Nursing Elites

1. A client diagnosed with major depressive disorder is prescribed an SSRI. Which side effect should the nurse monitor for in the initial weeks of treatment?

• A. Weight loss
• B. Increased risk of suicide
• C. Hypertension
• D. Photosensitivity

Correct answer: B

Rationale: When a client is prescribed an SSRI for major depressive disorder, the nurse should closely monitor for an increased risk of suicide, especially in younger patients, during the initial weeks of treatment. SSRIs may initially increase energy levels before improving mood, which can lead to a higher risk of suicide in some individuals. Weight loss is not a common side effect of SSRIs and may actually be a concern for some patients with major depressive disorder who experience appetite changes. Hypertension is not typically associated with SSRIs, and photosensitivity is not a common side effect of this class of medications.

2. Which of the following is a common side effect of electroconvulsive therapy (ECT)?

• A. Memory loss
• B. Weight gain
• C. Insomnia
• D. Increased appetite

Correct answer: A

Rationale: Memory loss, particularly short-term memory loss, is a common side effect of electroconvulsive therapy (ECT). ECT can affect memory due to its impact on brain function during and after treatment. While the memory issues are often temporary and tend to improve over time, they are important considerations when discussing the risks and benefits of ECT with patients. Choices B, C, and D are incorrect as weight gain, insomnia, and increased appetite are not common side effects of ECT.

3. When educating the family of a client diagnosed with dissociative identity disorder, which of the following instructions should the nurse include?

• A. Encourage the client to avoid stressful situations.
• B. Encourage the client to participate in daily activities.
• C. Encourage the client to express their feelings.
• D. Encourage the client to develop a daily routine.

Correct answer: D

Rationale: In cases of dissociative identity disorder, it is beneficial for the client to establish a daily routine. This structure can enhance symptom management and provide a sense of stability, which is particularly important for individuals with this condition. Encouraging the client to avoid stressful situations (Choice A) may not always be possible and does not address the need for structure. While encouraging the client to participate in daily activities (Choice B) is important, having a routine is more crucial for managing dissociative identity disorder. Expressing feelings (Choice C) is valuable but establishing a routine takes precedence in this situation.

4. A client is experiencing panic attacks. Which intervention should the nurse implement to help the client manage anxiety?

• A. Encourage the client to avoid situations that trigger anxiety.
• B. Encourage the client to practice deep breathing exercises.
• C. Encourage the client to take anti-anxiety medication as prescribed.
• D. Encourage the client to engage in regular physical activity.

Correct answer: B

Rationale: During panic attacks, deep breathing exercises can help the client manage anxiety effectively by promoting relaxation and reducing the intensity of symptoms. Encouraging the client to practice deep breathing can provide a quick and accessible strategy to cope with the immediate distress of a panic attack. Choices A, C, and D are incorrect because avoiding triggering situations may reinforce avoidance behavior, anti-anxiety medication is not the first-line intervention during a panic attack, and engaging in physical activity may not be feasible or effective during an acute episode of panic.

5. 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.

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