Nursing Elites

1. A patient with generalized anxiety disorder (GAD) is prescribed venlafaxine. The nurse should educate the patient about which potential side effect?

• A. Hypertension
• B. Hypotension
• C. Bradycardia
• D. Hyperglycemia

Correct answer: A

Rationale: The correct answer is A: Hypertension. Venlafaxine, an SNRI, can lead to hypertension as a side effect. This medication can cause an increase in blood pressure, particularly at higher doses. Educating the patient about this potential adverse effect is crucial to enhance awareness and monitoring for any signs or symptoms of elevated blood pressure. Choices B, C, and D are incorrect because venlafaxine is more likely to cause hypertension rather than hypotension, bradycardia, or hyperglycemia.

2. When assessing a client diagnosed with post-traumatic stress disorder (PTSD), which finding should the nurse expect?

• A. Hypervigilance
• B. Insomnia
• C. Flashbacks
• D. Suicidal ideation

Correct answer: A

Rationale: Clients with PTSD commonly exhibit symptoms such as hypervigilance, insomnia, flashbacks, difficulty concentrating, and increased irritability. Hypervigilance refers to an enhanced state of awareness and alertness, often seen in individuals with PTSD as they are constantly on guard for potential threats. Insomnia is a common sleep disturbance associated with PTSD, where individuals may have trouble falling or staying asleep. Flashbacks involve re-experiencing the traumatic event as if it is occurring in the present moment. Suicidal ideation, while a serious concern in mental health, is not a hallmark symptom specifically associated with PTSD. Therefore, the correct finding that the nurse should expect when assessing a client diagnosed with PTSD is hypervigilance.

3. In the treatment of a patient with obsessive-compulsive disorder (OCD) using cognitive-behavioral therapy (CBT), which specific type of CBT is most effective?

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

Correct answer: B

Rationale: Exposure and response prevention (ERP) is a specific type of CBT that is considered the most effective treatment for OCD. ERP involves exposing the individual to anxiety-provoking stimuli and preventing the usual compulsive responses, leading to a decreased anxiety response over time. This type of therapy helps individuals learn to tolerate the anxiety triggered by obsessions without engaging in compulsions, ultimately reducing OCD symptoms. Choices A, C, and D are incorrect. Dialectical behavior therapy (Choice A) is more commonly used for treating conditions like borderline personality disorder, not OCD. Interpersonal therapy (Choice C) focuses on improving interpersonal relationships and communication skills, which is not the primary approach for OCD. Supportive therapy (Choice D) provides emotional support and guidance but is not as effective as ERP in treating OCD.

4. A client with bipolar disorder is experiencing a depressive episode. Which intervention should the nurse implement to support the client's recovery?

• A. Encourage the client to engage in physical activity.
• B. Encourage the client to maintain a regular sleep schedule.
• C. Encourage the client to set realistic goals for daily activities.
• D. Encourage the client to express feelings of sadness.

Correct answer: C

Rationale: During a depressive episode in bipolar disorder, encouraging the client to set realistic goals for daily activities can be beneficial. Setting achievable goals can provide structure, a sense of accomplishment, and help in breaking tasks into manageable steps, which can support the client's recovery process. Options A and B, while important in managing bipolar disorder, may not directly address the client's depressive symptoms during this episode. Option D, encouraging the client to express feelings of sadness, is not as effective as setting achievable goals in providing structure and a sense of accomplishment during a depressive episode.

5. Which therapeutic approach is most effective for managing obsessive-compulsive disorder (OCD)?

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

Correct answer: A

Rationale: Cognitive-behavioral therapy (CBT), especially exposure and response prevention, is considered the most effective therapeutic approach for managing obsessive-compulsive disorder (OCD). CBT helps individuals identify and modify their distorted beliefs and behaviors related to OCD, while exposure and response prevention specifically target the core symptoms of OCD by gradually exposing the individual to feared stimuli and preventing compulsive responses. While medication management can be used as an adjunct to therapy, CBT has shown to have long-lasting benefits in reducing OCD symptoms and improving the overall quality of life. Psychoanalysis focuses more on exploring unconscious conflicts and childhood experiences, which may not be as effective for OCD. Group therapy can be beneficial as a supplemental treatment but is not typically as effective as individual CBT tailored to the specific needs of the individual with OCD.

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