Nursing Elites

1. What intervention should the nurse implement for a client with obsessive-compulsive disorder (OCD) performing ritualistic handwashing?

• A. Allow the client to continue the ritualistic behavior initially
• B. Immediately stop the client from performing the ritual
• C. Encourage the client to perform the ritual more quickly
• D. Provide a distraction to interrupt the ritual

Correct answer: A

Rationale: For a client with OCD performing ritualistic handwashing, the nurse should initially allow the client to continue the behavior. Abruptly stopping the behavior or providing a distraction can heighten the client's anxiety. Encouraging the client to perform the ritual more quickly does not address the underlying issue of OCD and may exacerbate their anxiety. Providing a distraction to interrupt the ritual may not be effective in the long term and could lead to increased distress. Gradual limits should be established over time to help the client manage and reduce the ritualistic behavior effectively.

2. A healthcare provider is providing care for a patient with attention-deficit/hyperactivity disorder (ADHD). Which therapeutic intervention is most effective for this condition?

• A. Group therapy
• B. Cognitive-behavioral therapy
• C. Psychoanalysis
• D. Family therapy

Correct answer: B

Rationale: Cognitive-behavioral therapy (CBT) is the most effective therapeutic intervention for managing ADHD symptoms. CBT helps individuals with ADHD develop coping strategies, improve focus, organization, and time management skills, and address behavioral challenges effectively. Group therapy might not provide the specific skills training needed for ADHD management. Psychoanalysis focuses on exploring deeper unconscious processes and may not be as practical for addressing ADHD symptoms. Family therapy can be beneficial for family dynamics but may not directly target individual ADHD symptoms as effectively as CBT.

3. For a patient with obsessive-compulsive disorder (OCD) who spends several hours a day washing her hands, which type of therapy is most appropriate?

• A. Exposure and response prevention
• B. Dialectical behavior therapy
• C. Family therapy
• D. Interpersonal therapy

Correct answer: A

Rationale: Exposure and response prevention (ERP) is the most appropriate therapy for managing OCD. ERP involves exposing the patient to anxiety-provoking stimuli (such as touching dirty objects) and preventing the compulsive response (hand washing), thus helping the patient learn to tolerate the anxiety without performing the ritualistic behavior. Dialectical behavior therapy (DBT) focuses more on emotional regulation and interpersonal skills, making it less suitable for directly addressing OCD symptoms. Family therapy and interpersonal therapy may be beneficial for other conditions or relationship issues but are not specifically designed to target OCD symptoms like ERP.

4. When providing care for 10-year-old Harper diagnosed with posttraumatic stress disorder (PTSD), which goal should be addressed initially?

• A. Harper will be able to identify feelings through the use of play therapy.
• B. Harper and her parents will have access to protective resources available through social services.
• C. Harper will demonstrate the effective use of relaxation techniques to restore a sense of control over disturbing thoughts.
• D. Harper and her parents will demonstrate an understanding of the personal human response to traumatic events.

Correct answer: C

Rationale: The initial goal when caring for a child with PTSD like Harper is to address restoring a sense of control over disturbing thoughts by teaching relaxation techniques. This approach helps the child manage their distressing emotions and promotes a feeling of empowerment in dealing with their condition.

5. During a community education session on mental health, which statement about stigma and mental illness is correct?

• A. Stigma has no impact on treatment outcomes.
• B. Stigma can prevent individuals from seeking treatment.
• C. Stigma is only a problem in developing countries.
• D. Stigma related to mental illness is decreasing significantly worldwide.

Correct answer: B

Rationale: The correct answer is B: 'Stigma can prevent individuals from seeking treatment.' Stigma surrounding mental illness can create barriers for individuals seeking treatment. It can lead to feelings of shame, fear of judgment, and discrimination, which may deter individuals from accessing the necessary support and care they need. Choices A, C, and D are incorrect. Stigma does have a significant impact on treatment outcomes by discouraging individuals from seeking help, it is not limited to developing countries but is a global issue, and unfortunately, stigma related to mental illness is still prevalent worldwide, although efforts are being made to reduce it.

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