Nursing Elites

1. 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.

2. A patient with major depressive disorder has been prescribed an MAOI. The patient should be educated to avoid which type of food to prevent hypertensive crises?

• A. High-protein foods
• B. High-fiber foods
• C. Tyramine-rich foods
• D. Low-fat foods

Correct answer: C

Rationale: The correct answer is C: Tyramine-rich foods. Patients prescribed MAOIs should avoid tyramine-rich foods to prevent hypertensive crises. Tyramine-rich foods can interact with MAOIs, leading to a sudden and dangerous increase in blood pressure. Examples of tyramine-rich foods include aged cheeses, cured meats, pickled or fermented foods, and certain beverages like beer and wine. Choices A, B, and D are incorrect because they are not associated with causing hypertensive crises when taken with MAOIs.

3. In the care plan of a male patient diagnosed with a dissociative disorder, the nursing diagnosis of ineffective coping is included. Which behavior demonstrated by the patient supports this nursing diagnosis?

• A. Has no memory of the physical abuse he endured.
• B. Using both alcohol and marijuana.
• C. Often reports being unaware of surroundings.
• D. Reports feelings of 'not really being here.'

Correct answer: B

Rationale: The correct answer is B because using substances like alcohol and marijuana can be a sign of ineffective coping mechanisms in patients with dissociative disorders. Substance abuse is often used as a maladaptive way to cope with stress, trauma, or other underlying issues. Choices A, C, and D may be related to dissociative symptoms but do not directly reflect ineffective coping behaviors as substance abuse does.

4. Which of the following therapies is considered the most effective for treating phobias?

• A. Cognitive-behavioral therapy
• B. Psychoanalysis
• C. Medication management
• D. Group therapy

Correct answer: A

Rationale: Cognitive-behavioral therapy (CBT) is widely recognized as the most effective treatment for phobias. CBT helps individuals identify and change negative thought patterns and behaviors associated with their phobias, leading to long-lasting improvement and symptom reduction. Unlike psychoanalysis, which focuses on exploring unconscious conflicts, CBT provides practical strategies to address phobias directly. Medication management may be used in conjunction with therapy but is not typically considered a standalone treatment for phobias. Group therapy can be beneficial for some individuals, but CBT is specifically tailored to target and alleviate phobia symptoms effectively.

5. Cabot has multiple symptoms of depression including mood reactivity, social phobia, anxiety, and overeating. With a history of mild hypertension, which classification of antidepressants dispensed as a transdermal patch would be a safe medication?

• A. Tricyclic antidepressants
• B. Selective serotonin reuptake inhibitors
• C. Serotonin and norepinephrine reuptake inhibitors
• D. Monoamine oxidase inhibitors

Correct answer: D

Rationale: Monoamine oxidase inhibitors dispensed as transdermal patches can be a safer option for patients with mild hypertension due to reduced systemic absorption compared to other forms of antidepressants, potentially minimizing cardiovascular effects associated with hypertension.

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