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A patient with obsessive-compulsive disorder (OCD) is undergoing treatment with an SSRI. Which SSRI is commonly utilized for this condition?
- A. Fluoxetine
- B. Citalopram
- C. Paroxetine
- D. Escitalopram
Correct Answer: C
Rationale: Paroxetine is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed for obsessive-compulsive disorder due to its efficacy in managing OCD symptoms. While different SSRIs may be used based on individual patient response and tolerability, Paroxetine stands out as a well-established option for treating OCD. Fluoxetine (Choice A) is another SSRI commonly used for OCD, but Paroxetine is more commonly associated with this indication. Citalopram (Choice B) and Escitalopram (Choice D) are also SSRIs but are not typically the first choice for treating OCD.
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For a patient with obsessive-compulsive disorder (OCD) who spends several hours a day washing her hands, which type of therapy is most appropriate?
- A. Exposure and response prevention
- B. Dialectical behavior therapy
- C. Family therapy
- D. Interpersonal therapy
Correct Answer: A
Rationale: Exposure and response prevention (ERP) is the most appropriate therapy for managing OCD. ERP involves exposing the patient to anxiety-provoking stimuli (such as touching dirty objects) and preventing the compulsive response (hand washing), thus helping the patient learn to tolerate the anxiety without performing the ritualistic behavior. Dialectical behavior therapy (DBT) focuses more on emotional regulation and interpersonal skills, making it less suitable for directly addressing OCD symptoms. Family therapy and interpersonal therapy may be beneficial for other conditions or relationship issues but are not specifically designed to target OCD symptoms like ERP.
In the treatment of a patient with obsessive-compulsive disorder (OCD) using cognitive-behavioral therapy (CBT), which specific type of CBT is most effective?
- A. Dialectical behavior therapy
- B. Exposure and response prevention
- C. Interpersonal therapy
- D. Supportive therapy
Correct Answer: B
Rationale: Exposure and response prevention (ERP) is a specific type of CBT that is considered the most effective treatment for OCD. ERP involves exposing the individual to anxiety-provoking stimuli and preventing the usual compulsive responses, leading to a decreased anxiety response over time. This type of therapy helps individuals learn to tolerate the anxiety triggered by obsessions without engaging in compulsions, ultimately reducing OCD symptoms. Choices A, C, and D are incorrect. Dialectical behavior therapy (Choice A) is more commonly used for treating conditions like borderline personality disorder, not OCD. Interpersonal therapy (Choice C) focuses on improving interpersonal relationships and communication skills, which is not the primary approach for OCD. Supportive therapy (Choice D) provides emotional support and guidance but is not as effective as ERP in treating OCD.
What information should the nurse provide in patient education for a patient prescribed sertraline for major depressive disorder?
- A. Take the medication with food.
- B. It may take several weeks to feel the full effect.
- C. Avoid consuming grapefruit while taking this medication.
- D. Regular blood tests are necessary to monitor levels.
Correct Answer: B
Rationale: Patients prescribed sertraline for major depressive disorder should be educated that it may take several weeks before experiencing the full therapeutic effects of the medication. This delay in onset of action is common with antidepressants like sertraline, and patients need to be aware of this to manage their expectations and continue with the treatment regimen. It's important for the patient to understand that consistent adherence to the prescribed dosage is crucial, even if the full effects are not immediately apparent. Choices A, C, and D are incorrect because taking the medication with food, avoiding grapefruit, and regular blood tests are not specific education points related to the expected timeframe for therapeutic effects of sertraline.
A patient with bipolar disorder has been prescribed lithium. Which dietary advice is important for the nurse to include?
- A. Avoid foods high in tyramine.
- B. Maintain a consistent salt intake.
- C. Increase protein intake.
- D. Avoid foods high in fat.
Correct Answer: B
Rationale: Patients prescribed lithium should maintain a consistent salt intake to prevent fluctuations in lithium levels. Salt intake can impact lithium levels, and sudden changes in salt intake can affect how the body absorbs and excretes lithium. Therefore, advising the patient to maintain a stable salt intake is crucial for the effectiveness and safety of lithium therapy. Choices A, C, and D are incorrect. Avoiding foods high in tyramine is more relevant for patients taking MAOIs, not lithium. Increasing protein intake or avoiding foods high in fat are not specific dietary recommendations for patients on lithium therapy.
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.