Nursing Elites

1. A healthcare professional is assessing a client diagnosed with anorexia nervosa. Which of the following findings shouldn't the professional expect?

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

Correct answer: D

Rationale: When assessing a client diagnosed with anorexia nervosa, healthcare professionals should expect findings such as amenorrhea, lanugo, hypotension, and bradycardia. Hyperkalemia is not typically associated with anorexia nervosa; instead, hypokalemia, which is low potassium levels, is more commonly seen in these individuals due to malnutrition and other factors.

2. In a client with obsessive-compulsive disorder (OCD) undergoing cognitive-behavioral therapy, which outcome indicates that the therapy is effective?

• A. The client reports a decrease in the frequency of compulsive behaviors.
• B. The client reports a decrease in the intensity of obsessive thoughts.
• C. The client reports an improvement in overall mood.
• D. The client reports an improvement in sleep patterns.

Correct answer: A

Rationale: In clients with OCD undergoing cognitive-behavioral therapy, a decrease in the frequency of compulsive behaviors is a key indicator of treatment effectiveness. This reduction signifies progress in managing and controlling the compulsions associated with OCD, which is a primary goal of the therapy. Choices B, C, and D may also be positive outcomes of therapy, but the most critical aspect in treating OCD with cognitive-behavioral therapy is targeting and reducing the frequency of compulsive behaviors.

3. Which statement by the patient indicates a need for further teaching regarding the treatment of major depressive disorder?

• A. I have been on this antidepressant for 3 days. I understand that the full effect may take weeks to occur.
• B. I am going to ask my nurse practitioner to discontinue my Prozac today and let me start taking a monoamine oxidase inhibitor tomorrow.
• C. I may ask to have my medication changed to Wellbutrin due to the problems I am having being romantic with my wife.
• D. I realize that there are many antidepressants and it might take a while until we find the one that works best for me.

Correct answer: B

Rationale: Choice B indicates a need for further teaching because the patient is planning to switch directly from Prozac, an SSRI, to a monoamine oxidase inhibitor (MAOI) without allowing for a washout period. This abrupt switch poses a risk of serotonin syndrome, which can be life-threatening. It is essential to educate the patient about the importance of consulting healthcare providers before changing medications to prevent potential adverse effects.

4. What assessment question will provide information to the healthcare provider regarding the effects of a woman's circadian rhythms on her quality of life?

• A. How much sleep do you usually get each night?
• B. Does your heart ever seem to skip a beat?
• C. When was the last time you had a fever?
• D. Do you have problems urinating?

Correct answer: A

Rationale: The correct assessment question to understand the effects of a woman's circadian rhythms on her quality of life is to inquire about her sleep duration. Circadian rhythms significantly influence sleep patterns, so knowing how much sleep she usually gets each night can provide valuable insight into potential circadian rhythm disturbances and their impact on her overall well-being.

5. When evaluating a client's progress in psychotherapy, which outcome is appropriate for the client?

• A. The client will identify triggers for anxiety.
• B. The client will develop coping strategies.
• C. The client will decrease avoidance behaviors.
• D. The client will express feelings of anger.

Correct answer: A

Rationale: In psychotherapy, identifying triggers for anxiety is a crucial step towards understanding and managing one's anxiety symptoms. By recognizing these triggers, clients can work on developing coping strategies and addressing the root cause of their anxiety, leading to improved mental health outcomes. Decreasing avoidance behaviors and expressing feelings of anger are also important aspects of therapy. However, identifying triggers for anxiety is a more specific and foundational goal in addressing anxiety disorders, making it the most appropriate outcome to evaluate a client's progress in psychotherapy.

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