Nursing Elites

1. A client has been diagnosed with post-traumatic stress disorder (PTSD). Which intervention should the nurse implement to reduce the client's anxiety?

• A. Encourage the client to avoid discussing the traumatic event.
• B. Encourage the client to participate in group therapy sessions.
• C. Encourage the client to engage in relaxation techniques.
• D. Encourage the client to maintain a daily journal.

Correct answer: C

Rationale: Engaging in relaxation techniques, such as deep breathing, mindfulness, or progressive muscle relaxation, can help reduce anxiety for clients with PTSD. These techniques promote relaxation and help manage stress responses, contributing to a sense of calmness and improved coping mechanisms in dealing with anxiety triggers associated with PTSD. Avoiding discussing the traumatic event (Choice A) may hinder the client's progress in processing and coping with the trauma. While group therapy (Choice B) can be beneficial, relaxation techniques are more specific for reducing anxiety in this context. Maintaining a daily journal (Choice D) may be helpful for some clients but might not directly address anxiety reduction as effectively as relaxation techniques.

2. A healthcare provider is assessing a client with generalized anxiety disorder (GAD). Which of the following findings shouldn't the healthcare provider expect?

• A. Restlessness
• B. Fatigue
• C. Excessive worry
• D. Mania

Correct answer: D

Rationale: In clients with generalized anxiety disorder (GAD), common symptoms include restlessness, fatigue, excessive worry, and irritability. Mania is not typically associated with GAD; instead, it is a key feature of bipolar disorder. Therefore, the healthcare provider should not expect to find mania in a client with GAD.

3. When caring for a client with major depressive disorder, what is the most 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: The most appropriate short-term goal for a client with major depressive disorder is for them to report a decrease in depressive symptoms. This goal is specific, measurable, and achievable, focusing on the primary symptoms of the disorder. By monitoring and assessing the client's self-reported improvement in depressive symptoms, the healthcare team can track progress and adjust interventions accordingly.

4. A patient with major depressive disorder is started on venlafaxine. Which class of antidepressant does this medication belong to?

• A. Selective serotonin reuptake inhibitors (SSRIs)
• B. Tricyclic antidepressants (TCAs)
• C. Monoamine oxidase inhibitors (MAOIs)
• D. Serotonin-norepinephrine reuptake inhibitors (SNRIs)

Correct answer: D

Rationale: Venlafaxine is classified as a serotonin-norepinephrine reuptake inhibitor (SNRI). SNRIs work by increasing the levels of both serotonin and norepinephrine in the brain, which helps alleviate symptoms of depression. This mechanism of action distinguishes SNRIs from other classes of antidepressants like SSRIs, TCAs, and MAOIs, making venlafaxine an effective choice for patients with major depressive disorder. Therefore, the correct answer is D. Choice A, SSRIs, primarily target serotonin reuptake only. Choice B, TCAs, work by inhibiting the reuptake of norepinephrine and serotonin, but they are not as selective as SNRIs. Choice C, MAOIs, inhibit the enzyme monoamine oxidase, leading to increased levels of various neurotransmitters, including serotonin and norepinephrine, but they are typically used as second- or third-line agents due to dietary restrictions and potential side effects.

5. A 33-year-old female diagnosed with bipolar I disorder has been functioning well on lithium for 11 months. At her most recent checkup, the psychiatric nurse practitioner states, 'You are ready to enter the maintenance therapy stage, so at this time I am going to adjust your dosage by prescribing:'

• A. A higher dosage
• B. Once-weekly dosing
• C. A lower dosage
• D. A different drug

Correct answer: C

Rationale: During the maintenance therapy stage for bipolar I disorder, it is common to lower the dosage of lithium to prevent side effects while still maintaining stability. Lowering the dosage helps to find the lowest effective dose that can still manage symptoms effectively with minimal side effects.

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