Nursing Elites

1. A nurse is providing discharge teaching to a patient prescribed fluoxetine for panic disorder. Which statement should be included in the teaching?

• A. You should notice the effects of this medication within a few days.
• B. It's important to take this medication only when you feel anxious.
• C. It may take several weeks before you notice the full effects of this medication.
• D. You can stop taking this medication as soon as you feel better.

Correct answer: C

Rationale: The correct statement to include in the teaching is that it may take several weeks before the patient notices the full effects of fluoxetine. This is because fluoxetine, like other SSRIs, requires time to reach its full therapeutic effect. Choice A is incorrect as fluoxetine does not show its effects within a few days. Choice B is incorrect as fluoxetine should be taken regularly as prescribed, not only when feeling anxious. Choice D is incorrect as discontinuing fluoxetine abruptly can lead to withdrawal symptoms and a return of panic disorder symptoms.

2. A patient with social anxiety disorder is learning cognitive-behavioral therapy (CBT) techniques. Which skill is most likely being taught?

• A. Avoiding social situations that cause anxiety
• B. Challenging and changing negative thoughts
• C. Using deep breathing exercises during social interactions
• D. Taking anti-anxiety medication before social events

Correct answer: B

Rationale: The correct answer is B. In cognitive-behavioral therapy (CBT) for social anxiety disorder, the focus is on challenging and changing negative thoughts that contribute to anxiety. This process involves identifying distorted thought patterns and replacing them with more balanced and realistic thoughts, helping individuals develop healthier perspectives on social situations. Choices A, C, and D are incorrect because avoiding social situations, using deep breathing exercises, and taking medication are not the primary skills taught in CBT for social anxiety disorder. CBT aims to address the underlying thought patterns and behaviors that maintain anxiety, rather than avoidance or temporary relief.

3. In an outpatient mental health clinic, a nurse is preparing to conduct an initial client interview. Which of the following actions should the nurse identify as a priority?

• A. Coordinate holistic care with social services
• B. Identify the client’s perception of their mental health status
• C. Include the client’s family in the interview
• D. Educate the client about their current mental health disorder

Correct answer: B

Rationale: During an initial client interview in a mental health clinic, it is essential for the nurse to prioritize identifying the client’s perception of their mental health status. Understanding how the client views their mental health can provide valuable insights into their condition, concerns, and needs, facilitating the development of a tailored and effective care plan. Coordinating holistic care with social services, including the client’s family in the interview, and educating the client about their current mental health disorder are important aspects of care but may not be the priority during the initial interview, where understanding the client's own perspective is crucial.

4. A patient is receiving education about taking clozapine. Which statement indicates the patient understands the side effects?

• A. I should report any signs of infection to my healthcare provider immediately.
• B. I can stop taking this medication once I feel better.
• C. I should take this medication on an empty stomach.
• D. I should avoid drinking alcohol while taking this medication.

Correct answer: A

Rationale: The correct answer is A because patients taking clozapine should report signs of infection immediately due to the risk of agranulocytosis. Agranulocytosis is a potentially life-threatening side effect of clozapine characterized by a significant decrease in white blood cell count, which can leave the patient vulnerable to infections. Reporting signs of infection promptly is crucial to prevent serious complications.

5. A patient with bipolar disorder is prescribed lithium. What is a common side effect the nurse should monitor for?

• A. Increased energy
• B. Constipation
• C. Weight gain
• D. Dry mouth

Correct answer: C

Rationale: Weight gain is a common side effect associated with lithium therapy. It is essential for the nurse to monitor the patient for changes in weight as it can impact the individual's overall health and well-being. Patients on lithium should be advised on dietary and lifestyle modifications to manage potential weight gain and maintain a healthy weight.

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