Nursing Elites

1. When assessing a patient with schizophrenia who exhibits disorganized speech and behavior, these symptoms are classified as:

• A. Positive symptoms
• B. Negative symptoms
• C. Cognitive symptoms
• D. Mood symptoms

Correct answer: A

Rationale: Positive symptoms in schizophrenia refer to excesses or distortions in normal behavior and include symptoms like hallucinations, delusions, and disorganized speech and behavior. Disorganized speech and behavior are considered positive symptoms because they represent an excess or distortion of normal functions. Negative symptoms involve deficits in normal behavior, cognitive symptoms affect thinking processes, and mood symptoms relate to emotional experiences. Therefore, in this scenario, the disorganized speech and behavior exhibited by the patient are classified as positive symptoms.

2. Which of the following is a common side effect of benzodiazepines prescribed for anxiety?

• A. Insomnia
• B. Weight gain
• C. Drowsiness
• D. Increased appetite

Correct answer: C

Rationale: Drowsiness is a common side effect of benzodiazepines prescribed for anxiety. Benzodiazepines work by depressing the central nervous system, which can lead to drowsiness as a side effect. This sedative effect is often desired in the treatment of anxiety disorders, but individuals should be cautious when engaging in activities that require alertness, such as driving, while taking these medications. Insomnia, weight gain, and increased appetite are not typically associated with benzodiazepines; instead, drowsiness and sedation are more common side effects.

3. When an individual's stress response is sustained over a long period of time, which physiological effect of the endocrine system should one anticipate?

• A. Decreased resistance to disease
• B. Increased libido
• C. Decreased blood pressure
• D. Increased inflammatory response

Correct answer: A

Rationale: When stress is prolonged, the body reaches the stage of exhaustion in the general adaptation syndrome, where compensatory mechanisms fail, and diseases of adaptation may occur. One physiological effect includes a decreased immune response, leading to decreased resistance to disease. Therefore, the correct answer is A. Increased libido (choice B) is not a typical physiological effect related to prolonged stress. Decreased blood pressure (choice C) is not commonly associated with sustained stress. Increased inflammatory response (choice D) may occur in the short term due to stress, but over a prolonged period, the immune system's function weakens, leading to decreased resistance to disease.

4. A client has been prescribed bupropion (Wellbutrin) for depression. Which instruction should the nurse provide during discharge?

• A. Take the medication with a full glass of water.
• B. Stop taking the medication if you feel better.
• C. Avoid drinking alcohol while taking this medication.
• D. Double the dose if you miss a dose.

Correct answer: C

Rationale: The correct instruction for the nurse to provide is to advise the client to avoid drinking alcohol while taking bupropion (Wellbutrin) due to the increased risk of side effects like seizures. Alcohol can interact with bupropion and worsen its side effects, making it important to abstain from alcohol consumption during the treatment. Option A is incorrect because taking the medication with a full glass of water is a general instruction for medications and not specific to bupropion. Option B is incorrect as abruptly stopping bupropion can lead to withdrawal symptoms and should only be done under medical supervision. Option D is incorrect as doubling the dose of bupropion is dangerous and should not be done, even if a dose is missed.

5. A client with schizophrenia is prescribed risperidone. Which statement by the client indicates a need for further teaching?

• A. I can stop taking this medication once I feel better.
• B. I need to avoid drinking alcohol while taking this medication.
• C. I should take this medication with food to avoid stomach upset.
• D. This medication may cause weight gain.

Correct answer: A

Rationale: The correct answer is A. Risperidone should be taken consistently as prescribed and should not be stopped abruptly. It is essential to educate the client that discontinuing the medication without medical advice can lead to a worsening of symptoms or potential relapse. Choices B, C, and D demonstrate understanding of important considerations when taking risperidone, such as avoiding alcohol, taking it with food to reduce stomach upset, and being aware of the potential side effect of weight gain. Choice A suggests a misconception that the medication can be discontinued once the client feels better, which is incorrect and requires further clarification to ensure treatment adherence and effectiveness.

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