Nursing Elites

1. A client with schizophrenia is being discharged with a prescription for risperidone (Risperdal). What is the most important instruction for the nurse to provide?

• A. Stop taking the medication if you start feeling better.
• B. Be aware of the potential for weight gain with this medication.
• C. Report any unusual muscle movements immediately.
• D. You can drive as soon as you feel ready.

Correct answer: C

Rationale: The correct answer is C: "Report any unusual muscle movements immediately." Unusual muscle movements may indicate extrapyramidal symptoms (EPS) or tardive dyskinesia, which are serious side effects of antipsychotic medications like risperidone. It is crucial to address these symptoms promptly to prevent long-term effects. Choice A is incorrect because stopping the medication suddenly can be dangerous and should only be done under medical supervision. Choice B, while important, is not the most critical instruction in this scenario. Choice D is also incorrect as the ability to drive may be affected by the medication and should be discussed with a healthcare provider.

2. A client with schizophrenia is being discharged with a prescription for risperidone (Risperdal). What is the most important information for the nurse to provide?

• A. You need to have regular blood tests while taking this medication.
• B. Report any muscle stiffness or unusual movements immediately.
• C. Avoid foods high in tyramine while taking this medication.
• D. This medication may cause weight loss.

Correct answer: B

Rationale: The correct answer is B: "Report any muscle stiffness or unusual movements immediately." This information is crucial because muscle stiffness or unusual movements may indicate extrapyramidal symptoms (EPS), a potential side effect of risperidone that requires immediate attention. Choice A is less critical as regular blood tests are important but not as urgent as identifying EPS. Choice C is irrelevant as tyramine interactions are not associated with risperidone. Choice D is incorrect as weight gain is more common than weight loss with risperidone.

3. A female client is admitted to the psychiatric unit with a diagnosis of anorexia nervosa. What is the priority nursing intervention?

• A. Monitor the client's vital signs regularly.
• B. Encourage the client to participate in group therapy.
• C. Offer the client frequent, high-calorie snacks.
• D. Weigh the client daily at the same time.

Correct answer: D

Rationale: The correct answer is to weigh the client daily at the same time. Daily weights are crucial in monitoring the client's nutritional status and guiding treatment for weight restoration in anorexia nervosa. Monitoring vital signs is important but weighing the client daily takes precedence in this situation. Encouraging group therapy and offering high-calorie snacks are important aspects of treatment but do not take priority over monitoring the client's weight.

4. A 45-year-old female client is admitted to the psychiatric unit for evaluation. Her husband states that she has been reluctant to leave home for the last six months. The client has not gone to work for a month and has been terminated from her job. She has not left the house since that time. This client is displaying symptoms of what condition?

• A. Claustrophobia
• B. Acrophobia
• C. Agoraphobia
• D. Post-traumatic stress disorder

Correct answer: C

Rationale: The correct answer is C: Agoraphobia. Agoraphobia is the fear of crowds or being in open places, often leading individuals to avoid situations where they feel trapped, insecure, or out of control. In the case described, the client's reluctance to leave home, avoidance of work, and isolation within the house are indicative of agoraphobia. Claustrophobia (A) is the fear of closed places, while acrophobia (B) is the fear of high places. Post-traumatic stress disorder (D) involves the development of anxiety symptoms following a traumatic event, characterized by terror, fear, and helplessness, and is different from a phobia.

5. A LPN/LVN is performing a follow-up teaching session with a client discharged 1 month ago. The client is taking fluoxetine (Prozac). What information would be important for the nurse to obtain during this client visit regarding the side effects of the medication?

• A. Cardiovascular symptoms
• B. Gastrointestinal dysfunctions
• C. Problems with mouth dryness
• D. Problems with excessive sweating

Correct answer: B

Rationale: The correct answer is B: 'Gastrointestinal dysfunctions.' Fluoxetine commonly causes gastrointestinal side effects such as nausea, diarrhea, or constipation. These symptoms can significantly impact the client's quality of life and adherence to the medication regimen. Monitoring gastrointestinal issues is crucial for the nurse to ensure the client's well-being and optimize treatment outcomes. Choices A, C, and D are incorrect because cardiovascular symptoms, problems with mouth dryness, and problems with excessive sweating are not typically associated with fluoxetine use and are less likely to be a focus of concern during this client visit.

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