Nursing Elites

1. A patient with social anxiety disorder is starting cognitive-behavioral therapy (CBT). Which statement by the nurse best explains the purpose of this therapy?

• A. CBT will help you understand and change your thought patterns.
• B. CBT will focus on exploring your childhood experiences.
• C. CBT will teach you relaxation techniques to use in social situations.
• D. CBT will help you avoid situations that cause anxiety.

Correct answer: A

Rationale: Cognitive-behavioral therapy (CBT) is a structured, short-term psychotherapy that aims to help patients identify and change negative thought patterns and behaviors associated with anxiety. By understanding and altering these patterns, individuals can learn to manage and alleviate their symptoms effectively. Choice A is the correct answer as it accurately describes the purpose of CBT for social anxiety disorder. Choices B, C, and D are incorrect. B is incorrect because while childhood experiences may be explored, the primary focus of CBT is on thought patterns and behaviors in the present. C is incorrect because although relaxation techniques may be a component of CBT, the primary goal is not just to teach relaxation but to address underlying cognitive and behavioral patterns. D is incorrect because the goal of CBT is not avoidance but rather to confront and manage anxiety-provoking situations.

2. Which of the following medications is commonly used to treat attention deficit hyperactivity disorder (ADHD)?

• A. Sertraline
• B. Diazepam
• C. Methylphenidate
• D. Clozapine

Correct answer: C

Rationale: Methylphenidate is the correct answer. It is a stimulant medication commonly used to treat ADHD. Methylphenidate works by increasing the activity of certain chemicals in the brain that are involved in attention and impulse control. Sertraline is an antidepressant used for depression, anxiety, and other conditions, not ADHD. Diazepam is a benzodiazepine mainly prescribed for anxiety, muscle spasms, and seizures, not ADHD. Clozapine is an antipsychotic medication used for schizophrenia when other medications are ineffective, not for ADHD.

3. A patient is receiving education about taking clozapine. Which statement indicates the patient understands the side effects?

• A. I should report any signs of infection to my healthcare provider immediately.
• B. I can stop taking this medication once I feel better.
• C. I should take this medication on an empty stomach.
• D. I should avoid drinking alcohol while taking this medication.

Correct answer: A

Rationale: The correct answer is A because patients taking clozapine should report signs of infection immediately due to the risk of agranulocytosis. Agranulocytosis is a potentially life-threatening side effect of clozapine characterized by a significant decrease in white blood cell count, which can leave the patient vulnerable to infections. Reporting signs of infection promptly is crucial to prevent serious complications.

4. Which therapeutic communication statement might a healthcare professional use when a patient’s nursing diagnosis is altered thought processes?

• A. I know you mention hearing voices, but I cannot hear them.
• B. Stop listening to the voices, they are NOT real.
• C. You say you hear voices, what are they telling you?
• D. Please ask the voices to leave you alone for now.

Correct answer: C

Rationale: Choice C is the most appropriate therapeutic communication statement in this scenario. By asking the patient what the voices are telling them, the healthcare professional encourages the patient to express their thoughts and feelings, aiding in understanding their altered thought processes. This approach can help establish a therapeutic relationship and provide valuable insight into the patient's experiences.

5. Carolina is surprised when her patient does not show for a regularly scheduled appointment. When contacted, the patient states, ‘I don’t need to come see you anymore. I have found a therapy app on my phone that I love.’ How should Carolina respond to this news?

• A. That sounds exciting; would you be willing to visit and show me the app?
• B. At this time, there is no real evidence that the app can replace our therapy.
• C. I am not sure that is a good idea right now; we are so close to progress.
• D. Why would you think that is a better option than meeting with me?

Correct answer: A

Rationale: Carolina should respond with openness and curiosity to maintain a positive therapeutic relationship. By showing interest in the patient's new therapy method and inviting them to share the app, Carolina demonstrates a willingness to explore alternative approaches while also ensuring the patient feels heard and valued in their decision-making process. Choice B is incorrect because it dismisses the patient's choice without exploring it further. Choice C focuses more on Carolina's concerns rather than engaging with the patient's decision. Choice D comes off as defensive and may make the patient feel misunderstood or judged.

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