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. Which intervention would be appropriate for assisting a client diagnosed with major depressive disorder?

• A. Encourage discussion of feelings
• B. Offer family therapy sessions
• C. Discuss childhood events
• D. Teach alternate coping skills

Correct answer: B

Rationale: Offering family therapy sessions would be the most appropriate intervention for a client diagnosed with major depressive disorder. Family therapy can be beneficial as it addresses interpersonal relationships within the family system, which is crucial in managing major depressive disorder effectively. This approach aligns with Sullivan's interpersonal theory, which emphasizes the impact of interpersonal relationships on individual behavior and personality development. In contrast, encouraging discussion of feelings, discussing childhood events, or teaching alternate coping skills may not directly address the interpersonal dynamics contributing to the client's major depressive disorder.

3. 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.

4. A patient with panic disorder is prescribed a benzodiazepine. The nurse should educate the patient that this medication is typically used for:

• A. For long-term maintenance therapy.
• B. As a first-line treatment.
• C. For short-term use due to the risk of dependence.
• D. To treat depression symptoms.

Correct answer: C

Rationale: The correct answer is C: 'For short-term use due to the risk of dependence.' Benzodiazepines are usually prescribed for short-term relief of anxiety symptoms due to the risk of dependence. Prolonged use can lead to tolerance, dependence, and other adverse effects, so they are not typically used for long-term maintenance therapy (choice A). They are not considered first-line treatments for panic disorder (choice B) and are not primarily used to treat depression symptoms (choice D), as their main indication is for anxiety and panic disorders.

5. Which characteristic in an adolescent female is sometimes associated with the prodromal phase of schizophrenia?

• A. Constantly afraid another student will steal her belongings.
• B. An unusual interest in numbers and specific topics.
• C. Demonstrates no interest in athletics or organized sports.
• D. Appears more comfortable among males.

Correct answer: B

Rationale: During the prodromal phase of schizophrenia, individuals may exhibit subtle changes in behavior or interests. An unusual interest in numbers and specific topics may be a sign of cognitive disturbances that can precede the onset of schizophrenia. While the other choices may also be observed in adolescents, an unusual interest in numbers and specific topics is more specifically linked to potential prodromal symptoms of schizophrenia.

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