Nursing Elites

1. A healthcare professional is assessing a client who is experiencing severe anxiety. Which of the following symptoms should the healthcare professional expect to observe?

• A. Restlessness
• B. Rapid heart rate
• C. Sweating
• D. Dry mouth

Correct answer: B

Rationale: Rapid heart rate is a characteristic symptom of severe anxiety due to the body's fight-or-flight response being activated. This physiological response leads to an increased heart rate to prepare the body to deal with perceived threats. Healthcare professionals should be vigilant in monitoring and managing this symptom in clients experiencing severe anxiety.

2. 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.

3. A client with obsessive-compulsive disorder (OCD) spends hours each day washing her hands. Which intervention should the nurse implement to help the client reduce this behavior?

• A. Encourage the client to set a time limit for washing hands.
• B. Encourage the client to wash hands only when necessary.
• C. Encourage the client to use hand sanitizer instead of washing.
• D. Encourage the client to explore the reasons behind the hand washing.

Correct answer: A

Rationale: Setting a time limit for hand washing is an effective intervention in managing obsessive-compulsive disorder (OCD) symptoms. By establishing boundaries around the behavior, the client can gradually work towards reducing the excessive hand washing and regaining control over the compulsion. Choice B is not as effective because it does not address the underlying compulsion. Choice C may not be helpful as it may not satisfy the client's need for cleanliness and could reinforce the behavior. Choice D, while important in therapy, may not be the most immediate intervention needed to address the excessive hand washing behavior.

4. When educating a client prescribed diazepam for anxiety, which statement indicates an accurate understanding of the medication?

• A. I should take this medication only when I feel anxious.
• B. I should avoid drinking alcohol while taking this medication.
• C. I should avoid driving until I know how this medication affects me.
• D. I can stop taking this medication abruptly if I feel better.

Correct answer: B

Rationale: The correct answer is B. Clients prescribed diazepam for anxiety should avoid drinking alcohol while taking this medication. Alcohol can potentiate the side effects of diazepam, such as drowsiness and dizziness, increasing the risk of harm. Choice A is incorrect because diazepam is typically taken regularly as prescribed, not just when feeling anxious. Choice C is also important but not directly related to the medication itself. Choice D is dangerous advice; stopping diazepam abruptly can lead to withdrawal symptoms and should only be done under medical supervision.

5. The healthcare provider is providing medication education to a patient who has been prescribed lithium to stabilize mood. Which early signs and symptoms of toxicity should the healthcare provider stress to the patient? Select one that does not apply.

• A. Increased attentiveness
• B. Getting up at night to urinate
• C. Improved vision
• D. An upset stomach for no apparent reason

Correct answer: C

Rationale: Early signs of lithium toxicity include gastrointestinal upset, tremors, increased urination, and increased thirst. Improved vision is not a typical early sign of lithium toxicity and should be ruled out as a symptom to watch for.

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