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Which therapeutic approach is most effective for managing obsessive-compulsive disorder (OCD)?
- A. Cognitive-behavioral therapy
- B. Psychoanalysis
- C. Medication management
- D. Group therapy
Correct Answer: A
Rationale: Cognitive-behavioral therapy (CBT), especially exposure and response prevention, is considered the most effective therapeutic approach for managing obsessive-compulsive disorder (OCD). CBT helps individuals identify and modify their distorted beliefs and behaviors related to OCD, while exposure and response prevention specifically target the core symptoms of OCD by gradually exposing the individual to feared stimuli and preventing compulsive responses. While medication management can be used as an adjunct to therapy, CBT has shown to have long-lasting benefits in reducing OCD symptoms and improving the overall quality of life. Psychoanalysis focuses more on exploring unconscious conflicts and childhood experiences, which may not be as effective for OCD. Group therapy can be beneficial as a supplemental treatment but is not typically as effective as individual CBT tailored to the specific needs of the individual with OCD.
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What information should the nurse include in patient education for a patient prescribed valproic acid for bipolar disorder?
- A. Avoid consuming dairy products while taking this medication.
- B. Regular blood tests are necessary to monitor medication levels.
- C. Take the medication on an empty stomach for better absorption.
- D. It is safe to stop the medication abruptly if side effects occur.
Correct Answer: B
Rationale: The correct answer is B: Regular blood tests are crucial when taking valproic acid to monitor the medication levels in the bloodstream. This monitoring helps ensure that the patient is receiving the correct dosage for effective treatment and to prevent adverse effects associated with either subtherapeutic or toxic levels of the medication. Choice A is incorrect because there is no specific interaction between valproic acid and dairy products. Choice C is incorrect as valproic acid can generally be taken with food to reduce gastrointestinal side effects. Choice D is incorrect as abruptly stopping valproic acid can lead to withdrawal symptoms and worsening of the condition.
A patient diagnosed with bipolar disorder is experiencing a depressive episode. Which medication is commonly prescribed for this phase of the disorder?
- A. Valproic acid
- B. Risperidone
- C. Fluoxetine
- D. Lithium
Correct Answer: C
Rationale: The correct answer is C, Fluoxetine. Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), is commonly prescribed to manage the depressive episodes in bipolar disorder. SSRIs are effective in treating the depressive phase of bipolar disorder as they help regulate serotonin levels in the brain, which can improve mood and reduce symptoms of depression. Choice A, Valproic acid, is used more commonly in the treatment of acute mania or mixed episodes in bipolar disorder. Choice B, Risperidone, is an atypical antipsychotic often used to manage psychotic symptoms in bipolar disorder. Choice D, Lithium, is primarily used for the maintenance treatment of bipolar disorder to prevent future manic and depressive episodes.
A patient with generalized anxiety disorder (GAD) is prescribed escitalopram. The nurse should educate the patient that the full therapeutic effect of this medication may take:
- A. 1-2 days
- B. 1-2 weeks
- C. 2-4 weeks
- D. 6-8 weeks
Correct Answer: D
Rationale: Escitalopram, an SSRI used in treating generalized anxiety disorder, typically takes 6-8 weeks to achieve its full therapeutic effect. While some improvement may be noticed earlier, the maximum benefit is usually experienced after this timeframe. Options A, B, and C are incorrect because they underestimate the time required for escitalopram to reach its full effectiveness. Educating patients about the realistic timeline for medication effectiveness is crucial in managing expectations and ensuring adherence to the prescribed treatment.
A patient with major depressive disorder is started on a tricyclic antidepressant (TCA). Which common side effect should the nurse educate the patient about?
- A. Hypertension
- B. Diarrhea
- C. Dry mouth
- D. Weight loss
Correct Answer: C
Rationale: The correct answer is C: Dry mouth. Dry mouth is a common side effect associated with tricyclic antidepressants (TCAs). TCAs block acetylcholine receptors, leading to anticholinergic effects such as dry mouth, constipation, blurred vision, and urinary retention. It is important for the nurse to educate the patient about this side effect to promote awareness and provide appropriate management strategies, such as maintaining good oral hygiene and staying hydrated. Choice A, hypertension, is not a common side effect of TCAs. Choice B, diarrhea, is not a typical side effect of TCAs; in fact, TCAs are more likely to cause constipation. Choice D, weight loss, is less common with TCAs as they are more likely to cause weight gain.
During a routine health screening, a grieving widow whose husband died 15 months ago reports emptiness, a loss of self, difficulty thinking of the future, and anger at her dead husband. The nurse suggests bereavement counseling. The widow is most likely suffering from:
- A. Major depression
- B. Normal grieving
- C. Adjustment disorder
- D. Posttraumatic stress disorder
Correct Answer: C
Rationale: The widow's symptoms align more closely with an adjustment disorder rather than major depression, normal grieving, or posttraumatic stress disorder. The widow's prolonged struggle in coping with the loss, characterized by emptiness, loss of self, difficulty envisioning the future, and anger towards her deceased husband, indicates an inability to adapt to the loss. These symptoms are indicative of an adjustment disorder, which typically arises in response to a significant life stressor and persists beyond what is considered a normal grieving process. Bereavement counseling can help the widow navigate her emotions and coping strategies during this challenging period.