Nursing Elites

1. A client has been prescribed lithium for the treatment of bipolar disorder. Which of the following instructions should the nurse include?

• A. Avoid driving until you know how the medication affects you.
• B. Take the medication with food to prevent stomach upset.
• C. You may experience mild nausea when initiating the medication.
• D. Do not double the next dose if you miss one.

Correct answer: A

Rationale: The correct instruction for the nurse to provide is to advise the client to avoid driving until they know how the medication affects them. Lithium can lead to side effects like dizziness and drowsiness, which could impair one's ability to drive safely. Choice B is incorrect because lithium is usually taken on an empty stomach. Choice C may be true but is not as critical as the potential side effects affecting driving. Choice D is important but not as immediate as ensuring the client's safety while driving.

2. When should healthcare professionals be most alert to the possibility of communication errors resulting in harm to the patient?

• A. Change of shift reports
• B. Admission interviews
• C. One-to-one conversations with patients
• D. Conversations with patient families

Correct answer: A

Rationale: Healthcare professionals should be most alert to the possibility of communication errors resulting in harm to the patient during change of shift reports. This is a critical time when information is transferred between healthcare providers, and any errors in communication during this handover can lead to adverse outcomes for the patient.

3. When educating a client prescribed diazepam for anxiety, which statement indicates an accurate understanding of the medication?

• A. I should take this medication only when I feel anxious.
• B. I should avoid drinking alcohol while taking this medication.
• C. I should avoid driving until I know how this medication affects me.
• D. I can stop taking this medication abruptly if I feel better.

Correct answer: B

Rationale: The correct answer is B. Clients prescribed diazepam for anxiety should avoid drinking alcohol while taking this medication. Alcohol can potentiate the side effects of diazepam, such as drowsiness and dizziness, increasing the risk of harm. Choice A is incorrect because diazepam is typically taken regularly as prescribed, not just when feeling anxious. Choice C is also important but not directly related to the medication itself. Choice D is dangerous advice; stopping diazepam abruptly can lead to withdrawal symptoms and should only be done under medical supervision.

4. A client has been diagnosed with major depressive disorder. Which is an appropriate short-term goal for the client?

• A. The client will report a decrease in depressive symptoms.
• B. The client will establish a sleep routine.
• C. The client will improve social interactions.
• D. The client will set realistic goals for the future.

Correct answer: A

Rationale: Setting a goal for the client to report a decrease in depressive symptoms is appropriate as it is specific, measurable, and achievable in the short term. Monitoring changes in depressive symptoms provides valuable feedback on the effectiveness of the treatment plan. While establishing a sleep routine, improving social interactions, and setting realistic goals for the future are important aspects of recovery, they are more suitable as intermediate or long-term goals. In the context of short-term goals, focusing on symptom reduction can provide immediate feedback on the client's progress and help adjust the treatment plan accordingly.

5. Which client statement indicates an understanding of the education provided about the antidepressant medication sertraline (Zoloft)?

• A. I should take this medication on an empty stomach.
• B. It may take several weeks for this medication to be effective.
• C. I can stop taking this medication when I feel better.
• D. I should avoid taking this medication with other medications.

Correct answer: B

Rationale: Choice B is the correct answer. It is crucial for clients to understand that sertraline (Zoloft) may take several weeks to show its full effects. Patients should be informed about this delay in onset of action to set realistic expectations and adhere to the treatment plan. This education helps prevent premature discontinuation of the medication due to perceived lack of efficacy. Choices A, C, and D are incorrect. Choice A is inaccurate because sertraline (Zoloft) should be taken with food to reduce the risk of gastrointestinal side effects. Choice C is incorrect because abruptly stopping the medication can lead to withdrawal symptoms and worsening of the condition. Choice D is inaccurate as there are specific medications that should be avoided with sertraline, but a general statement to avoid all other medications is overly broad and not necessary.

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