Nursing Elites

1. During pregnancy, a woman is in a relationship with a male who routinely abuses her. Her unborn child may engage in high-risk behavior as a teen as a result of:

• A. Maternal stress
• B. Parental nurturing
• C. Appropriate stress responses in the brain
• D. Memories of the abuse

Correct answer: A

Rationale: Maternal stress during pregnancy can have long-term effects on the child's behavior and stress responses. Research shows that exposure to high levels of stress hormones in the womb can influence the developing fetal brain and the child's future behavior, potentially leading to high-risk behaviors during adolescence.

2. In treating a patient with generalized anxiety disorder (GAD) using cognitive-behavioral therapy (CBT), what is the most appropriate goal of this therapy?

• A. To explore the patient's childhood experiences.
• B. To reduce the patient's symptoms through medication.
• C. To change the patient's negative thought patterns.
• D. To improve the patient's social skills.

Correct answer: C

Rationale: The most appropriate goal of cognitive-behavioral therapy (CBT) in treating generalized anxiety disorder (GAD) is to change the patient's negative thought patterns. This therapy focuses on identifying and modifying distorted thinking patterns that contribute to anxiety. Exploring childhood experiences (Choice A) may be part of therapy, but the primary focus is on present thoughts and behaviors. While medication (Choice B) can help manage symptoms, CBT aims to address the root cause through cognitive restructuring. Improving social skills (Choice D) is not the primary goal of CBT for GAD, although it may be a secondary benefit as confidence improves with reduced anxiety.

3. The school nurse has been alerted to the fact that an 8-year-old boy routinely playacts as a police officer, 'locking up' other children on the playground to the point where the children get scared. The nurse recognizes that this behavior is most likely an indication of:

• A. The need to dominate others
• B. Inventing traumatic events
• C. A need to develop close relationships
• D. A potential symptom of traumatization

Correct answer: D

Rationale: The behavior of an 8-year-old boy playacting as a police officer and 'locking up' other children to the point of scaring them is likely a symptom of traumatization. Children may reenact traumatic experiences through play, and acting out aggressive or controlling roles can be a sign of underlying trauma. This behavior should be further assessed and addressed with appropriate support and intervention to help the child process and cope with any potential trauma.

4. A client has been prescribed fluoxetine (Prozac) for the treatment of depression. Which of the following instructions should the nurse include in the discharge instructions?

• A. Take the medication at bedtime to avoid daytime drowsiness.
• B. Avoid drinking alcohol while taking this medication.
• C. Take the medication with a full glass of water.
• D. Stop taking the medication if you feel better.

Correct answer: B

Rationale: The correct answer is B. The nurse should instruct the client to avoid drinking alcohol while taking fluoxetine (Prozac) because alcohol can increase the risk of side effects such as drowsiness and dizziness. It is important to follow this instruction to ensure the safe and effective use of the medication in the treatment of depression. Choice A is incorrect because fluoxetine (Prozac) is usually taken in the morning to prevent insomnia. Choice C is not a crucial instruction for this medication. Choice D is incorrect as abruptly stopping fluoxetine can lead to withdrawal symptoms and should only be done under medical supervision.

5. Which intervention would be appropriate for assisting a client diagnosed with major depressive disorder?

• A. Encourage discussion of feelings
• B. Offer family therapy sessions
• C. Discuss childhood events
• D. Teach alternate coping skills

Correct answer: B

Rationale: Offering family therapy sessions would be the most appropriate intervention for a client diagnosed with major depressive disorder. Family therapy can be beneficial as it addresses interpersonal relationships within the family system, which is crucial in managing major depressive disorder effectively. This approach aligns with Sullivan's interpersonal theory, which emphasizes the impact of interpersonal relationships on individual behavior and personality development. In contrast, encouraging discussion of feelings, discussing childhood events, or teaching alternate coping skills may not directly address the interpersonal dynamics contributing to the client's major depressive disorder.

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