Nursing Elites

1. A client is undergoing systematic desensitization for an extreme fear of elevators. Which of the following actions should be implemented with this form of therapy?

• A. Demonstrate riding in an elevator, then ask the client to imitate the behavior.
• B. Advise the client to say “stop” out loud every time they begin to feel an anxiety response related to an elevator.
• C. Gradually expose the client to an elevator while practicing relaxation techniques.
• D. Stay with the client in an elevator until the anxiety response diminishes.

Correct answer: C

Rationale: Systematic desensitization is a type of therapy used to help individuals overcome phobias or anxieties. It involves gradually exposing the client to the feared object or situation, in this case, an elevator, while simultaneously practicing relaxation techniques. This process helps the client associate relaxation with the previously feared stimulus, gradually reducing anxiety levels over time. Choice A is incorrect as it involves imitation rather than gradual exposure. Choice B is incorrect as it focuses on a verbal response rather than the systematic process of exposure and relaxation. Choice D is incorrect as it does not involve the systematic approach of gradually exposing the client while teaching relaxation techniques.

2. A patient with obsessive-compulsive disorder (OCD) frequently washes their hands. Which nursing intervention is most appropriate?

• A. Allow the patient to wash their hands, then gradually limit the time spent on this behavior.
• B. Discourage the patient from discussing their obsessions.
• C. Encourage the patient to suppress their compulsive behaviors.
• D. Avoid setting limits on the patient's compulsive behaviors.

Correct answer: A

Rationale: In managing a patient with OCD who frequently washes their hands, it is important to understand that compulsive behaviors provide temporary relief from anxiety. Allowing the patient to engage in their rituals initially and then gradually setting limits on the time spent can help them gain control over their compulsions. This approach supports the patient without causing undue distress, ultimately assisting in managing OCD symptoms effectively. Choice B is incorrect as discouraging the patient from discussing their obsessions can hinder therapeutic communication and understanding of their condition. Choice C is wrong because encouraging the patient to suppress their compulsive behaviors may increase their anxiety and lead to worsening symptoms. Choice D is also incorrect as avoiding setting limits on the patient's compulsive behaviors does not help the patient in gaining control over their OCD symptoms.

3. Which medication is commonly used to treat obsessive-compulsive disorder (OCD)?

• A. Lorazepam
• B. Fluoxetine
• C. Lithium
• D. Haloperidol

Correct answer: B

Rationale: The correct answer is Fluoxetine (Choice B). Fluoxetine, an SSRI (Selective Serotonin Reuptake Inhibitor), is commonly used in the treatment of obsessive-compulsive disorder (OCD). SSRIs like Fluoxetine are considered first-line medications for managing OCD symptoms by helping to increase serotonin levels in the brain, which plays a role in mood regulation and anxiety reduction. Choice A, Lorazepam, is a benzodiazepine primarily used for anxiety disorders but is not a first-line treatment for OCD. Choice C, Lithium, is typically used in conditions like bipolar disorder, not OCD. Choice D, Haloperidol, is an antipsychotic medication and is not commonly used to treat OCD.

4. Which symptom is most indicative of posttraumatic stress disorder (PTSD)?

• A. Persistent low mood
• B. Frequent nightmares
• C. Hallucinations
• D. Compulsive behaviors

Correct answer: B

Rationale: Frequent nightmares are a hallmark symptom of posttraumatic stress disorder (PTSD). Individuals with PTSD often experience intrusive and distressing nightmares related to the traumatic event they have experienced. These nightmares can contribute to sleep disturbances and further exacerbate the individual's overall psychological distress. Persistent low mood, hallucinations, and compulsive behaviors are not specific symptoms of PTSD and are more commonly associated with other mental health conditions such as depression, psychotic disorders, and obsessive-compulsive disorder respectively.

5. When caring for a patient with dissociative identity disorder, which nursing intervention is a priority?

• A. Providing detailed education about the condition
• B. Monitoring for signs of self-harm or suicidal ideation
• C. Encouraging the patient to recall traumatic events
• D. Helping the patient develop a strong sense of identity

Correct answer: B

Rationale: When caring for a patient with dissociative identity disorder, the priority nursing intervention is to monitor for signs of self-harm or suicidal ideation. Ensuring patient safety is crucial, as individuals with this disorder may be at increased risk of self-harm or suicidal behaviors. Providing education about the condition is beneficial but ensuring immediate safety takes precedence. Encouraging the patient to recall traumatic events can be detrimental and should be done cautiously under professional guidance. While helping the patient develop a strong sense of identity is important in the long term, it is not the immediate priority when safety is a concern.

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