Nursing Elites

1. For a patient diagnosed with borderline personality disorder exhibiting self-harming behavior, which therapeutic approach is most appropriate?

• A. Dialectical behavior therapy
• B. Psychoanalysis
• C. Supportive therapy
• D. Pharmacotherapy

Correct answer: A

Rationale: The most appropriate therapeutic approach for a patient diagnosed with borderline personality disorder exhibiting self-harming behavior is dialectical behavior therapy (DBT). DBT is specifically designed to address the core symptoms of borderline personality disorder, including self-harming behaviors. It focuses on teaching patients skills to manage emotions, improve interpersonal relationships, and enhance distress tolerance. Psychoanalysis (Choice B) is not the most appropriate for immediate symptom management in this case. Supportive therapy (Choice C) may not provide the structured approach needed to address self-harming behaviors effectively. Pharmacotherapy (Choice D) may be used as an adjunct in some cases, but DBT is the frontline therapy for managing self-harming behaviors in borderline personality disorder.

2. When a patient with major depressive disorder is started on fluoxetine, what is the most important side effect for the nurse to monitor?

• A. Weight gain
• B. Suicidal ideation
• C. Hypertension
• D. Hyperglycemia

Correct answer: B

Rationale: When initiating fluoxetine therapy in a patient with major depressive disorder, monitoring for suicidal ideation is crucial due to the increased risk of suicidal thoughts or behaviors that can occur, especially in the initial phase of treatment. This close monitoring is essential to ensure patient safety and intervene promptly if such symptoms arise. Weight gain, hypertension, and hyperglycemia are potential side effects of some medications used to treat depression, but suicidal ideation is the most critical and immediate side effect to monitor for when starting fluoxetine.

3. A client with bipolar disorder is experiencing a depressive episode. Which of the following interventions should the nurse avoid implementing?

• A. Encourage participation in activities
• B. Promote adequate nutrition and hydration
• C. Monitor for suicidal ideation
• D. Discourage verbalization of feelings

Correct answer: D

Rationale: In caring for a client with bipolar disorder in a depressive episode, the nurse should implement interventions that promote mental well-being. Encouraging participation in activities, promoting adequate nutrition and hydration, and monitoring for suicidal ideation are all essential components of care. Discouraging verbalization of feelings is counterproductive as it hinders the therapeutic process and communication, which are crucial for the client's emotional expression and recovery.

4. A client with a history of alcohol use disorder is admitted to the hospital for detoxification. Which of the following symptoms shouldn't the nurse expect to observe during withdrawal?

• A. Tremors
• B. Hallucinations
• C. Diaphoresis
• D. Bradycardia

Correct answer: D

Rationale: During alcohol withdrawal, the nurse should expect to observe symptoms such as tremors, hallucinations, and diaphoresis. Seizures may also occur during severe withdrawal. Bradycardia is not typically associated with alcohol withdrawal; instead, tachycardia (an increased heart rate) is more commonly observed due to the stimulant effects of alcohol withdrawal on the sympathetic nervous system.

5. A patient with schizophrenia is prescribed risperidone. The nurse should monitor the patient for which common side effect of this medication?

• A. Agranulocytosis
• B. Weight gain
• C. Hair loss
• D. Hyperthyroidism

Correct answer: B

Rationale: When a patient is prescribed risperidone, an atypical antipsychotic, the nurse should monitor for weight gain as it is a common side effect of this medication. Weight gain can occur due to metabolic changes and increased appetite associated with risperidone use. Agranulocytosis is a severe decrease in a type of white blood cells, and it is not a common side effect of risperidone. Hair loss and hyperthyroidism are also not typically associated with risperidone use.

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