Nursing Elites

1. A client has been diagnosed with major depressive disorder. Which is an appropriate short-term goal for the client?

• A. The client will report a decrease in depressive symptoms.
• B. The client will establish a sleep routine.
• C. The client will improve social interactions.
• D. The client will set realistic goals for the future.

Correct answer: A

Rationale: Setting a goal for the client to report a decrease in depressive symptoms is appropriate as it is specific, measurable, and achievable in the short term. Monitoring changes in depressive symptoms provides valuable feedback on the effectiveness of the treatment plan. While establishing a sleep routine, improving social interactions, and setting realistic goals for the future are important aspects of recovery, they are more suitable as intermediate or long-term goals. In the context of short-term goals, focusing on symptom reduction can provide immediate feedback on the client's progress and help adjust the treatment plan accordingly.

2. A client prescribed fluoxetine for depression is receiving education from a healthcare provider. Which statement by the client indicates an accurate understanding of the medication?

• A. I should take this medication at bedtime to avoid nausea.
• B. I should avoid driving until I know how this medication affects me.
• C. I should take this medication with food to avoid stomach upset.
• D. I should take this medication as needed for anxiety.

Correct answer: B

Rationale: The correct answer is B. Fluoxetine can cause drowsiness, affecting a person's ability to drive safely. It is essential to avoid driving until the client knows how the medication affects them to ensure safety. Choice A is incorrect because fluoxetine is usually taken in the morning due to its potential to cause insomnia. Choice C is incorrect as fluoxetine is recommended to be taken with food to minimize gastrointestinal side effects, not specifically to avoid stomach upset. Choice D is incorrect because fluoxetine is typically prescribed for depression or other mood disorders on a daily basis, not as needed for anxiety.

3. During a mental status examination, which of the following components should be included in the assessment? Select one that doesn't apply.

• A. Appearance and behavior
• B. Thought processes
• C. Mood and affect
• D. The greater the cultural distance from the mainstream of society, the greater the likelihood that the illness will be treated with sensitivity and compassion.

Correct answer: D

Rationale: During a mental status examination, key components to be assessed include the client's appearance and behavior, thought processes, mood and affect, and cognitive function. These components help in evaluating the client's mental health status. The statement about cultural distance and illness treatment is not a part of a mental status examination and is not relevant to the assessment of mental health. Choices A, B, and C are essential components of a mental status examination and contribute to a comprehensive evaluation of an individual's mental well-being.

4. A healthcare provider is assessing a client with suspected post-traumatic stress disorder (PTSD). Which of the following findings should the provider expect? Select one that does not apply.

• A. Flashbacks
• B. Avoidance of reminders of the trauma
• C. Increased arousal and hypervigilance
• D. Manic episodes

Correct answer: D

Rationale: Post-traumatic stress disorder (PTSD) is characterized by various symptoms, including flashbacks, avoidance of reminders of the trauma, increased arousal, and hypervigilance. Additionally, individuals with PTSD often experience negative changes in thoughts and mood. Manic episodes, which are periods of abnormally elevated mood and energy, are not typically associated with PTSD. Therefore, the correct answer is 'Manic episodes.' Choices A, B, and C are all common findings in individuals with PTSD.

5. A nurse is providing education to the family of a client who has been diagnosed with major depressive disorder. Which of the following instructions should the nurse include?

• A. Encourage the client to avoid caffeine.
• B. Encourage the client to participate in physical activity.
• C. Encourage the client to express their feelings.
• D. Encourage the client to avoid isolation.

Correct answer: D

Rationale: The nurse should instruct the family to encourage the client to avoid isolation. Social support and interaction are crucial for individuals with major depressive disorder as it can help in improving mood, reducing feelings of loneliness, and providing a sense of belonging and support. Choices A, B, and C are not the most appropriate instructions for a client with major depressive disorder. While avoiding caffeine can be beneficial for some individuals with anxiety or sleep issues, it is not a primary intervention for major depressive disorder. Encouraging physical activity and expressing feelings are important aspects of managing depression, but avoiding isolation is more critical to address first.

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