Nursing Elites

1. Which characteristic is most commonly associated with dissociative identity disorder?

• A. Frequent nightmares
• B. Auditory hallucinations
• C. Multiple distinct personalities
• D. Chronic fatigue

Correct answer: C

Rationale: Dissociative identity disorder, commonly known as multiple personality disorder, is characterized by the presence of two or more distinct personality states within an individual. These distinct personalities may have their own way of perceiving and interacting with the world, often leading to gaps in memory and a sense of detachment. Frequent nightmares, auditory hallucinations, and chronic fatigue are not primary characteristics of dissociative identity disorder. Option C, multiple distinct personalities, is the hallmark feature of this disorder, making it the correct choice.

2. Which individual is likely experiencing symptoms of derealization?

• A. I just feel like I’m looking at life through a fog and that can’t be my face in the mirror.
• B. I cannot recall why I’m living in this town or how I got here.
• C. There are just too many people living in my head now.
• D. I feel like I’m going to die, I’m having a heart attack.

Correct answer: A

Rationale: The individual describing feeling like they are looking at life through a fog and questioning their reflection in the mirror is likely experiencing symptoms of derealization. Derealization involves feelings of detachment from one's surroundings, which can manifest as a sense of unreality or distortion of the environment. Choice B describes dissociative amnesia, which involves memory loss related to personal information or traumatic events. Choice C suggests dissociative identity disorder (DID), where a person experiences two or more distinct identities or personality states. Choice D indicates symptoms of a panic attack, such as fearing imminent death and physical sensations like a heart attack.

3. When discharging a patient with schizophrenia on risperidone, what is an important point to include in the discharge teaching?

• A. Avoiding foods high in tyramine is essential.
• B. Getting blood levels checked regularly is necessary.
• C. Being cautious when driving due to possible drowsiness is crucial.
• D. Taking this medication on an as-needed basis is recommended.

Correct answer: B

Rationale: Regular monitoring of blood levels is crucial for patients taking risperidone to ensure the medication is at therapeutic levels and to prevent potential toxicity. This monitoring helps healthcare providers adjust the dosage as needed to optimize treatment outcomes and minimize adverse effects.

4. What is the primary benefit of using exposure therapy for patients with phobias?

• A. To eliminate the phobia completely
• B. To gradually reduce the patient’s fear and anxiety
• C. To teach the patient relaxation techniques
• D. To provide immediate relief from anxiety

Correct answer: B

Rationale: The primary benefit of using exposure therapy for patients with phobias is to gradually reduce the patient's fear and anxiety. Exposure therapy involves exposing the individual to the feared object or situation in a controlled manner to help them confront their fears and learn that the perceived threat is not as harmful as initially believed. Over time, repeated exposure can lead to a decrease in anxiety and fear responses, helping the individual manage and overcome their phobia. Choice A is incorrect because exposure therapy aims to reduce fear and anxiety, not necessarily eliminate the phobia completely. Choice C is incorrect as although relaxation techniques might be part of the therapy, the primary goal is fear reduction. Choice D is incorrect as exposure therapy typically involves gradual exposure rather than providing immediate relief.

5. When working with a patient diagnosed with posttraumatic stress disorder (PTSD), which therapeutic approach is most appropriate?

• A. Encouraging the patient to avoid discussing the traumatic event.
• B. Using exposure therapy to help the patient confront their fears.
• C. Advising the patient to focus on positive thoughts.
• D. Suggesting that the patient keep busy to distract from traumatic memories.

Correct answer: B

Rationale: Exposure therapy is an evidence-based treatment for PTSD that involves gradually exposing the patient to their traumatic memories in a safe and controlled environment. This approach helps individuals confront and process their fears, reducing the impact of the traumatic event over time. Avoiding discussing the trauma (choice A) may lead to avoidance behaviors and hinder recovery. Focusing on positive thoughts (choice C) may provide temporary relief but does not address the underlying trauma. Keeping busy to distract from memories (choice D) is a form of avoidance that does not help in processing the traumatic experiences. Therefore, using exposure therapy (choice B) is the most appropriate approach to effectively treat PTSD.

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