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 with major depressive disorder expresses feelings of hopelessness. Which nursing intervention should the nurse implement to address these feelings?

• A. Encourage the client to engage in physical activity.
• B. Provide opportunities for the client to make decisions.
• C. Help the client identify positive aspects of their life.
• D. Encourage the client to verbalize feelings of hopelessness.

Correct answer: C

Rationale: When a client with major depressive disorder expresses feelings of hopelessness, helping them identify positive aspects of their life can be an effective nursing intervention. This approach can assist in shifting their focus from negativity to positivity, promoting a sense of hope and potentially improving their overall outlook and well-being. By highlighting the positive aspects, the nurse can support the client in recognizing reasons for hope and encourage a more optimistic perspective, which can aid in addressing and alleviating feelings of hopelessness. Encouraging physical activity (Choice A) may be beneficial for overall well-being but may not directly address feelings of hopelessness. Providing opportunities for decision-making (Choice B) can empower the client but may not specifically target feelings of hopelessness. Encouraging verbalization of feelings (Choice D) is important but may not be as effective as helping the client shift their focus to positive aspects of life.

3. Which of the following are therapeutic communication techniques that a healthcare professional can use when interacting with clients? Select one that doesn't apply.

• A. Using silence
• B. Offering self
• C. Giving advice
• D. Providing reassurance

Correct answer: C

Rationale: Therapeutic communication techniques aim to promote understanding and trust between the professional and the client. Using silence allows the client to process thoughts, feelings, and information. Offering self involves making oneself available and showing empathy. Providing reassurance helps instill confidence. However, giving advice can sometimes be non-therapeutic as it may undermine the client's autonomy and decision-making process.

4. A client has been prescribed fluoxetine (Prozac). What information should the nurse include in discharge teaching?

• A. Take the medication with food to avoid stomach upset.
• B. Avoid drinking alcohol while taking this medication.
• C. Take the medication only when feeling depressed.
• D. Report any unusual side effects to the healthcare provider.

Correct answer: B

Rationale: The correct answer is to advise the client to avoid drinking alcohol while taking fluoxetine (Prozac) due to potential interactions. Alcohol consumption can increase the risk of certain side effects and may reduce the effectiveness of the medication. Choice A is incorrect because fluoxetine can be taken with or without food. Choice C is incorrect as fluoxetine is usually taken daily regardless of the client's mood. Choice D is not the priority teaching point; while reporting side effects is important, avoiding alcohol is critical due to the potential interactions.

5. A client with major depressive disorder is prescribed an antidepressant. Which of the following instructions should the nurse include in the teaching? Select the one that does not apply.

• A. It may take several weeks for the medication to take effect
• B. Avoid alcohol while taking this medication
• C. Discontinue the medication abruptly
• D. You may experience an increase in energy before your mood improves

Correct answer: C

Rationale: Teaching for a client prescribed an antidepressant should include several key instructions. Firstly, it's important to inform the client that it may take several weeks for the medication to take effect, so they should be patient. Secondly, they should be advised to avoid alcohol while taking the medication as it can interact negatively with antidepressants. Additionally, abrupt discontinuation of antidepressants can lead to withdrawal symptoms and should be avoided. Lastly, clients may experience an increase in energy before their mood improves, which is a common effect of some antidepressants. Regular blood tests are not typically required for most antidepressants, but adherence to the prescribed regimen and reporting any concerning side effects to the healthcare provider are crucial.

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