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In a patient with bipolar disorder, which symptom would indicate a manic episode?
- A. Excessive sleeping
- B. Low self-esteem
- C. Decreased need for sleep
- D. Anhedonia
Correct Answer: C
Rationale: The correct answer is C: Decreased need for sleep. A decreased need for sleep is a hallmark symptom of a manic episode in bipolar disorder. During manic episodes, individuals may experience significantly reduced sleep without feeling tired, which can lead to increased energy levels, impulsivity, and other manic symptoms. Excessive sleeping (choice A) is more indicative of depression rather than mania. Low self-esteem (choice B) and anhedonia (choice D) are also more commonly associated with depressive episodes rather than manic episodes in bipolar disorder.
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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.
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.
A patient with social anxiety disorder is prescribed propranolol. The nurse understands that this medication is used primarily to:
- A. Reduce anxiety symptoms
- B. Improve mood
- C. Increase energy levels
- D. Enhance social interactions
Correct Answer: A
Rationale: The correct answer is A: Reduce anxiety symptoms. Propranolol, a beta-blocker, is primarily used to reduce physical symptoms of anxiety, such as rapid heartbeat and trembling, in patients with social anxiety disorder. It does not directly affect mood, energy levels, or social interactions. Choice B is incorrect because propranolol does not target mood improvement. Choice C is incorrect because propranolol does not aim to increase energy levels. Choice D is incorrect because propranolol does not enhance social interactions; its primary role is in reducing physical symptoms of anxiety.
Which therapeutic approach is considered most effective for treating posttraumatic stress disorder (PTSD)?
- A. Cognitive processing therapy
- B. Psychoanalysis
- C. Medication management
- D. Group therapy
Correct Answer: A
Rationale: Cognitive processing therapy is a specialized form of cognitive-behavioral therapy that has been shown to be highly effective in treating posttraumatic stress disorder (PTSD). This therapy focuses on helping individuals process and make sense of their traumatic experiences, leading to symptom reduction and improved coping mechanisms. Psychoanalysis, medication management, and group therapy can be beneficial in some cases, but cognitive processing therapy is specifically tailored for addressing the symptoms and underlying causes of PTSD. Psychoanalysis may not be as effective for PTSD due to its focus on unconscious conflicts rather than trauma processing. Medication management can be useful as an adjunct to therapy but does not address the core issues of PTSD. Group therapy can provide support but may not offer the individualized approach that cognitive processing therapy provides.
Which of the following is a negative symptom of schizophrenia?
- A. Hallucinations
- B. Delusions
- C. Alogia
- D. Paranoia
Correct Answer: C
Rationale: Alogia, also known as poverty of speech, is a negative symptom of schizophrenia. It refers to a reduction in the amount of speech or the feeling that one has nothing to say. Hallucinations and delusions are positive symptoms, characterized by the presence of abnormal experiences and beliefs. Paranoia is a symptom involving intense anxious or fearful feelings, which is not classified as a negative symptom of schizophrenia.