Nursing Elites

1. A client with major depressive disorder is prescribed an antidepressant. Which of the following instructions should the nurse exclude from the teaching?

• A. It may take several weeks for the medication to take effect
• B. Avoid alcohol while taking this medication
• C. Discourage the client from washing her hands
• D. You may experience an increase in energy before your mood improves

Correct answer: C

Rationale: The nurse should not include the instruction to discourage the client from washing her hands in the teaching for a client prescribed an antidepressant. This instruction is not relevant to the medication regimen. Instead, the nurse should educate the client that it may take several weeks for the medication to take effect, to avoid alcohol, not to discontinue the medication abruptly, and that there may be an increase in energy before mood improves. Regular blood tests are not typically required for most antidepressants.

2. When developing a care plan for a client with generalized anxiety disorder (GAD), which of the following interventions should not be included?

• A. Encourage the client to avoid anxiety-provoking situations.
• B. Teach the client relaxation techniques.
• C. Encourage the client to express their feelings.
• D. Provide a structured daily routine.

Correct answer: A

Rationale: Avoiding anxiety-provoking situations is not a recommended intervention in caring for a client with generalized anxiety disorder (GAD) as it can reinforce the client's anxiety. Exposing the client gradually to feared situations can help reduce anxiety in the long term through techniques like cognitive-behavioral therapy. Teaching relaxation techniques helps the client manage stress and anxiety effectively. Encouraging the client to express their feelings promotes emotional processing and reduces internal tension. Providing a structured daily routine can offer predictability and stability, which are beneficial for individuals with GAD.

3. Which of the following are therapeutic communication techniques that a healthcare provider can use when interacting with clients? Select one that does not apply.

• A. Using Noise
• B. Offering self
• C. Giving advice
• D. Providing reassurance

Correct answer: C

Rationale: Therapeutic communication techniques aim to promote a therapeutic relationship and client well-being. Using noise is a non-therapeutic technique that can hinder effective communication. Offering self, providing reassurance, and using silence are considered therapeutic. However, giving advice is often seen as non-therapeutic as it can diminish client autonomy and hinder problem-solving skills.

4. When caring for a client with anorexia nervosa in a psychiatric unit, which intervention should the nurse implement to address the client's nutritional needs?

• A. Provide small, frequent meals throughout the day.
• B. Monitor the client's weight daily.
• C. Offer a liquid supplement if the client refuses solid food.
• D. Encourage the client to choose from a variety of food options.

Correct answer: A

Rationale: Providing small, frequent meals throughout the day is a crucial intervention when caring for a client with anorexia nervosa. This approach helps in gradually increasing caloric intake and meeting the client's nutritional needs. Offering large meals can be overwhelming and may contribute to anxiety in these clients. By providing small, frequent meals, the nurse supports the client in establishing a healthier eating pattern and aids in the restoration of adequate nutrition levels. Monitoring the client's weight daily (Choice B) may exacerbate anxiety related to body image and weight, which are common concerns in anorexia nervosa. Offering a liquid supplement if the client refuses solid food (Choice C) may not address the underlying issues related to food aversion and may not provide the necessary nutrients in a balanced way. Encouraging the client to choose from a variety of food options (Choice D) may be overwhelming for someone with anorexia nervosa and could lead to increased anxiety around food choices.

5. In a client's history, a significant indicator suggesting marginal coping skills and the need for careful risk assessment for violence is a history of

• A. childhood trauma.
• B. family involvement.
• C. academic problems.
• D. chemical dependence.

Correct answer: D

Rationale: A history of chemical dependence is a critical factor indicating marginal coping skills and the need for assessing the risk of violence. Substance abuse can impair judgment, increase impulsivity, and escalate the likelihood of violent behavior. It is essential to thoroughly evaluate and address substance abuse issues in clients to enhance treatment outcomes and ensure safety.

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