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 is an example of a cognitive-behavioral therapy (CBT) technique?

• A. Free association
• B. Thought stopping
• C. Dream analysis
• D. Systematic desensitization

Correct answer: B

Rationale: Thought stopping is a specific cognitive-behavioral therapy (CBT) technique aimed at helping individuals manage and interrupt negative or intrusive thoughts. This technique involves identifying and stopping negative thought patterns to promote healthier thinking and emotional well-being. Free association and dream analysis are associated with psychoanalytic therapy, while systematic desensitization is a technique commonly used in behavior therapy.

3. A nurse is providing discharge teaching to a patient prescribed fluoxetine for panic disorder. Which statement should be included in the teaching?

• A. You should notice the effects of this medication within a few days.
• B. It's important to take this medication only when you feel anxious.
• C. It may take several weeks before you notice the full effects of this medication.
• D. You can stop taking this medication as soon as you feel better.

Correct answer: C

Rationale: The correct statement to include in the teaching is that it may take several weeks before the patient notices the full effects of fluoxetine. This is because fluoxetine, like other SSRIs, requires time to reach its full therapeutic effect. Choice A is incorrect as fluoxetine does not show its effects within a few days. Choice B is incorrect as fluoxetine should be taken regularly as prescribed, not only when feeling anxious. Choice D is incorrect as discontinuing fluoxetine abruptly can lead to withdrawal symptoms and a return of panic disorder symptoms.

4. 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.

5. A client is discussing free associations as a therapeutic tool with a nurse. Which of the following client statements indicates an understanding of this technique?

• A. “I will write down my dreams as soon as I wake up.”
• B. “I might begin to associate my therapist with important people in my life.”
• C. “I can learn to express myself in a nonaggressive manner.”
• D. “I should say the first thing that comes to my mind.”

Correct answer: D

Rationale: Free association is a psychoanalytic technique where the client is encouraged to say the first thing that comes to their mind without censoring or filtering. This technique helps uncover unconscious thoughts and emotions. Choice D, “I should say the first thing that comes to my mind,” indicates an understanding of free association as it aligns with the principle of allowing thoughts to flow freely without inhibition. Choices A, B, and C do not reflect an understanding of free association and its purpose, making them incorrect. A, focusing on writing down dreams, does not relate to the immediate expression of thoughts. B, associating the therapist with important people, and C, learning to express oneself nonaggressively, do not capture the essence of free association as a technique for exploring unconscious processes.

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