Nursing Elites

1. When working with a patient diagnosed with posttraumatic stress disorder (PTSD), which therapeutic approach is most appropriate?

• A. Encouraging the patient to avoid discussing the traumatic event.
• B. Using exposure therapy to help the patient confront their fears.
• C. Advising the patient to focus on positive thoughts.
• D. Suggesting that the patient keep busy to distract from traumatic memories.

Correct answer: B

Rationale: Exposure therapy is an evidence-based treatment for PTSD that involves gradually exposing the patient to their traumatic memories in a safe and controlled environment. This approach helps individuals confront and process their fears, reducing the impact of the traumatic event over time. Avoiding discussing the trauma (choice A) may lead to avoidance behaviors and hinder recovery. Focusing on positive thoughts (choice C) may provide temporary relief but does not address the underlying trauma. Keeping busy to distract from memories (choice D) is a form of avoidance that does not help in processing the traumatic experiences. Therefore, using exposure therapy (choice B) is the most appropriate approach to effectively treat PTSD.

2. Gilbert, age 19, is described by his parents as a 'moody child' with an onset of odd behavior at age 14, which caused Gilbert to suffer academically and socially. Gilbert has lost the ability to complete household chores, is reluctant to leave the house, and is obsessed with the locks on the windows and doors. Due to Gilbert’s early and slow onset of what is now recognized as schizophrenia, his prognosis is considered:

• A. Favorable with medication
• B. In the relapse stage
• C. Improvable with psychosocial interventions
• D. To have a less positive outcome

Correct answer: D

Rationale: Individuals with an early and slow onset of schizophrenia typically have a less positive outcome or prognosis. This is because early onset schizophrenia is often associated with a more severe form of the illness and can lead to greater functional impairment in various aspects of life, including academic and social functioning. Therefore, the prognosis for Gilbert, given his presentation and age of onset, would be considered to have a less positive outcome.

3. Child protective services have removed 10-year-old Christopher from his parents’ home due to neglect. Christopher reveals to the nurse that he considers the woman next door his “nice” mom, that he loves school, and gets above-average grades. The strongest explanation for this response is:

• A. Temperament
• B. Genetic factors
• C. Resilience
• D. Paradoxical effects of neglect

Correct answer: C

Rationale: Resilience is the ability to adapt well despite adversity, which is demonstrated by Christopher's positive relationships and school performance. Despite the challenging situation of being removed from his parents' home, Christopher's ability to form a positive bond with the neighbor, enjoy school, and excel academically showcases his resilience in coping with the circumstances.

4. A patient with obsessive-compulsive disorder (OCD) spends hours washing their hands. Which nursing intervention is most appropriate?

• A. Encouraging the patient to stop washing their hands
• B. Allowing the patient to wash hands at specified times
• C. Ignoring the patient's behavior
• D. Setting strict limits on the time allowed for hand washing

Correct answer: B

Rationale: In managing a patient with OCD who spends excessive time washing hands, allowing the patient to wash hands at specified times is the most appropriate nursing intervention. This approach helps establish a structured routine for hand washing, which can assist in managing OCD symptoms without reinforcing the behavior. Encouraging the patient to stop washing hands may lead to increased anxiety and resistance. Ignoring the behavior can perpetuate the cycle of OCD, and setting strict limits on hand washing time may cause distress and may not effectively address the underlying issues associated with OCD.

5. Which of the following is an example of a mood stabilizer used to treat bipolar disorder?

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

Correct answer: B

Rationale: Lithium is a widely recognized mood stabilizer used in the treatment of bipolar disorder. It helps to control mood swings, prevent manic episodes, and reduce the risk of suicidal behavior in individuals with bipolar disorder. Fluoxetine is an antidepressant, Haloperidol is an antipsychotic, and Lorazepam is a benzodiazepine used for anxiety and insomnia, none of which are primary mood stabilizers for bipolar disorder.

Similar Questions