Nursing Elites

1. A client with bipolar disorder is experiencing a depressive episode. Which nursing intervention is most appropriate?

• A. Encourage the client to avoid physical activity.
• B. Encourage the client to engage in social activities.
• C. Encourage the client to participate in group therapy.
• D. Encourage the client to set realistic goals.

Correct answer: C

Rationale: Encouraging the client to participate in group therapy is the most appropriate nursing intervention for a client with bipolar disorder experiencing a depressive episode. Group therapy provides a supportive environment where the client can share experiences, learn coping strategies, and receive emotional support from peers and mental health professionals. It can help reduce feelings of isolation, improve social skills, and enhance overall well-being. Group therapy also promotes a sense of belonging and understanding, which are essential for individuals dealing with bipolar disorder and depressive symptoms. Choices A, B, and D are not the most appropriate interventions for a client experiencing a depressive episode in bipolar disorder. Encouraging the client to avoid physical activity may worsen their symptoms, promoting social activities may not address the underlying issues effectively, and setting goals may be overwhelming during a depressive episode.

2. Which neurotransmitter is primarily implicated in the development of schizophrenia?

• A. Serotonin
• B. Norepinephrine
• C. Dopamine
• D. Acetylcholine

Correct answer: C

Rationale: The correct answer is dopamine. Dopamine dysregulation is a key factor in the development of schizophrenia. Excess dopamine activity in certain brain regions is associated with positive symptoms of schizophrenia, such as hallucinations and delusions. Dopaminergic medications that reduce dopamine levels are often used to manage these symptoms, further supporting the role of dopamine in schizophrenia. Serotonin (Choice A) is more commonly associated with mood regulation and is implicated in depression and anxiety disorders. Norepinephrine (Choice B) is involved in the body's 'fight or flight' response and is linked to conditions like anxiety and PTSD. Acetylcholine (Choice D) plays a role in muscle movement and memory but is not primarily implicated in schizophrenia.

3. A healthcare professional is assessing a client diagnosed with narcissistic personality disorder. Which of the following behaviors should the healthcare professional expect?

• A. Grandiose sense of self-importance
• B. Lack of empathy
• C. Need for excessive admiration
• D. Envy of others

Correct answer: A

Rationale: Clients with narcissistic personality disorder often exhibit a grandiose sense of self-importance, believing they are special and unique. This behavior is characterized by an exaggerated sense of achievements and talents, expecting to be recognized as superior without commensurate achievements. While individuals with this disorder may lack empathy and have a need for excessive admiration, the prominent feature of grandiosity is a core aspect of narcissistic personality disorder. Therefore, the correct behavior expected in this case is a grandiose sense of self-importance (Choice A). Lack of empathy (Choice B) and need for excessive admiration (Choice C) are also common traits in narcissistic personality disorder, but they are not the primary behavior associated with the disorder. Envy of others (Choice D) is not a characteristic behavior typically seen in individuals with narcissistic personality disorder.

4. A healthcare professional is providing education to the family of a client who has been diagnosed with schizophrenia. Which of the following instructions should the healthcare professional include?

• A. Encourage the client to participate in daily activities.
• B. Encourage the client to express their feelings.
• C. Encourage the client to avoid caffeine.
• D. Encourage the client to spend time alone.

Correct answer: A

Rationale: Encouraging the client to participate in daily activities is crucial in managing schizophrenia. Engaging in activities can enhance the quality of life and reduce symptoms by providing structure, routine, and social interaction, which are beneficial for individuals with schizophrenia. Choices B, C, and D are not the most appropriate instructions for managing schizophrenia. While expressing feelings can be helpful, daily activities have a more significant impact on managing the condition. Avoiding caffeine and spending time alone are not directly related to managing schizophrenia and may not be the most beneficial strategies.

5. A client prescribed sertraline for depression is receiving discharge instructions. Which statement by the client indicates an accurate understanding of the medication?

• A. I should take this medication at bedtime to avoid nausea.
• B. I should avoid drinking alcohol while taking this medication.
• C. I should take this medication with food to avoid stomach upset.
• D. It may take several weeks for this medication to be effective.

Correct answer: D

Rationale: The correct answer is D because sertraline, used for depression, typically takes several weeks to become effective. It is important for clients to understand this delayed onset of action to manage their expectations and continue taking the medication as prescribed despite not seeing immediate results.

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