Nursing Elites

1. A healthcare professional is assessing a client with major depressive disorder. Which of the following findings should the professional expect? Select one that does not apply.

• A. Anhedonia
• B. Hypersomnia
• C. Fatigue
• D. Flight of ideas

Correct answer: D

Rationale: In major depressive disorder, common findings include anhedonia (loss of interest or pleasure), hypersomnia (excessive sleepiness), fatigue, and feelings of worthlessness. Flight of ideas, characterized by racing thoughts and rapid speech, is more commonly associated with bipolar disorder, particularly during manic episodes. Therefore, 'Flight of ideas' does not apply to the expected findings in major depressive disorder.

2. A client diagnosed with schizophrenia is receiving discharge teaching. Which of the following instructions should the healthcare provider include? Select one that does not apply.

• A. Continue taking medications as prescribed
• B. Avoid all social interactions
• C. Report any side effects of medications to the healthcare provider
• D. Develop a daily routine

Correct answer: B

Rationale: Discharge instructions for a client diagnosed with schizophrenia should focus on promoting medication adherence, monitoring and reporting any medication side effects, and establishing a structured daily routine to support stability and well-being. Encouraging the client to avoid all social interactions is not appropriate as social support can be beneficial for individuals with schizophrenia. Social interactions can help reduce feelings of isolation, improve overall well-being, and provide emotional support. Therefore, advising the client to avoid all social interactions would not be in the best interest of their recovery and management of the condition.

3. A client has a history of excessive drinking, which has led to multiple arrests for driving under the influence (DUI). The client states, 'I work hard to provide for my family. I don't see why I can't drink to relax.' The nurse recognizes the use of which defense mechanism?

• A. Projection
• B. Rationalization
• C. Regression
• D. Sublimation

Correct answer: B

Rationale: The correct answer is Rationalization. The client is using rationalization as a defense mechanism by justifying their excessive drinking as a way to relax due to working hard to provide for their family. Rationalization involves creating logical excuses to justify unacceptable feelings or behaviors. Projection involves attributing one's unacceptable feelings or thoughts to others. Regression is reverting to an earlier stage of development in the face of unacceptable thoughts or impulses. Sublimation is the channeling of unacceptable impulses into socially acceptable activities.

4. Which medication is commonly prescribed for the treatment of panic disorder?

• A. Haloperidol
• B. Clonazepam
• C. Lithium
• D. Fluoxetine

Correct answer: B

Rationale: Clonazepam, a benzodiazepine, is commonly prescribed for the treatment of panic disorder due to its anxiolytic properties. It helps reduce the frequency and intensity of panic attacks by acting on the central nervous system to produce a calming effect. Haloperidol is an antipsychotic medication, lithium is primarily used for bipolar disorder, and fluoxetine is a selective serotonin reuptake inhibitor (SSRI) commonly used for depression and some anxiety disorders, but not as a first-line treatment for panic disorder.

5. During an assessment, a client is demonstrating symptoms of moderate anxiety. Which of the following symptoms would be indicative of moderate anxiety?

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

Correct answer: C

Rationale: Palpitations are a common physical symptom seen in clients experiencing moderate anxiety. Fidgeting, laughing inappropriately, and nail biting can also indicate heightened stress levels. It's important for healthcare providers to recognize these signs and provide appropriate support. While anxiety can manifest in various ways, other indicators of moderate anxiety may include restlessness, difficulty concentrating, muscle tension, and sleep disturbance. It's crucial for healthcare providers to assess these symptoms to provide effective care and interventions. Laughing inappropriately and nail biting are more commonly associated with nervousness or social discomfort, while fidgeting may signal mild anxiety.

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