Nursing Elites

1. What is the priority intervention for a patient admitted for an overdose of sedatives and diagnosed with dissociative identity disorder?

• A. Conducting a suicide assessment
• B. Arranging for placement in a group home
• C. Providing a low-stimulation environment
• D. Establishing trust and rapport

Correct answer: A

Rationale: Conducting a suicide assessment is the priority intervention for a patient admitted for an overdose of sedatives and diagnosed with dissociative identity disorder. In this scenario, the immediate concern is to assess the risk of harm to the patient's life. It is crucial to determine if the overdose was intentional and if the patient has suicidal ideation or intent. Arranging for placement in a group home (choice B) may be necessary at a later stage depending on the patient's needs, but it is not the priority in this urgent situation. Providing a low-stimulation environment (choice C) and establishing trust and rapport (choice D) are important aspects of care but addressing the immediate risk of suicide takes precedence in this case.

2. A 33-year-old female diagnosed with bipolar I disorder has been functioning well on lithium for 11 months. At her most recent checkup, the psychiatric nurse practitioner states, ‘You are ready to enter the maintenance therapy stage, so at this time I am going to adjust your dosage by prescribing:'

• A. A higher dosage
• B. Once-a-week dosing
• C. A lower dosage
• D. A different drug

Correct answer: C

Rationale: As the patient transitions to maintenance therapy, the typical approach involves decreasing the dosage to a lower level. This adjustment is made to find the minimum effective dose needed for symptom control while reducing the potential side effects associated with long-term use. Choosing a higher dosage (A) would not align with the goal of maintenance therapy, as it may increase the risk of adverse effects. Once-a-week dosing (B) is not a common adjustment for lithium, which is usually prescribed daily for bipolar disorder. Switching to a different drug (D) is typically considered if the current medication is ineffective or intolerable, not as a routine step in transitioning to maintenance therapy.

3. 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.

4. What is the priority nursing intervention for a patient experiencing a panic attack?

• A. Encourage the patient to talk about their feelings.
• B. Provide a safe, calm environment.
• C. Administer prescribed anti-anxiety medication.
• D. Teach the patient deep breathing exercises.

Correct answer: B

Rationale: The priority nursing intervention for a patient experiencing a panic attack is to provide a safe, calm environment. This action is crucial as it helps reduce the patient's anxiety and creates a sense of security, which can aid in managing the panic attack effectively. Encouraging the patient to talk about their feelings, administering medication, or teaching deep breathing exercises can be beneficial interventions, but creating a safe and calm environment takes precedence in addressing the immediate needs of the patient during a panic attack.

5. A client with anxiety disorder is scheduled to begin classical psychoanalysis. Which client statement indicates an understanding of this form of therapy?

• A. “Even if my anxiety improves, I will need to continue this therapy for 6 weeks”
• B. “The therapist will focus on my past relationships during our sessions”
• C. “Psychoanalysis will help me reduce my anxiety by changing my behaviors”
• D. “This therapy will address my conscious feelings about stressful experiences”

Correct answer: B

Rationale: In classical psychoanalysis, the therapist delves into the client's past relationships, childhood experiences, and unconscious thoughts to uncover underlying issues contributing to the client's current symptoms. Understanding that the therapist will focus on past relationships aligns with the core principles of classical psychoanalysis. Choice A is incorrect because the duration of classical psychoanalysis is typically longer than 6 weeks. Choice C is incorrect as changing behaviors is more aligned with behavioral therapy than classical psychoanalysis. Choice D is incorrect as classical psychoanalysis primarily focuses on unconscious thoughts rather than conscious feelings about stressful experiences.

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