Nursing Elites

1. A client with major depressive disorder is prescribed an antidepressant. Which of the following instructions should the nurse include in the teaching? Select the one that does not apply.

• A. It may take several weeks for the medication to take effect
• B. Avoid alcohol while taking this medication
• C. Discontinue the medication abruptly
• D. You may experience an increase in energy before your mood improves

Correct answer: C

Rationale: Teaching for a client prescribed an antidepressant should include several key instructions. Firstly, it's important to inform the client that it may take several weeks for the medication to take effect, so they should be patient. Secondly, they should be advised to avoid alcohol while taking the medication as it can interact negatively with antidepressants. Additionally, abrupt discontinuation of antidepressants can lead to withdrawal symptoms and should be avoided. Lastly, clients may experience an increase in energy before their mood improves, which is a common effect of some antidepressants. Regular blood tests are not typically required for most antidepressants, but adherence to the prescribed regimen and reporting any concerning side effects to the healthcare provider are crucial.

2. When assessing a client with bipolar disorder who is experiencing a depressive episode, which of the following findings should the nurse not expect?

• A. Low energy
• B. Feelings of hopelessness
• C. Insomnia or hypersomnia
• D. Difficulty concentrating

Correct answer: D

Rationale: In a client experiencing a depressive episode in bipolar disorder, common findings include low energy, feelings of hopelessness, insomnia or hypersomnia, and decreased appetite. Difficulty concentrating is more indicative of attention deficit disorders or cognitive impairment rather than a typical presentation of a depressive episode in bipolar disorder.

3. For a patient with obsessive-compulsive disorder (OCD) who spends several hours a day washing her hands, which type of therapy is most appropriate?

• A. Exposure and response prevention
• B. Dialectical behavior therapy
• C. Family therapy
• D. Interpersonal therapy

Correct answer: A

Rationale: Exposure and response prevention (ERP) is the most appropriate therapy for managing OCD. ERP involves exposing the patient to anxiety-provoking stimuli (such as touching dirty objects) and preventing the compulsive response (hand washing), thus helping the patient learn to tolerate the anxiety without performing the ritualistic behavior. Dialectical behavior therapy (DBT) focuses more on emotional regulation and interpersonal skills, making it less suitable for directly addressing OCD symptoms. Family therapy and interpersonal therapy may be beneficial for other conditions or relationship issues but are not specifically designed to target OCD symptoms like ERP.

4. A patient diagnosed with bipolar disorder is experiencing a depressive episode. Which medication is commonly prescribed for this phase of the disorder?

• A. Valproic acid
• B. Risperidone
• C. Fluoxetine
• D. Lithium

Correct answer: C

Rationale: The correct answer is C, Fluoxetine. Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), is commonly prescribed to manage the depressive episodes in bipolar disorder. SSRIs are effective in treating the depressive phase of bipolar disorder as they help regulate serotonin levels in the brain, which can improve mood and reduce symptoms of depression. Choice A, Valproic acid, is used more commonly in the treatment of acute mania or mixed episodes in bipolar disorder. Choice B, Risperidone, is an atypical antipsychotic often used to manage psychotic symptoms in bipolar disorder. Choice D, Lithium, is primarily used for the maintenance treatment of bipolar disorder to prevent future manic and depressive episodes.

5. A client has been prescribed sertraline (Zoloft) and is receiving education from a healthcare provider. Which statement by the client indicates an accurate understanding of the medication?

• A. I should take this medication at the same time every day.
• B. It may take several weeks for this medication to be effective.
• C. I should take this medication on an empty stomach.
• D. I should avoid eating aged cheeses and processed meats.

Correct answer: B

Rationale: The correct answer is B. Sertraline (Zoloft) may take several weeks to be effective, so it is important for the client to be informed about this timeframe. This medication does not need to be taken on an empty stomach, but it can be taken with or without food. Choice A is a good practice for many medications but not specifically related to sertraline (Zoloft). Choice D is not directly related to sertraline (Zoloft) but pertains to dietary restrictions when taking MAOIs due to potential interactions with tyramine.

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