Nursing Elites

1. A client has been prescribed escitalopram (Lexapro) for depression. Which instruction should the nurse include in the discharge teaching?

• A. Take the medication at bedtime to prevent daytime drowsiness.
• B. Avoid consuming alcohol while taking this medication.
• C. Take the medication with food to prevent stomach upset.
• D. Discontinue the medication if you start feeling better.

Correct answer: B

Rationale: The correct instruction for the nurse to include in the discharge teaching is to advise the client to avoid consuming alcohol while taking escitalopram (Lexapro). Alcohol can potentiate side effects such as drowsiness and dizziness when combined with this medication. Choice A is incorrect because escitalopram is usually taken in the morning due to its potential to cause insomnia if taken at bedtime. Choice C is incorrect because taking the medication with or without food does not significantly affect its absorption or side effects. Choice D is incorrect because it is essential for the client to continue taking the medication even if they start feeling better, as abruptly stopping an antidepressant can lead to withdrawal symptoms and a relapse of depression.

2. A patient with obsessive-compulsive disorder (OCD) is undergoing treatment with an SSRI. Which SSRI is commonly utilized for this condition?

• A. Fluoxetine
• B. Citalopram
• C. Paroxetine
• D. Escitalopram

Correct answer: C

Rationale: Paroxetine is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed for obsessive-compulsive disorder due to its efficacy in managing OCD symptoms. While different SSRIs may be used based on individual patient response and tolerability, Paroxetine stands out as a well-established option for treating OCD. Fluoxetine (Choice A) is another SSRI commonly used for OCD, but Paroxetine is more commonly associated with this indication. Citalopram (Choice B) and Escitalopram (Choice D) are also SSRIs but are not typically the first choice for treating OCD.

3. When discussing the main differences between narcolepsy and obstructive sleep apnea syndrome, what should the nurse highlight?

• A. Symptoms of the two diagnoses are essentially the same, making it challenging to differentiate between them
• B. Naps are contraindicated for clients with narcolepsy due to their association with cataplexy
• C. People with narcolepsy awaken from a nap feeling rested and replenished
• D. People with obstructive sleep apnea syndrome may experience temporary paralysis during sleep

Correct answer: C

Rationale: Narcolepsy is characterized by excessive daytime sleepiness and sudden attacks of sleep, while individuals with narcolepsy often feel refreshed after a brief nap. In contrast, obstructive sleep apnea syndrome is marked by pauses in breathing or shallow breathing during sleep, leading to fragmented sleep and excessive daytime sleepiness. Therefore, the correct answer is that individuals with narcolepsy awaken from a nap feeling rested and replenished, which is a key distinguishing feature from obstructive sleep apnea syndrome.

4. When assessing a client's behavior for potential aggression, what behavior would be recognized as the highest predictor of future violence?

• A. Pacing and restlessness
• B. Verbal threats
• C. History of violence
• D. Substance abuse

Correct answer: C

Rationale: A history of violence is considered the highest predictor of future violence. Clients who have a history of violent behavior are more likely to engage in violent acts in the future compared to those who exhibit other behaviors such as pacing, making verbal threats, or having substance abuse issues. Understanding a client's history of violence is crucial in assessing the risk of potential aggression and violence. Pacing and restlessness, verbal threats, and substance abuse can be concerning behaviors but do not carry the same predictive value for future violence as a documented history of violent behavior.

5. In addition to antianxiety agents, which classification of drugs is commonly prescribed to treat anxiety and anxiety disorders?

• A. Antipsychotics
• B. Mood stabilizers
• C. Antidepressants
• D. Cholinesterase inhibitors

Correct answer: C

Rationale: Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are frequently used in the treatment of anxiety disorders. These medications help alleviate symptoms by affecting neurotransmitters in the brain associated with mood regulation and anxiety.

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