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When working with a patient diagnosed with posttraumatic stress disorder (PTSD), which therapeutic approach is most appropriate?
- A. Encouraging the patient to avoid discussing the traumatic event.
- B. Using exposure therapy to help the patient confront their fears.
- C. Advising the patient to focus on positive thoughts.
- D. Suggesting that the patient keep busy to distract from traumatic memories.
Correct Answer: B
Rationale: Exposure therapy is an evidence-based treatment for PTSD that involves gradually exposing the patient to their traumatic memories in a safe and controlled environment. This approach helps individuals confront and process their fears, reducing the impact of the traumatic event over time. Avoiding discussing the trauma (choice A) may lead to avoidance behaviors and hinder recovery. Focusing on positive thoughts (choice C) may provide temporary relief but does not address the underlying trauma. Keeping busy to distract from memories (choice D) is a form of avoidance that does not help in processing the traumatic experiences. Therefore, using exposure therapy (choice B) is the most appropriate approach to effectively treat PTSD.
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When developing a care plan for a patient with generalized anxiety disorder (GAD), which long-term goal is most appropriate?
- A. The patient will experience no episodes of anxiety.
- B. The patient will recognize and modify anxiety-provoking thoughts.
- C. The patient will avoid situations that cause anxiety.
- D. The patient will take medication as prescribed.
Correct Answer: B
Rationale: The most appropriate long-term goal for managing generalized anxiety disorder is for the patient to recognize and modify anxiety-provoking thoughts. By addressing and modifying these thoughts, the patient can develop coping mechanisms and strategies to manage their anxiety more effectively in the long term. Choices A and C are not ideal long-term goals as complete elimination of anxiety episodes or avoidance of anxiety-provoking situations may not be realistic or sustainable. Choice D focuses solely on medication adherence, which is important but does not address the core cognitive-behavioral aspects of managing anxiety in GAD.
A patient diagnosed with dissociative identity disorder has been undergoing therapy for several months. Which outcome indicates that the patient is progressing in therapy?
- A. The patient has developed a strong therapeutic relationship with the therapist.
- B. The patient's different personalities are beginning to merge.
- C. The patient is able to recall traumatic events without dissociating.
- D. The patient reports fewer gaps in memory.
Correct Answer: B
Rationale: In dissociative identity disorder, the merging of different personalities is a crucial indicator of progress in therapy. As the different identities merge, it signifies that the patient is integrating fragmented aspects of their self, leading to a more cohesive sense of identity and a reduction in dissociative symptoms. This process is a significant therapeutic milestone in the treatment of dissociative identity disorder as it promotes internal cohesion and decreases internal conflict. Choices A, C, and D are incorrect because while developing a strong therapeutic relationship, recalling traumatic events without dissociating, and reporting fewer gaps in memory are important aspects of therapy, the merging of different personalities is specifically indicative of substantial progress in treating dissociative identity disorder.
A patient with obsessive-compulsive disorder (OCD) is under the care of a nurse. Which intervention is most appropriate?
- A. Encourage the patient to suppress their compulsive behaviors.
- B. Allow the patient to perform their rituals, then gradually limit the time spent on these rituals.
- C. Discourage the patient from discussing their obsessions.
- D. Avoid setting limits on the patient's compulsive behaviors.
Correct Answer: B
Rationale: In managing a patient with OCD, it is crucial to allow them to perform their rituals while gradually limiting the time spent on these rituals. This approach helps the patient feel supported while working towards reducing the compulsive behaviors. Choice A is incorrect because suppressing compulsive behaviors can increase anxiety and distress. Choice C is inappropriate as discussing obsessions is part of therapy. Choice D is not recommended as setting limits on compulsive behaviors is essential for treatment.
What is a common side effect of benzodiazepines prescribed for anxiety?
- A. Weight gain
- B. Insomnia
- C. Drowsiness
- D. Increased appetite
Correct Answer: C
Rationale: The correct answer is C: Drowsiness. Benzodiazepines, commonly prescribed for anxiety, often cause drowsiness as a side effect due to their sedative properties. This can lead to impairments in cognitive and motor skills, making it important for individuals on these medications to exercise caution when performing tasks that require alertness, such as driving or operating machinery. Choices A, B, and D are incorrect because weight gain, insomnia, and increased appetite are not typically associated with benzodiazepines; instead, drowsiness and sedation are more commonly reported side effects.
What is the priority intervention for a patient admitted for an overdose of sedatives and diagnosed with dissociative identity disorder?
- A. Conducting a suicide assessment
- B. Arranging for placement in a group home
- C. Providing a low-stimulation environment
- D. Establishing trust and rapport
Correct Answer: A
Rationale: Conducting a suicide assessment is the priority intervention for a patient admitted for an overdose of sedatives and diagnosed with dissociative identity disorder. In this scenario, the immediate concern is to assess the risk of harm to the patient's life. It is crucial to determine if the overdose was intentional and if the patient has suicidal ideation or intent. Arranging for placement in a group home (choice B) may be necessary at a later stage depending on the patient's needs, but it is not the priority in this urgent situation. Providing a low-stimulation environment (choice C) and establishing trust and rapport (choice D) are important aspects of care but addressing the immediate risk of suicide takes precedence in this case.