Nursing Elites

1. Which medication is commonly used to treat both major depressive disorder and neuropathic pain?

• A. Gabapentin
• B. Duloxetine
• C. Amitriptyline
• D. Tramadol

Correct answer: B

Rationale: Duloxetine, also known as Cymbalta, is a medication commonly used to treat both major depressive disorder and neuropathic pain. It is a serotonin-norepinephrine reuptake inhibitor (SNRI) that helps alleviate symptoms associated with these conditions. Gabapentin is primarily used for neuropathic pain, Amitriptyline is commonly used as an antidepressant, and Tramadol is an opioid analgesic often used for pain relief but not typically indicated for major depressive disorder.

2. Which behavior is most characteristic of agoraphobia?

• A. Avoiding crowded places and public transportation
• B. Excessively washing hands to prevent contamination
• C. Experiencing unexpected panic attacks
• D. Having a fear of gaining weight

Correct answer: A

Rationale: Agoraphobia is characterized by the avoidance of situations where escape might be difficult or help unavailable in the event of a panic attack. Avoiding crowded places and public transportation aligns with this fear of being in situations where escape might be challenging, making choice A the most characteristic behavior of agoraphobia. Choices B, C, and D do not directly relate to the core feature of agoraphobia, which is the avoidance of situations perceived as difficult to escape from.

3. A patient with posttraumatic stress disorder (PTSD) is experiencing flashbacks. What is the most appropriate initial nursing intervention?

• A. Encourage the patient to talk briefly about the traumatic event.
• B. Reassure the patient that they are safe and the event is not happening now.
• C. Administer a sedative medication as prescribed.
• D. Suggest the patient write about their feelings in a journal.

Correct answer: B

Rationale: During a flashback, the patient may feel as though the traumatic event is reoccurring. Reassuring the patient that they are safe and the event is not happening presently can help ground them in reality and reduce anxiety. This approach can provide a sense of safety and security, which is crucial in managing flashbacks associated with PTSD. Encouraging the patient to talk briefly about the traumatic event may worsen the distress during a flashback by intensifying the re-experiencing of the trauma. Administering sedative medication should not be the initial intervention, as non-pharmacological approaches are preferred in managing flashbacks. Suggesting the patient write about their feelings in a journal may be beneficial as part of ongoing therapy, but it is not the most appropriate initial intervention during a flashback.

4. During the working phase of a therapeutic relationship, a client with methamphetamine use disorder displays transference behavior. Which action by the client indicates transference behavior?

• A. The client asks the nurse if they will go out to dinner together
• B. The client accuses the nurse of being controlling just like an ex-partner
• C. The client reminds the nurse of a friend who died from substance toxicity
• D. The client becomes angry and threatens to engage in self-harm

Correct answer: B

Rationale: Transference occurs when a client projects feelings, often unconscious, onto the nurse that are associated with significant figures in their past or present life. In this scenario, the client accusing the nurse of being controlling like an ex-partner demonstrates transference behavior by attributing characteristics of someone from their past onto the nurse. Choices A, C, and D do not reflect transference behavior. Choice A involves a social invitation, which is not necessarily transference. Choice C is more related to countertransference as it triggers memories in the nurse, not the client. Choice D describes aggressive behavior and self-harm threats, which are not indicative of transference.

5. A patient with panic disorder is prescribed alprazolam. Which instruction is most important for the nurse to include in the teaching plan?

• A. Avoid driving until you know how the medication affects you.
• B. Take the medication with food to avoid stomach upset.
• C. Take the medication at bedtime to help with sleep.
• D. Increase the dose if you do not feel better in a few days.

Correct answer: A

Rationale: The most important instruction for a patient prescribed alprazolam is to avoid driving until they know how the medication affects them. Alprazolam can cause drowsiness and impaired coordination, which may affect the ability to drive safely. This caution is crucial to prevent accidents and ensure the safety of the patient and others on the road.

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