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In treating a patient with generalized anxiety disorder (GAD) using cognitive-behavioral therapy (CBT), what is the most appropriate goal of this therapy?
- A. To explore the patient's childhood experiences.
- B. To reduce the patient's symptoms through medication.
- C. To change the patient's negative thought patterns.
- D. To improve the patient's social skills.
Correct Answer: C
Rationale: The most appropriate goal of cognitive-behavioral therapy (CBT) in treating generalized anxiety disorder (GAD) is to change the patient's negative thought patterns. This therapy focuses on identifying and modifying distorted thinking patterns that contribute to anxiety. Exploring childhood experiences (Choice A) may be part of therapy, but the primary focus is on present thoughts and behaviors. While medication (Choice B) can help manage symptoms, CBT aims to address the root cause through cognitive restructuring. Improving social skills (Choice D) is not the primary goal of CBT for GAD, although it may be a secondary benefit as confidence improves with reduced anxiety.
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What should the nurse include in patient education for a patient starting on bupropion for major depressive disorder?
- A. Avoid consuming alcohol while taking this medication.
- B. Take the medication in the morning to prevent insomnia.
- C. It may cause significant weight gain.
- D. It is used as a first-line treatment for anxiety.
Correct Answer: A
Rationale: Patients prescribed bupropion should be educated to avoid consuming alcohol while on this medication to reduce the risk of seizures. Bupropion lowers the seizure threshold, and alcohol can further increase this risk. It is important for patients to understand the potential consequences of combining bupropion with alcohol to ensure their safety and treatment effectiveness. Choices B, C, and D are incorrect. Taking bupropion in the morning does not prevent insomnia; it is not associated with significant weight gain; and it is not a first-line treatment for anxiety.
When assessing a patient with generalized anxiety disorder (GAD), which symptom would the nurse most likely observe?
- A. Flashbacks
- B. Excessive worry
- C. Hallucinations
- D. Compulsive behaviors
Correct Answer: B
Rationale: Excessive worry is a characteristic feature of generalized anxiety disorder (GAD). Patients with GAD experience persistent and excessive worry about various aspects of their life, such as work, health, or family, even when there is little or no reason for concern. This chronic worrying can significantly impact their daily functioning and quality of life. Flashbacks are more commonly associated with post-traumatic stress disorder (PTSD), hallucinations are more typical in conditions like schizophrenia, while compulsive behaviors are seen in obsessive-compulsive disorder (OCD). Therefore, in the context of GAD, excessive worry is the symptom that the nurse is most likely to observe.
When assessing a patient with schizophrenia who exhibits disorganized speech and behavior, these symptoms are classified as:
- A. Positive symptoms
- B. Negative symptoms
- C. Cognitive symptoms
- D. Mood symptoms
Correct Answer: A
Rationale: Positive symptoms in schizophrenia refer to excesses or distortions in normal behavior and include symptoms like hallucinations, delusions, and disorganized speech and behavior. Disorganized speech and behavior are considered positive symptoms because they represent an excess or distortion of normal functions. Negative symptoms involve deficits in normal behavior, cognitive symptoms affect thinking processes, and mood symptoms relate to emotional experiences. Therefore, in this scenario, the disorganized speech and behavior exhibited by the patient are classified as positive symptoms.
In a patient with schizophrenia, which of the following symptoms would indicate a poor prognosis?
- A. Auditory hallucinations
- B. Paranoia
- C. Flat affect
- D. Delusions of grandeur
Correct Answer: C
Rationale: A flat affect, characterized by a lack of emotional expression, is often linked to a poorer prognosis in schizophrenia. It can hinder social interactions and affect the individual's ability to engage in therapy or express emotions, thereby impacting the overall treatment outcomes. Auditory hallucinations (Choice A) and delusions of grandeur (Choice D) are common symptoms in schizophrenia but may not always indicate a poor prognosis. Paranoia (Choice B) can also vary in its impact on prognosis depending on the individual and the severity of the symptom.
When a patient with major depressive disorder is started on fluoxetine, what is the most important side effect for the nurse to monitor?
- A. Weight gain
- B. Suicidal ideation
- C. Hypertension
- D. Hyperglycemia
Correct Answer: B
Rationale: When initiating fluoxetine therapy in a patient with major depressive disorder, monitoring for suicidal ideation is crucial due to the increased risk of suicidal thoughts or behaviors that can occur, especially in the initial phase of treatment. This close monitoring is essential to ensure patient safety and intervene promptly if such symptoms arise. Weight gain, hypertension, and hyperglycemia are potential side effects of some medications used to treat depression, but suicidal ideation is the most critical and immediate side effect to monitor for when starting fluoxetine.