Nursing Elites

1. 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.

2. A client tells a nurse, 'Don’t tell anyone, but I hid a sharp knife under my mattress to protect myself from my threatening roommate.' Which of the following actions should the nurse take?

• A. Keep the client’s communication confidential, but talk to the client daily using therapeutic communication to convince them to admit to hiding the knife
• B. Keep the client’s communication confidential, but watch the client and their roommate closely
• C. Tell the client that this must be reported to the health care team because it concerns the health and safety of the client and others
• D. Report the incident to the health care team but do not inform the client of the intention to do so

Correct answer: C

Rationale: In this scenario, the nurse must prioritize the safety of the client and others. The client's disclosure of hiding a sharp knife under the mattress poses a significant risk. It is crucial for the nurse to inform the health care team about this situation to ensure immediate intervention and prevent any harm. Confidentiality is important in nursing care, but in cases where there is a clear threat to safety, the duty to protect overrides the duty of confidentiality. Reporting the incident to the health care team is essential to address the safety concerns and provide appropriate support and intervention for the client. Choices A and B are incorrect because while confidentiality is important, the immediate safety concern outweighs keeping the client's communication confidential or simply monitoring the situation. Choice D is incorrect as it does not involve informing the client, which can impact the therapeutic relationship and trust between the nurse and the client.

3. Which symptom is most commonly associated with generalized anxiety disorder (GAD)?

• A. Frequent panic attacks
• B. Persistent and excessive worry
• C. Recurrent, intrusive thoughts
• D. Compulsive behaviors

Correct answer: B

Rationale: The correct answer is B: Persistent and excessive worry. Generalized anxiety disorder (GAD) is characterized by persistent and excessive worry about a variety of things, even when there is little or no reason to worry. This worry is difficult to control and can significantly impact daily life. While panic attacks, recurrent intrusive thoughts, and compulsive behaviors can occur in other anxiety disorders, persistent and excessive worry is the hallmark symptom of GAD. Therefore, choices A, C, and D are incorrect as they do not represent the primary symptom associated with GAD.

4. Which assessment finding best supports dissociative fugue?

• A. The patient states that he cannot remember important information about himself.
• B. The patient is found to be wandering in a park and cannot remember his name or where he lives.
• C. The patient reports feeling as if she is outside her body and observing herself from a distance.
• D. The patient has a sudden onset of symptoms after experiencing a traumatic event.

Correct answer: B

Rationale: The key feature of dissociative fugue is sudden, unexpected travel away from home during which the individual may not be able to recall their identity or past events. Choice B best reflects this by describing a scenario where the patient is found wandering in a park and unable to remember their name or residence, which aligns with the characteristic dissociative amnesia seen in dissociative fugue. Choices A, C, and D do not directly support dissociative fugue. Choice A refers more to general dissociative amnesia, Choice C describes depersonalization/derealization disorder, and Choice D suggests acute stress reaction rather than dissociative fugue.

5. A patient with bipolar disorder is prescribed lithium. What is a common side effect the nurse should monitor for?

• A. Increased energy
• B. Constipation
• C. Weight gain
• D. Dry mouth

Correct answer: C

Rationale: Weight gain is a common side effect associated with lithium therapy. It is essential for the nurse to monitor the patient for changes in weight as it can impact the individual's overall health and well-being. Patients on lithium should be advised on dietary and lifestyle modifications to manage potential weight gain and maintain a healthy weight.

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