Nursing Elites

1. Which response by a 15-year-old demonstrates a common symptom observed in patients diagnosed with major depressive disorder?

• A. I'm so restless. I can't seem to sit still.
• B. I spend most of my time studying. I have to get into a good college.
• C. I'm not trying to diet, but I've lost about 5 pounds in the past 5 months.
• D. I go to sleep around 11 p.m. but I'm always up by 3 a.m. and can't go back to sleep.

Correct answer: D

Rationale: Sleep disturbances, such as early morning awakening, are common symptoms of major depressive disorder.

2. When assessing a client diagnosed with major depressive disorder who states, 'I feel like I can't go on,' which of the following actions should the nurse take first?

• A. Administer a prescribed antidepressant medication.
• B. Ask the client if they have a plan to commit suicide.
• C. Encourage the client to attend a support group.
• D. Contact the client's family to provide support.

Correct answer: B

Rationale: The priority action for the nurse is to assess the client's risk for suicide. By asking if the client has a plan to commit suicide, the nurse can determine the immediate safety of the client and take appropriate interventions to prevent harm. Administering antidepressant medication is not the first action to take in this situation as assessing the client's safety is the priority. Encouraging the client to attend a support group or contacting the client's family, although beneficial, are not immediate actions to ensure the client's safety in a crisis situation.

3. A healthcare professional is assessing a client with obsessive-compulsive disorder (OCD). Which of the following findings should the professional expect? Select one that does not apply.

• A. Recurrent, intrusive thoughts
• B. Compulsive behaviors
• C. Delusions of grandeur
• D. Avoidance of situations that trigger obsessions

Correct answer: C

Rationale: Obsessive-compulsive disorder (OCD) is characterized by recurrent, intrusive thoughts (obsessions), compulsive behaviors, and avoidance of situations that trigger obsessions. Delusions of grandeur, which involve inflated beliefs about one's own importance or abilities, are not typically associated with OCD. Therefore, the presence of delusions of grandeur would not be an expected finding in a client with OCD. Choices A, B, and D are all typical features of OCD and would be expected findings during the assessment of a client with this disorder.

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. A client with bipolar disorder is experiencing a manic episode. Which intervention should the nurse implement to ensure the client's safety?

• A. Provide a structured environment with minimal stimuli.
• B. Monitor the client closely for signs of exhaustion.
• C. Encourage the client to rest and sleep as needed.
• D. Encourage the client to engage in regular physical activity.

Correct answer: A

Rationale: During a manic episode in bipolar disorder, individuals may exhibit increased energy levels, impulsivity, and reduced need for sleep, which can lead to risky behaviors and accidents. Providing a structured environment with minimal stimuli helps to reduce the risk of overstimulation and impulsive actions, thereby promoting the client's safety. This intervention aims to create a calm and controlled setting that can prevent potential harm to the client during this phase of the disorder.

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