Nursing Elites

1. When assessing a client with bipolar disorder who is experiencing a depressive episode, which of the following findings should the nurse not expect?

• A. Low energy
• B. Feelings of hopelessness
• C. Insomnia or hypersomnia
• D. Difficulty concentrating

Correct answer: D

Rationale: In a client experiencing a depressive episode in bipolar disorder, common findings include low energy, feelings of hopelessness, insomnia or hypersomnia, and decreased appetite. Difficulty concentrating is more indicative of attention deficit disorders or cognitive impairment rather than a typical presentation of a depressive episode in bipolar disorder.

2. Which activity is most appropriate for a child with ADHD?

• A. Reading an adventure novel
• B. Monopoly
• C. Checkers
• D. Tennis

Correct answer: D

Rationale: Engaging in physical activities like tennis is beneficial for children with ADHD as it allows them to release excess energy and enhance concentration. Exercise can help improve focus and reduce hyperactivity in children with ADHD.

3. What information should the nurse include in patient education for a patient prescribed fluoxetine for obsessive-compulsive disorder (OCD)?

• A. Take the medication in the morning to avoid insomnia.
• B. The medication may take several weeks to achieve the full effect.
• C. It is safe to consume alcohol while taking this medication.
• D. Report any side effects to the healthcare provider immediately.

Correct answer: B

Rationale: Patients prescribed fluoxetine should be educated that the medication may take several weeks to achieve its full therapeutic effect. This information helps manage patient expectations and ensures they do not discontinue the medication prematurely due to lack of immediate results. Taking the medication in the morning to avoid insomnia is not a specific requirement for fluoxetine. Consuming alcohol while taking fluoxetine is not safe and can lead to adverse effects. It is crucial to report any side effects to the healthcare provider promptly for timely management and adjustment of the treatment plan.

4. During a panic attack, what is the nurse's priority intervention for a patient with panic disorder?

• A. Encourage the patient to verbalize their feelings.
• B. Provide reassurance and stay with the patient.
• C. Leave the patient alone to calm down.
• D. Distract the patient with a task.

Correct answer: B

Rationale: During a panic attack, the priority intervention for the nurse is to provide reassurance and stay with the patient. This action helps reduce fear and provides a sense of safety, which can aid in calming the patient and preventing further escalation of the panic attack. Encouraging the patient to verbalize their feelings (Choice A) may be beneficial after the acute phase of the panic attack. Leaving the patient alone (Choice C) may increase feelings of abandonment and escalate the panic attack. Distracting the patient with a task (Choice D) is not recommended during a panic attack as it may divert attention but not address the underlying anxiety and fear.

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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