Nursing Elites

1. When assessing a client diagnosed with anorexia nervosa, which of the following findings should the nurse expect? Select one that does not apply.

• A. Amenorrhea
• B. Lanugo
• C. Hypotension
• D. Hyperkalemia

Correct answer: D

Rationale: In a client diagnosed with anorexia nervosa, expected findings include amenorrhea, lanugo, hypotension, and bradycardia. Hyperkalemia is not typically associated with anorexia nervosa; instead, hypokalemia, which is low potassium levels, is more common. Hypokalemia can result from decreased intake of potassium-rich foods or excessive purging behaviors commonly seen in individuals with anorexia nervosa.

2. A client with schizophrenia is experiencing delusions. Which intervention should the nurse implement to address this symptom?

• A. Encourage the client to ignore the delusions.
• B. Provide reality-based feedback to the client.
• C. Distract the client from the delusions.
• D. Encourage the client to discuss the delusions.

Correct answer: B

Rationale: When a client with schizophrenia is experiencing delusions, providing reality-based feedback is considered an effective intervention to address this symptom. This approach helps the client differentiate between what is real and what is not real, assisting them in managing their delusions and promoting their overall well-being. Choice A is incorrect because ignoring the delusions does not help the client in distinguishing reality from delusions. Choice C is incorrect as distraction may only provide temporary relief but does not address the underlying issue. Choice D is incorrect because encouraging the client to discuss the delusions may reinforce or intensify them rather than help in managing them effectively.

3. What should the nurse include in patient education for a patient starting on bupropion for major depressive disorder?

• A. Avoid consuming alcohol while taking this medication.
• B. Take the medication in the morning to prevent insomnia.
• C. It may cause significant weight gain.
• D. It is used as a first-line treatment for anxiety.

Correct answer: A

Rationale: Patients prescribed bupropion should be educated to avoid consuming alcohol while on this medication to reduce the risk of seizures. Bupropion lowers the seizure threshold, and alcohol can further increase this risk. It is important for patients to understand the potential consequences of combining bupropion with alcohol to ensure their safety and treatment effectiveness. Choices B, C, and D are incorrect. Taking bupropion in the morning does not prevent insomnia; it is not associated with significant weight gain; and it is not a first-line treatment for anxiety.

4. A patient with major depressive disorder is started on venlafaxine. Which class of antidepressant does this medication belong to?

• A. Selective serotonin reuptake inhibitors (SSRIs)
• B. Tricyclic antidepressants (TCAs)
• C. Monoamine oxidase inhibitors (MAOIs)
• D. Serotonin-norepinephrine reuptake inhibitors (SNRIs)

Correct answer: D

Rationale: Venlafaxine is classified as a serotonin-norepinephrine reuptake inhibitor (SNRI). SNRIs work by increasing the levels of both serotonin and norepinephrine in the brain, which helps alleviate symptoms of depression. This mechanism of action distinguishes SNRIs from other classes of antidepressants like SSRIs, TCAs, and MAOIs, making venlafaxine an effective choice for patients with major depressive disorder. Therefore, the correct answer is D. Choice A, SSRIs, primarily target serotonin reuptake only. Choice B, TCAs, work by inhibiting the reuptake of norepinephrine and serotonin, but they are not as selective as SNRIs. Choice C, MAOIs, inhibit the enzyme monoamine oxidase, leading to increased levels of various neurotransmitters, including serotonin and norepinephrine, but they are typically used as second- or third-line agents due to dietary restrictions and potential side effects.

5. Meditation has been shown to be an effective stress management technique. When meditation is effective, what should a healthcare professional expect to assess?

• A. An achieved state of relaxation
• B. An achieved insight into one's feelings
• C. A demonstration of appropriate role behaviors
• D. An enhanced ability to problem-solve

Correct answer: A

Rationale: Corrected Rationale: When meditation is effective, a healthcare professional should expect to assess an achieved state of relaxation. Meditation is known to facilitate a special state of consciousness through concentrated focus, leading to a sense of calm and relaxation. While meditation can sometimes provide insights into one's feelings, the primary outcome related to stress management is the promotion of relaxation. Choices C and D are not directly related to the typical outcomes of effective meditation for stress management.

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