Nursing Elites

1. A client with generalized anxiety disorder (GAD) is being discharged. Which of the following instructions should the nurse include in the discharge teaching? Select one that does not apply.

• A. Practice relaxation techniques daily
• B. Avoid caffeine and alcohol
• C. Engage in regular physical activity
• D. Use benzodiazepines as the first line of treatment

Correct answer: D

Rationale: When discharging a client with GAD, it is important to provide instructions that promote holistic well-being and support without exacerbating the condition. Practicing relaxation techniques daily, avoiding caffeine and alcohol, and engaging in regular physical activity can help manage anxiety symptoms effectively. These strategies focus on self-care and healthy lifestyle choices. Seeking support from friends and family also plays a crucial role in maintaining mental health. However, using benzodiazepines as the first line of treatment is not recommended due to their potential for dependence and other associated risks. Non-pharmacological interventions and therapy are usually preferred as initial approaches in managing GAD. Therefore, the option 'D: Use benzodiazepines as the first line of treatment' is incorrect and should not be included in the discharge teaching for a client with GAD.

2. A healthcare provider is providing care for a patient with generalized anxiety disorder (GAD) who has been prescribed an SSRI. Which SSRI is commonly used for this condition?

• A. Methylphenidate
• B. Sertraline
• C. Lithium
• D. Haloperidol

Correct answer: B

Rationale: The correct answer is B: Sertraline. Sertraline, an SSRI, is commonly used to treat generalized anxiety disorder (GAD) due to its efficacy and tolerability. Methylphenidate is a central nervous system stimulant used for ADHD and narcolepsy, not for GAD. Lithium is mainly used for bipolar disorder, not for GAD. Haloperidol is an antipsychotic medication, not typically used for GAD.

3. A healthcare professional is assessing a client with suspected substance use disorder. Which of the following findings should the healthcare professional not expect?

• A. Neglect of responsibilities
• B. Increased tolerance to the substance
• C. Withdrawal symptoms when not using the substance
• D. Unsuccessful attempts to cut down or control use

Correct answer: B

Rationale: Findings in a client with substance use disorder typically include neglect of responsibilities, withdrawal symptoms when not using the substance, and unsuccessful attempts to cut down or control use. Increased tolerance to the substance is a common phenomenon in substance use disorder and is expected as the individual requires higher doses to achieve the same effect.

4. Which intervention should the nurse implement when caring for a patient demonstrating manic behavior? Select one that doesn't apply.

• A. Monitor the patient's vital signs frequently.
• B. Keep the patient distracted with group-oriented activities.
• C. Provide the patient with frequent milkshakes and protein drinks.
• D. Reduce the volume on the television and dim bright lights in the environment.

Correct answer: B

Rationale: When caring for a patient demonstrating manic behavior, it is crucial to monitor vital signs frequently to ensure the patient's physical health is stable. Providing nutrition, such as milkshakes and protein drinks, is essential to meet the patient's dietary needs. Diminishing environmental stimuli by reducing the volume on the television and dimming bright lights can help create a calmer environment. However, keeping the patient distracted with group-oriented activities may not be the most appropriate intervention as it could potentially exacerbate the manic behavior by overstimulating the patient. Therefore, this choice is the one that doesn't apply in managing manic behavior effectively.

5. A nurse is providing discharge instructions to a client who has been prescribed fluoxetine (Prozac). Which information should the nurse include?

• A. Take the medication with food to avoid stomach upset.
• B. Avoid drinking alcohol while taking this medication.
• C. Report any unusual side effects to the healthcare provider.
• D. It may take several weeks for this medication to take effect.

Correct answer: B

Rationale: Clients taking fluoxetine (Prozac) should avoid alcohol to prevent adverse interactions.

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