anxiety levels. Loud or stimulating environments can exacerbate anxiety symptoms, so providing a serene setting can promote relaxation and a sense of security.

4. A client diagnosed with major depressive disorder is prescribed an SSRI. Which side effect should the nurse monitor for in the initial weeks of treatment?

• A. Weight loss
• B. Increased risk of suicide
• C. Hypertension
• D. Photosensitivity

Correct answer: B

Rationale: When a client is prescribed an SSRI for major depressive disorder, the nurse should closely monitor for an increased risk of suicide, especially in younger patients, during the initial weeks of treatment. SSRIs may initially increase energy levels before improving mood, which can lead to a higher risk of suicide in some individuals. Weight loss is not a common side effect of SSRIs and may actually be a concern for some patients with major depressive disorder who experience appetite changes. Hypertension is not typically associated with SSRIs, and photosensitivity is not a common side effect of this class of medications.

5. The client recently survived a plane crash and is assessed by the nurse. Which client statement would cause the nurse to suspect that the client may be experiencing PTSD?

• A. I believe that I was meant to survive this accident so that I can focus on the important things in life
• B. Although I have nightmares sometimes, I have started going to church to show gratitude for surviving the crash
• C. I am so afraid that I will never be able to fly again, but I know that it will take a while
• D. I keep having these thoughts about the crash that just pop into my mind at random times

Correct answer: D

Rationale: Experiencing intrusive thoughts about a traumatic event, such as a plane crash, that occur unexpectedly and repeatedly is a common symptom of Post-Traumatic Stress Disorder (PTSD). These thoughts can be distressing and are often a key indicator of PTSD. Options A, B, and C demonstrate coping mechanisms and fears related to the traumatic event but do not specifically address the hallmark symptom of intrusive thoughts. Therefore, option D is the correct choice as it aligns with a potential symptom of PTSD.

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