Nursing Elites

1. A patient with major depressive disorder has been prescribed an MAOI. The patient should be educated to avoid which type of food to prevent hypertensive crises?

• A. High-protein foods
• B. High-fiber foods
• C. Tyramine-rich foods
• D. Low-fat foods

Correct answer: C

Rationale: The correct answer is C: Tyramine-rich foods. Patients prescribed MAOIs should avoid tyramine-rich foods to prevent hypertensive crises. Tyramine-rich foods can interact with MAOIs, leading to a sudden and dangerous increase in blood pressure. Examples of tyramine-rich foods include aged cheeses, cured meats, pickled or fermented foods, and certain beverages like beer and wine. Choices A, B, and D are incorrect because they are not associated with causing hypertensive crises when taken with MAOIs.

2. How should the nurse characterize the client's appraisal of the job loss stressor?

• A. Irrelevant
• B. Harm/loss
• C. Threatening
• D. Challenging

Correct answer: D

Rationale: The client's statement reflects a positive outlook on the job loss, viewing it as a challenge and an opportunity for personal growth. This perspective suggests that the client is resilient and adaptive, focusing on new possibilities rather than dwelling on the negative aspects of the situation. Choice D, 'Challenging,' is the correct characterization as it aligns with the client's positive appraisal. Choices A, 'Irrelevant,' B, 'Harm/loss,' and C, 'Threatening,' are incorrect as they do not capture the client's adaptive response to the stressor.

3. A bright student confides in the school nurse about conflicts related to attending college or working to add needed financial support to the family. Which coping strategy is most appropriate for the nurse to recommend to the student at this time?

• A. Meditation
• B. Problem-solving training
• C. Relaxation
• D. Journaling

Correct answer: B

Rationale: In this scenario, the student is dealing with conflicting priorities of attending college or working to support the family financially. Problem-solving training is the most appropriate coping strategy to recommend. It can help the student objectively assess the situation, identify potential solutions, and make informed decisions. Problem-solving training provides structure and guidance, empowering the student to navigate the conflicting priorities effectively and choose the best course of action. Meditation, relaxation, and journaling may be beneficial for stress relief but may not directly address the decision-making process required in this situation.

4. 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.

5. A nurse is assessing a patient with schizophrenia who is experiencing delusions. Which intervention is most appropriate?

• A. Agree with the patient's delusions to avoid confrontation.
• B. Encourage the patient to explore the basis of the delusions.
• C. Engage the patient in reality-based activities.
• D. Ask the patient to explain the delusions in detail.

Correct answer: C

Rationale: The most appropriate intervention when assessing a patient with schizophrenia experiencing delusions is to engage the patient in reality-based activities. This intervention helps distract the patient from the delusions and reorients them to the present, promoting grounding in reality. Choice A is incorrect because agreeing with delusions can reinforce them and hinder treatment. Choice B may exacerbate the delusions by delving deeper into their basis. Choice D may not be beneficial as it focuses solely on the delusions without addressing the need to ground the patient in reality.

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