Nursing Elites

1. In what significant way should the therapeutic environment differ for a client who has ingested LSD from that of a client who has ingested PCP?

• A. For LSD ingestion, maintain a regimen of limited interaction and minimal verbal stimulation. For PCP ingestion, place client on one-on-one intensive supervision.
• B. For LSD ingestion, place the client in restraints. For PCP ingestion, place the client on seizure precautions.
• C. For LSD ingestion, provide continual medieval simulation involving as many senses as possible. For PCP ingestion, provide continual high-level stimulation.
• D. For PCP ingestion, place the client on one-on-one intensive supervision. For LSD ingestion, maintain a regimen of limited interaction and minimal verbal stimulation.

Correct answer: D

Rationale: When managing a client who has ingested PCP, it is crucial to provide one-on-one intensive supervision to ensure their safety and prevent any harm to themselves or others. This level of supervision is necessary due to the unpredictable and potentially dangerous effects of PCP. On the other hand, for a client who has ingested LSD, it is recommended to maintain a calm environment with limited interaction and minimal verbal stimulation. This approach aims to prevent exacerbating any adverse effects of LSD, such as anxiety or paranoia, by reducing external stimuli. Therefore, the correct approach is to provide one-on-one intensive supervision for PCP ingestion and limit interaction and verbal stimulation for LSD ingestion.

2. Which intervention is most appropriate for a patient with a phobia of flying?

• A. Exposure therapy
• B. Cognitive restructuring
• C. Medication management
• D. Psychoeducation

Correct answer: A

Rationale: Exposure therapy is considered the most appropriate intervention for a patient with a phobia of flying. This therapeutic approach involves gradually exposing the individual to the feared stimulus, in this case, flying, in a controlled and supportive environment. By facing the fear in a structured manner, the patient can learn to manage their anxiety response and eventually reduce their phobia-related symptoms. While cognitive restructuring may help change negative thought patterns and medication management can alleviate symptoms, exposure therapy is specifically designed to address phobias through systematic desensitization, making it the most suitable intervention in this scenario. Psychoeducation aims to provide information and support but may not directly target the phobia itself.

3. Which medication is commonly prescribed for the treatment of bipolar disorder?

• A. Sertraline
• B. Valproic acid
• C. Clozapine
• D. Haloperidol

Correct answer: B

Rationale: Valproic acid is commonly prescribed as a mood stabilizer for the treatment of bipolar disorder. It helps in controlling mood swings, preventing manic episodes, and reducing the risk of depressive episodes in individuals with bipolar disorder. Sertraline is an antidepressant typically used for major depressive disorder and other anxiety disorders, not for bipolar disorder. Clozapine and Haloperidol are antipsychotic medications primarily used in schizophrenia and other psychotic disorders, not as first-line treatments for bipolar disorder.

4. A client has been diagnosed with generalized anxiety disorder. Which of the following findings should the nurse expect?

• A. Shortness of breath
• B. Chest pain
• C. Excessive worry
• D. Decreased appetite

Correct answer: C

Rationale: Individuals with generalized anxiety disorder commonly exhibit symptoms like excessive worry, restlessness, and difficulty concentrating. Physical manifestations such as muscle tension and sleep disturbances are also prevalent. Shortness of breath and chest pain are more commonly associated with panic attacks rather than generalized anxiety disorder. Decreased appetite may be present in some cases, but excessive worry is a hallmark characteristic of generalized anxiety disorder.

5. For a patient with obsessive-compulsive disorder (OCD) who spends several hours a day washing her hands, which type of therapy is most appropriate?

• A. Exposure and response prevention
• B. Dialectical behavior therapy
• C. Family therapy
• D. Interpersonal therapy

Correct answer: A

Rationale: Exposure and response prevention (ERP) is the most appropriate therapy for managing OCD. ERP involves exposing the patient to anxiety-provoking stimuli (such as touching dirty objects) and preventing the compulsive response (hand washing), thus helping the patient learn to tolerate the anxiety without performing the ritualistic behavior. Dialectical behavior therapy (DBT) focuses more on emotional regulation and interpersonal skills, making it less suitable for directly addressing OCD symptoms. Family therapy and interpersonal therapy may be beneficial for other conditions or relationship issues but are not specifically designed to target OCD symptoms like ERP.

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