Nursing Elites

1. A healthcare professional is assessing a patient with major depressive disorder. Which finding is most concerning?

• A. Decreased interest in activities
• B. Feelings of worthlessness
• C. Difficulty sleeping
• D. Changes in appetite

Correct answer: C

Rationale: Among the symptoms listed, difficulty sleeping is particularly concerning in patients with major depressive disorder. Insomnia or other sleep disturbances can exacerbate depressive symptoms and increase the risk of suicidal ideation. Healthcare professionals should address sleep issues promptly to provide appropriate interventions and prevent further complications.

2. Which intervention is most appropriate for a patient experiencing a severe manic episode?

• A. Providing a structured and low-stimulation environment
• B. Encouraging the patient to engage in group activities
• C. Providing detailed information about the patient's condition
• D. Allowing the patient to have unsupervised time

Correct answer: A

Rationale: During a severe manic episode, it is crucial to provide a structured and low-stimulation environment to help manage the symptoms effectively. This environment aims to reduce stimuli that can exacerbate manic behavior and provide a sense of predictability and safety for the individual. Group activities, detailed information provision, or unsupervised time may not be suitable during a severe manic episode as they can potentially worsen the condition or pose safety risks.

3. A nurse is providing discharge teaching to a patient prescribed fluoxetine for panic disorder. Which statement should be included in the teaching?

• A. You should notice the effects of this medication within a few days.
• B. It's important to take this medication only when you feel anxious.
• C. It may take several weeks before you notice the full effects of this medication.
• D. You can stop taking this medication as soon as you feel better.

Correct answer: C

Rationale: The correct statement to include in the teaching is that it may take several weeks before the patient notices the full effects of fluoxetine. This is because fluoxetine, like other SSRIs, requires time to reach its full therapeutic effect. Choice A is incorrect as fluoxetine does not show its effects within a few days. Choice B is incorrect as fluoxetine should be taken regularly as prescribed, not only when feeling anxious. Choice D is incorrect as discontinuing fluoxetine abruptly can lead to withdrawal symptoms and a return of panic disorder symptoms.

4. A healthcare professional is assessing a patient with bipolar disorder. Which finding suggests the patient is experiencing a manic episode?

• A. Decreased need for sleep
• B. Feelings of worthlessness
• C. Increased need for sleep
• D. Avoidance of social interactions

Correct answer: A

Rationale: During a manic episode in patients with bipolar disorder, they often experience a decreased need for sleep. This symptom is characterized by feeling rested after only a few hours of sleep, or even feeling like they can go without sleep for extended periods without feeling tired. The increased energy levels and racing thoughts during a manic episode contribute to the decreased need for sleep.

5. A client is undergoing systematic desensitization for an extreme fear of elevators. Which of the following actions should be implemented with this form of therapy?

• A. Demonstrate riding in an elevator, then ask the client to imitate the behavior.
• B. Advise the client to say “stop” out loud every time they begin to feel an anxiety response related to an elevator.
• C. Gradually expose the client to an elevator while practicing relaxation techniques.
• D. Stay with the client in an elevator until the anxiety response diminishes.

Correct answer: C

Rationale: Systematic desensitization is a type of therapy used to help individuals overcome phobias or anxieties. It involves gradually exposing the client to the feared object or situation, in this case, an elevator, while simultaneously practicing relaxation techniques. This process helps the client associate relaxation with the previously feared stimulus, gradually reducing anxiety levels over time. Choice A is incorrect as it involves imitation rather than gradual exposure. Choice B is incorrect as it focuses on a verbal response rather than the systematic process of exposure and relaxation. Choice D is incorrect as it does not involve the systematic approach of gradually exposing the client while teaching relaxation techniques.

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