Nursing Elites

1. A healthcare provider is providing care for a patient with major depressive disorder who is prescribed a tricyclic antidepressant (TCA). Which common side effect should the healthcare provider educate the patient about?

• A. Hypertension
• B. Diarrhea
• C. Dry mouth
• D. Weight loss

Correct answer: C

Rationale: Dry mouth is a common side effect associated with tricyclic antidepressants (TCAs). TCAs can cause anticholinergic side effects, such as dry mouth, due to their mechanism of action. Educating the patient about dry mouth can help them stay informed and manage this common side effect effectively during treatment. Hypertension (Choice A) is not a common side effect of TCAs. Diarrhea (Choice B) is more commonly associated with selective serotonin reuptake inhibitors (SSRIs) than with TCAs. Weight loss (Choice D) is not a common side effect of TCAs; in fact, TCAs are more likely to cause weight gain.

2. A client is experiencing alcohol withdrawal. Which intervention should be included in the plan of care?

• A. Administer benzodiazepines as prescribed.
• B. Monitor the client's vital signs every 4 hours.
• C. Provide a high-protein diet.
• D. Encourage the client to drink plenty of fluids.

Correct answer: A

Rationale: Administering benzodiazepines as prescribed is a crucial intervention in managing alcohol withdrawal. Benzodiazepines help alleviate symptoms such as anxiety, agitation, and seizures commonly seen in alcohol withdrawal. Monitoring vital signs is important to assess the client's physiological stability, but addressing the withdrawal symptoms with benzodiazepines is a priority to prevent severe complications. Providing a high-protein diet and encouraging fluid intake are important for overall health but do not directly manage alcohol withdrawal symptoms.

3. A client diagnosed with schizophrenia is receiving discharge teaching. Which of the following instructions should the nurse exclude?

• A. Continue taking medications as prescribed
• B. Avoid all social interactions
• C. Report any side effects of medications to the healthcare provider
• D. Develop a daily routine

Correct answer: B

Rationale: The nurse should exclude the instruction to 'Avoid all social interactions' when providing discharge teaching to a client with schizophrenia. It's important for individuals with schizophrenia to continue taking medications as prescribed, report any medication side effects to the healthcare provider, and develop a daily routine to promote stability. Social interactions, albeit with appropriate boundaries, can be beneficial for the client's well-being and integration into the community.

4. When caring for a client with anorexia nervosa in a psychiatric unit, which intervention should the nurse implement to address the client's nutritional needs?

• A. Provide small, frequent meals throughout the day.
• B. Monitor the client's weight daily.
• C. Offer a liquid supplement if the client refuses solid food.
• D. Encourage the client to choose from a variety of food options.

Correct answer: A

Rationale: Providing small, frequent meals throughout the day is a crucial intervention when caring for a client with anorexia nervosa. This approach helps in gradually increasing caloric intake and meeting the client's nutritional needs. Offering large meals can be overwhelming and may contribute to anxiety in these clients. By providing small, frequent meals, the nurse supports the client in establishing a healthier eating pattern and aids in the restoration of adequate nutrition levels. Monitoring the client's weight daily (Choice B) may exacerbate anxiety related to body image and weight, which are common concerns in anorexia nervosa. Offering a liquid supplement if the client refuses solid food (Choice C) may not address the underlying issues related to food aversion and may not provide the necessary nutrients in a balanced way. Encouraging the client to choose from a variety of food options (Choice D) may be overwhelming for someone with anorexia nervosa and could lead to increased anxiety around food choices.

5. A distraught, single, first-time mother cries and asks a nurse, 'How can I go to work if I can't afford childcare?' What is the nurse's initial action in assisting the client with the problem-solving process?

• A. Determine the risks and benefits of each alternative.
• B. Formulate goals for resolving the problem.
• C. Evaluate the outcome of the implemented solution.
• D. Assess the facts of the situation.

Correct answer: D

Rationale: In this scenario, the nurse's first step should be to assess the facts of the situation. By gathering accurate information about the client's circumstances related to childcare and work, the nurse can better understand the client's needs and concerns, which is essential before proceeding with any problem-solving process. Choice A is incorrect because assessing risks and benefits comes later in the problem-solving process. Choice B is incorrect as formulating goals should follow a thorough assessment. Choice C is incorrect since evaluating outcomes happens after implementing a solution, which is premature at this stage.

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