Nursing Elites

1. A healthcare professional is assessing a client who appears to be experiencing moderate anxiety during questioning. Which symptom shouldn't the healthcare professional expect?

• A. Fidgeting
• B. Laughing inappropriately
• C. Palpitations
• D. Nail biting

Correct answer: C

Rationale: Palpitations are not typically associated with moderate anxiety. Fidgeting, laughing inappropriately, and nail biting are common behavioral symptoms of heightened stress levels. Palpitations may be more indicative of physiological responses, such as increased heart rate, which can occur in severe anxiety or panic attacks. Other signs of severe anxiety include restlessness, difficulty concentrating, muscle tension, and sleep disturbances.

2. A healthcare provider is evaluating the effectiveness of medication therapy for a client diagnosed with bipolar disorder. Which outcome should indicate that the medication has been effective?

• A. The client reports a decrease in manic episodes.
• B. The client experiences fewer mood swings.
• C. The client sleeps for 8 hours each night.
• D. The client maintains a stable weight.

Correct answer: A

Rationale: A decrease in manic episodes is a key indicator of the effectiveness of medication therapy for bipolar disorder. Manic episodes are a hallmark of bipolar disorder, and a decrease in their frequency or intensity suggests that the medication is helping to stabilize the client's mood and manage their symptoms. While choices B, C, and D are important aspects of overall health and well-being, they are not specific indicators of the effectiveness of medication therapy for bipolar disorder. Choice B focuses on mood swings in general, which may include depressive episodes as well, while choice C addresses sleep patterns and choice D relates to weight stability, which can be influenced by various factors unrelated to bipolar disorder treatment.

3. A client with schizophrenia is prescribed an antipsychotic medication. Which of the following side effects shouldn't the nurse monitor for?

• A. Tardive dyskinesia
• B. Decreased need for sleep
• C. Orthostatic hypotension
• D. Hyperglycemia

Correct answer: B

Rationale: The correct answer is B, 'Decreased need for sleep.' While antipsychotic medications can cause side effects like tardive dyskinesia, orthostatic hypotension, and hyperglycemia, a decreased need for sleep is not a common side effect. It is important for the nurse to monitor the client for the known side effects of antipsychotic medications to ensure early detection and appropriate management.

4. A client with major depressive disorder is receiving cognitive-behavioral therapy (CBT). Which outcome indicates that the therapy is effective?

• A. The client identifies and challenges negative thoughts.
• B. The client reports an increase in suicidal thoughts.
• C. The client experiences an increase in anxiety.
• D. The client shows no change in behavior.

Correct answer: A

Rationale: In cognitive-behavioral therapy, identifying and challenging negative thoughts is a fundamental aspect of the treatment process. This cognitive restructuring helps individuals with major depressive disorder to develop healthier thinking patterns and cope more effectively with their emotions, which ultimately leads to improvement in their mental health. Therefore, when a client is able to identify and challenge negative thoughts, it indicates that they are actively engaging in the therapeutic process and making progress towards better mental well-being.

5. Which statement made by the patient demonstrates an understanding of the effective use of newly prescribed lithium to manage bipolar mania? Select one that doesn't apply.

• A. I remind myself to consistently drink six 12-ounce glasses of fluid every day.
• B. I discussed the diuretic prescribed by my cardiologist with my psychiatric care provider.
• C. Lithium may help me lose the few extra pounds I tend to carry around.
• D. I take my lithium on an empty stomach to help with absorption.

Correct answer: C

Rationale: Proper hydration, discussing other medications, and taking lithium with or without food are important for effective and safe use of lithium. However, lithium is not prescribed for weight loss, and its usage should not be associated with losing extra pounds.

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