Nursing Elites

1. What is the primary goal of exposure therapy for a patient with specific phobia?

• A. To eliminate the phobic response completely
• B. To increase the patient's exposure to the feared object
• C. To help the patient confront and reduce their fear gradually
• D. To provide immediate relief from anxiety symptoms

Correct answer: C

Rationale: The primary goal of exposure therapy for a patient with a specific phobia is to help them confront their fear gradually, leading to a reduction in their fear response over time. This gradual exposure helps the individual learn to manage and cope with their phobia, ultimately reducing the intensity of their fear reactions. Choice A is incorrect because while the goal is to reduce the fear response, complete elimination may not always be feasible. Choice B is incorrect as the focus is not solely on increasing exposure but on gradual confrontation. Choice D is incorrect as the therapy aims for long-term reduction rather than immediate relief.

2. A patient with agoraphobia has difficulty leaving their home. Which nursing intervention would be most effective?

• A. Encourage the patient to make small, gradual steps outside the home.
• B. Advise the patient to avoid crowded places.
• C. Suggest that the patient focus on their breathing when anxious.
• D. Provide the patient with information about support groups.

Correct answer: A

Rationale: Encouraging the patient to make small, gradual steps outside the home is the most effective nursing intervention for agoraphobia. This approach helps the patient confront their fear gradually and build confidence in managing their symptoms. By taking small steps, the patient can start to expand their comfort zone and reduce anxiety associated with leaving their home, ultimately aiding in their recovery and increasing their independence. Choices B, C, and D are not as effective as choice A. Advising the patient to avoid crowded places does not address the underlying issue of agoraphobia. Suggesting that the patient focus on their breathing when anxious may help manage immediate symptoms but does not address the fear of leaving home. Providing information about support groups is beneficial but may not directly address the patient's difficulty leaving their home.

3. A patient with panic disorder is being cared for by a healthcare provider. Which medication is commonly prescribed as a first-line treatment?

• A. Benzodiazepines
• B. Tricyclic antidepressants
• C. Selective serotonin reuptake inhibitors (SSRIs)
• D. Monoamine oxidase inhibitors (MAOIs)

Correct answer: C

Rationale: Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed as a first-line treatment for panic disorder due to their efficacy and lower risk of dependence and tolerance development compared to benzodiazepines. Tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs) are not typically recommended as initial treatments for panic disorder because of their side effect profiles and the availability of safer and more effective options like SSRIs.

4. 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: When an 8-year-old boy engages in playacting as a police officer that instills fear in other children, it can be indicative of a potential symptom of traumatization. This behavior may reflect the child's attempt to process or express experiences of trauma, leading to a manifestation of such distress in his play interactions with others.

5. Which medication is commonly used to treat obsessive-compulsive disorder (OCD)?

• A. Lorazepam
• B. Fluoxetine
• C. Lithium
• D. Haloperidol

Correct answer: B

Rationale: The correct answer is Fluoxetine (Choice B). Fluoxetine, an SSRI (Selective Serotonin Reuptake Inhibitor), is commonly used in the treatment of obsessive-compulsive disorder (OCD). SSRIs like Fluoxetine are considered first-line medications for managing OCD symptoms by helping to increase serotonin levels in the brain, which plays a role in mood regulation and anxiety reduction. Choice A, Lorazepam, is a benzodiazepine primarily used for anxiety disorders but is not a first-line treatment for OCD. Choice C, Lithium, is typically used in conditions like bipolar disorder, not OCD. Choice D, Haloperidol, is an antipsychotic medication and is not commonly used to treat OCD.

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