Nursing Elites

1. In treating PTSD, which type of therapy is most commonly recommended?

• A. Cognitive-behavioral therapy (CBT)
• B. Psychoanalytic therapy
• C. Humanistic therapy
• D. Gestalt therapy

Correct answer: A

Rationale: Cognitive-behavioral therapy (CBT) is the most commonly recommended therapy for PTSD due to its effectiveness in helping patients identify and change negative thoughts and behaviors associated with trauma. This therapy focuses on providing practical coping strategies to manage symptoms and process traumatic experiences. Psychoanalytic therapy, humanistic therapy, and gestalt therapy are less commonly used for PTSD as they may not target the specific symptoms and cognitive distortions associated with this disorder.

2. James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for the day shift and anxiously reports, ‘Last night, demons came to my room and tried to rape me.’ Which response would be most therapeutic?

• A. There are no such things as demons. What you saw were hallucinations.
• B. It is not possible for anyone to enter your room at night. You are safe here.
• C. You seem very upset. Please tell me more about what you experienced last night.
• D. That must have been very frightening, but we’ll check on you at night and you’ll be safe.

Correct answer: C

Rationale: Choice C is the most therapeutic response as it acknowledges the patient’s feelings, shows empathy, and encourages further expression of his experiences. By actively listening and inviting the patient to share more details, the healthcare provider provides a supportive environment that can help the patient feel understood and validated. Option A dismisses the patient's experience and can make him feel unheard. Option B denies the patient's reality and can increase his distress. Option D, while offering reassurance, does not address the patient's emotional state or encourage further communication.

3. The nurse is providing medication education to a patient who has been prescribed lithium to stabilize mood. Which early signs and symptoms of toxicity should the nurse stress to the patient?

• A. Increased attentiveness
• B. Getting up at night to urinate
• C. Improved vision
• D. An upset stomach for no apparent reason

Correct answer: D

Rationale: The correct early sign of lithium toxicity that the nurse should stress to the patient is an upset stomach for no apparent reason. Early signs of lithium toxicity often manifest as gastrointestinal symptoms such as nausea, vomiting, and diarrhea. This can serve as an important indicator for the patient to seek medical attention promptly to prevent further complications. Choices A, B, and C are incorrect. Increased attentiveness, getting up at night to urinate, and improved vision are not early signs of lithium toxicity. It is crucial for the nurse to educate the patient on recognizing gastrointestinal symptoms as potential indicators of toxicity.

4. During a panic attack, what is the most appropriate nursing intervention?

• A. Encourage the patient to talk about their feelings.
• B. Provide a quiet, non-stimulating environment.
• C. Administer prescribed medication immediately.
• D. Teach the patient relaxation techniques.

Correct answer: B

Rationale: During a panic attack, a quiet, non-stimulating environment is the most appropriate nursing intervention. This helps reduce stimuli that may exacerbate the panic attack and allows the individual to focus on calming down. Encouraging the patient to talk about their feelings may not be effective during an acute panic attack as the focus should be on reducing stimuli. Administering medication should follow healthcare provider's orders and may not be the initial intervention. Teaching relaxation techniques is beneficial in managing anxiety but may not be the priority during the acute phase of a panic attack where reducing stimuli is crucial.

5. A patient diagnosed with panic disorder asks the nurse about the purpose of deep breathing exercises. Which explanation by the nurse is most accurate?

• A. Deep breathing helps distract you from your anxiety.
• B. Deep breathing can prevent future panic attacks.
• C. Deep breathing helps reduce physical symptoms of anxiety.
• D. Deep breathing increases your overall lung capacity.

Correct answer: C

Rationale: Deep breathing helps reduce the physical symptoms of anxiety, such as rapid heartbeat and shortness of breath.

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