Nursing Elites

1. A patient with social anxiety disorder is learning cognitive-behavioral therapy (CBT) techniques. Which skill is most likely being taught?

• A. Avoiding social situations that cause anxiety
• B. Challenging and changing negative thoughts
• C. Using deep breathing exercises during social interactions
• D. Taking anti-anxiety medication before social events

Correct answer: B

Rationale: The correct answer is B. In cognitive-behavioral therapy (CBT) for social anxiety disorder, the focus is on challenging and changing negative thoughts that contribute to anxiety. This process involves identifying distorted thought patterns and replacing them with more balanced and realistic thoughts, helping individuals develop healthier perspectives on social situations. Choices A, C, and D are incorrect because avoiding social situations, using deep breathing exercises, and taking medication are not the primary skills taught in CBT for social anxiety disorder. CBT aims to address the underlying thought patterns and behaviors that maintain anxiety, rather than avoidance or temporary relief.

2. Which intervention is most appropriate for a patient experiencing a severe manic episode?

• A. Providing a structured and low-stimulation environment
• B. Encouraging the patient to engage in group activities
• C. Providing detailed information about the patient's condition
• D. Allowing the patient to have unsupervised time

Correct answer: A

Rationale: During a severe manic episode, it is crucial to provide a structured and low-stimulation environment to help manage the symptoms effectively. This environment aims to reduce stimuli that can exacerbate manic behavior and provide a sense of predictability and safety for the individual. Group activities, detailed information provision, or unsupervised time may not be suitable during a severe manic episode as they can potentially worsen the condition or pose safety risks.

3. A patient is experiencing a manic episode. Which intervention is most effective?

• A. Encouraging the patient to participate in group activities
• B. Providing a low-stimulation environment
• C. Allowing the patient to move freely around the unit
• D. Engaging the patient in competitive games

Correct answer: B

Rationale: During a manic episode, individuals may be overwhelmed by stimuli. Providing a low-stimulation environment can help reduce excessive sensory input and minimize exacerbation of manic behaviors. This intervention aims to create a calm and structured setting that supports the individual in managing their symptoms effectively.

4. Which medication is commonly used to treat both major depressive disorder and neuropathic pain?

• A. Gabapentin
• B. Duloxetine
• C. Amitriptyline
• D. Tramadol

Correct answer: B

Rationale: Duloxetine, also known as Cymbalta, is a medication commonly used to treat both major depressive disorder and neuropathic pain. It is a serotonin-norepinephrine reuptake inhibitor (SNRI) that helps alleviate symptoms associated with these conditions. Gabapentin is primarily used for neuropathic pain, Amitriptyline is commonly used as an antidepressant, and Tramadol is an opioid analgesic often used for pain relief but not typically indicated for major depressive disorder.

5. A 33-year-old female diagnosed with bipolar I disorder has been functioning well on lithium for 11 months. At her most recent checkup, the psychiatric nurse practitioner states, 'You are ready to enter the maintenance therapy stage, so at this time I am going to adjust your dosage by prescribing:'

• A. A higher dosage
• B. Once-a-week dosing
• C. A lower dosage
• D. A different drug

Correct answer: C

Rationale: In the maintenance therapy stage for bipolar disorder, a lower dosage of lithium is often prescribed to prevent toxicity and maintain stability while minimizing side effects. Lower doses are typically used once the patient has achieved mood stabilization to reduce the risk of adverse effects associated with long-term lithium use.

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