Nursing Elites

1. Which symptom is most indicative of obsessive-compulsive disorder (OCD)?

• A. Flashbacks of traumatic events
• B. Persistent, intrusive thoughts
• C. Frequent mood swings
• D. Auditory hallucinations

Correct answer: B

Rationale: Persistent, intrusive thoughts are a hallmark symptom of obsessive-compulsive disorder. Individuals with OCD experience persistent and unwanted thoughts or obsessions that are intrusive and cause significant distress. These thoughts often lead to repetitive behaviors or compulsions to try to alleviate the anxiety or distress caused by the obsessions. Flashbacks of traumatic events (Choice A), frequent mood swings (Choice C), and auditory hallucinations (Choice D) are not typical symptoms of OCD. Flashbacks are more commonly associated with post-traumatic stress disorder, mood swings can be seen in mood disorders, and auditory hallucinations are more characteristic of psychotic disorders.

2. A healthcare professional is caring for a group of clients. Which of the following clients should the healthcare professional consider for referral to an assertive community treatment (ACT) group?

• A. A client in an acute care mental health facility who has fallen several times while running down the hallway
• B. A client who lives at home and keeps forgetting to come in for a scheduled monthly antipsychotic injection for schizophrenia
• C. A client in a day treatment program who reports increasing anxiety during group therapy
• D. A client in a weekly grief support group who reports still missing a deceased partner who has been dead for 3 months

Correct answer: B

Rationale: The client who lives at home and repeatedly forgets to come in for a scheduled monthly antipsychotic injection for schizophrenia should be considered for referral to an assertive community treatment (ACT) group. ACT teams provide intensive community-based treatment and support for individuals with severe mental illness who may have difficulty adhering to treatment on their own. Choices A, C, and D do not describe individuals with severe mental illness who have difficulty adhering to treatment or need intensive community-based support, which are the typical candidates for referral to an ACT group.

3. A nurse hears a newly licensed nurse discussing a client’s hallucinations in the hallway with another nurse. Which of the following actions should the nurse take first?

• A. Notify the nurse manager
• B. Tell the nurse to stop discussing the behavior
• C. Provide an in-service program about confidentiality
• D. Complete an incident report

Correct answer: B

Rationale: The correct action the nurse should take first in this situation is to tell the newly licensed nurse to stop discussing the client's hallucinations with another nurse. Maintaining client confidentiality is a critical aspect of nursing practice. By addressing the behavior immediately, the nurse helps prevent the inappropriate sharing of sensitive information about a client. Choice A is not the first action to take because addressing the behavior directly is more immediate and can prevent further breaches of confidentiality. Choice C is not the priority at this moment as immediate action is required to address the current situation. Choice D, completing an incident report, should come after addressing the immediate issue and ensuring that the inappropriate behavior ceases.

4. After Natasha's husband passed away two months ago, she has been overwhelmed with grief. When Natasha is subsequently diagnosed with major depressive disorder, her daughter, Nadia, makes which true statement?

• A. Depression often begins after a major loss. Losing dad was a major loss.
• B. Bereavement and depression are the same problem.
• C. Mourning is pathological and not normal behavior.
• D. Antidepressant medications will not help this type of depression.

Correct answer: A

Rationale: It is common for major depressive disorder to be triggered by significant life events, such as the sudden loss of a loved one. Therefore, Nadia's statement that 'Depression often begins after a major loss' is correct. Bereavement and major depressive disorder are related but distinct conditions, and while mourning can be intense, it is generally considered a normal response to loss. Antidepressant medications can be beneficial in treating depression, including cases triggered by a significant loss.

5. What is the primary benefit of cognitive-behavioral therapy (CBT) for patients with anxiety disorders?

• A. It focuses on the long-term use of medications.
• B. It helps patients understand and change their thought patterns.
• C. It primarily addresses childhood traumas.
• D. It encourages patients to avoid anxiety-provoking situations.

Correct answer: B

Rationale: The primary benefit of cognitive-behavioral therapy (CBT) for patients with anxiety disorders is that it helps individuals understand and change their thought patterns. By doing so, patients can effectively reduce their anxiety levels by altering their responses to anxious thoughts and situations, leading to improved coping mechanisms and overall well-being. Choice A is incorrect because CBT does not focus on the long-term use of medications but rather on changing cognitive patterns. Choice C is incorrect because while CBT may address past experiences, its primary focus is on current thoughts and behaviors. Choice D is incorrect as CBT aims to help patients confront and manage anxiety-provoking situations rather than avoid them.

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