Nursing Elites

1. A healthcare professional is providing care for a client with a diagnosis of bipolar disorder. Which client behavior would the healthcare professional identify as characteristic of a manic episode?

• A. Sleeping excessively
• B. Excessive energy
• C. Decreased appetite
• D. Lack of interest in activities

Correct answer: B

Rationale: During a manic episode in bipolar disorder, individuals often experience heightened energy levels, increased goal-directed activity, and may engage in risky behaviors. This excessive energy is a key characteristic of manic episodes. Choice A, sleeping excessively, is more characteristic of a depressive episode. Choice C, decreased appetite, can be seen in various mood disorders but is not specific to manic episodes. Choice D, lack of interest in activities, is more indicative of a depressive episode rather than a manic episode. It is important for healthcare professionals to recognize these signs to provide appropriate care and support to individuals with bipolar disorder.

2. Which statement made by a patient prescribed bupropion (Wellbutrin) demonstrates that the medication education the patient received was effective?

• A. I hope Wellbutrin will help my depression and also help me to finally quit smoking.
• B. I'm happy to hear that I won't need to worry too much about weight gain.
• C. It's okay to take Wellbutrin since I haven't had a seizure in 6 months.
• D. I need to be careful about driving since the medication could make me drowsy.

Correct answer: A

Rationale: Choice A is the correct answer because it shows that the patient understands the dual benefits of bupropion (Wellbutrin) in treating depression and aiding in smoking cessation. Bupropion is commonly prescribed for these reasons as it has a lower risk of weight gain compared to other antidepressants. Choices B, C, and D are not the most appropriate because they do not specifically reflect the benefits or key information related to bupropion therapy.

3. A client states, 'I am the only one who can hear voices.' Which is the nurse's best response?

• A. Tell me more about these voices.
• B. Let's explore these voices together.
• C. How long have you been hearing these voices?
• D. Have you told anyone else about these voices?

Correct answer: A

Rationale: The best response for the nurse is to encourage the client to talk about their experiences with hearing voices. By asking the client to share more details about the voices, the nurse can gain insight into the nature of the auditory hallucinations and better understand the client's condition. This open-ended question allows the client to express themselves freely and helps build rapport and trust between the client and the nurse. Choices B, C, and D do not directly address the client's statement or encourage further elaboration, making them less effective responses in this context.

4. Which therapeutic approach is most effective for managing obsessive-compulsive disorder (OCD)?

• A. Cognitive-behavioral therapy
• B. Psychoanalysis
• C. Medication management
• D. Group therapy

Correct answer: A

Rationale: Cognitive-behavioral therapy (CBT), especially exposure and response prevention, is considered the most effective therapeutic approach for managing obsessive-compulsive disorder (OCD). CBT helps individuals identify and modify their distorted beliefs and behaviors related to OCD, while exposure and response prevention specifically target the core symptoms of OCD by gradually exposing the individual to feared stimuli and preventing compulsive responses. While medication management can be used as an adjunct to therapy, CBT has shown to have long-lasting benefits in reducing OCD symptoms and improving the overall quality of life. Psychoanalysis focuses more on exploring unconscious conflicts and childhood experiences, which may not be as effective for OCD. Group therapy can be beneficial as a supplemental treatment but is not typically as effective as individual CBT tailored to the specific needs of the individual with OCD.

5. A client with major depressive disorder is prescribed an antidepressant. Which of the following instructions should the nurse exclude from the teaching?

• A. It may take several weeks for the medication to take effect
• B. Avoid alcohol while taking this medication
• C. Discourage the client from washing her hands
• D. You may experience an increase in energy before your mood improves

Correct answer: C

Rationale: The nurse should not include the instruction to discourage the client from washing her hands in the teaching for a client prescribed an antidepressant. This instruction is not relevant to the medication regimen. Instead, the nurse should educate the client that it may take several weeks for the medication to take effect, to avoid alcohol, not to discontinue the medication abruptly, and that there may be an increase in energy before mood improves. Regular blood tests are not typically required for most antidepressants.

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