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Which of the following interventions is most effective in managing a patient with obsessive-compulsive disorder (OCD)?
- A. Encouraging the patient to engage in repetitive behaviors.
- B. Helping the patient to understand that their thoughts are irrational.
- C. Providing the patient with a structured daily routine.
- D. Allowing the patient to avoid situations that trigger their obsessions.
Correct Answer: B
Rationale: The most effective intervention in managing a patient with obsessive-compulsive disorder (OCD) is helping the patient to understand that their thoughts are irrational. This cognitive-behavioral approach can assist in reducing the frequency and intensity of obsessive thoughts and compulsive behaviors by challenging and reframing maladaptive beliefs and thought patterns associated with OCD. Encouraging the patient to engage in repetitive behaviors (choice A) reinforces the compulsive behavior rather than addressing the underlying issue. Providing a structured daily routine (choice C) may help in some cases but does not directly target the irrational thoughts and beliefs. Allowing the patient to avoid trigger situations (choice D) can provide temporary relief but does not address the core problem of irrational thoughts and behaviors.
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A patient with major depressive disorder has been prescribed sertraline (Zoloft). Which statement by the patient indicates a need for further teaching?
- A. I should take my medication with food to avoid stomach upset.
- B. I should avoid alcohol while taking this medication.
- C. I can stop taking my medication once I feel better.
- D. I might experience some improvement in mood within a few weeks.
Correct Answer: C
Rationale: Choice C is the correct answer. It is crucial for patients to understand that they should not stop taking their medication once they feel better. Discontinuing antidepressants abruptly can lead to a relapse of depressive symptoms. Patients should continue taking their medication as prescribed by their healthcare provider, even if they start feeling better, to ensure the best outcomes in managing major depressive disorder. Choices A, B, and D are all accurate statements. Taking medication with food can help reduce stomach upset, avoiding alcohol is essential while on sertraline to prevent interactions, and experiencing some improvement in mood within a few weeks is a common expectation when starting an antidepressant like sertraline.
A patient with generalized anxiety disorder (GAD) is prescribed buspirone. Which statement by the patient indicates a need for further teaching?
- A. I can take this medication on an as-needed basis.
- B. It may take a few weeks to feel the full effect of this medication.
- C. This medication has a lower risk of dependency compared to benzodiazepines.
- D. I should take this medication consistently every day.
Correct Answer: A
Rationale: The correct answer is A. Buspirone is not meant to be taken on an as-needed basis. It should be taken consistently every day to achieve the desired therapeutic effect. Choice B is correct as it accurately reflects that buspirone may take a few weeks to reach its full effect. Choice C is also correct as buspirone indeed has a lower risk of dependency compared to benzodiazepines. Choice D is correct because taking buspirone consistently every day is the appropriate way to use this medication.
Which nursing response provides accurate information to discuss with the female patient diagnosed with bipolar disorder and her support system?
- A. Remember that alcohol and caffeine can trigger a relapse of your symptoms.
- B. Antidepressant therapy should be carefully monitored due to the risk of a manic episode in bipolar disorder.
- C. It's crucial to inform your healthcare provider promptly if you experience sleep disturbances.
- D. Are your family members prepared to play an active role in helping manage this disorder?
Correct Answer: A
Rationale: Choice A is the correct answer as it emphasizes the importance of avoiding triggers like alcohol and caffeine that can lead to symptom relapse in patients with bipolar disorder. Educating the patient and their support system about these triggers is essential for managing the condition effectively and preventing exacerbations of symptoms. Choice B is incorrect as it overly focuses on antidepressant therapy, which is not the primary concern related to triggers for symptom relapse. Choice C, while important, does not directly address triggers for symptom relapse in bipolar disorder. Choice D is also relevant but does not provide immediate information on managing triggers for symptom relapse.
The nurse is providing medication education to a patient who has been prescribed lithium to stabilize mood. Which early signs and symptoms of toxicity should the nurse stress to the patient?
- A. Increased attentiveness
- B. Getting up at night to urinate
- C. Improved vision
- D. An upset stomach for no apparent reason
Correct Answer: D
Rationale: The correct early sign of lithium toxicity that the nurse should stress to the patient is an upset stomach for no apparent reason. Early signs of lithium toxicity often manifest as gastrointestinal symptoms such as nausea, vomiting, and diarrhea. This can serve as an important indicator for the patient to seek medical attention promptly to prevent further complications. Choices A, B, and C are incorrect. Increased attentiveness, getting up at night to urinate, and improved vision are not early signs of lithium toxicity. It is crucial for the nurse to educate the patient on recognizing gastrointestinal symptoms as potential indicators of toxicity.
A patient with borderline personality disorder is admitted to the psychiatric unit. Which behavior is most characteristic of this disorder?
- A. Avoiding social interactions due to fear of rejection.
- B. Engaging in impulsive and self-destructive behaviors.
- C. Having a grandiose sense of self-importance.
- D. Exhibiting a pattern of unstable relationships.
Correct Answer: B
Rationale: Borderline personality disorder is characterized by impulsivity and self-destructive behaviors, such as substance abuse, reckless driving, and self-harm. These behaviors are often used to cope with intense emotional distress and are a key feature of this disorder. While individuals with borderline personality disorder may also struggle with unstable relationships, the hallmark feature that sets it apart is the impulsivity and self-destructive behaviors. Avoiding social interactions due to fear of rejection is more characteristic of avoidant personality disorder. Having a grandiose sense of self-importance is a feature of narcissistic personality disorder.