Nursing Elites

1. A patient is receiving education about dietary restrictions while taking a monoamine oxidase inhibitor (MAOI). Which food should the patient avoid?

• A. Aged cheese
• B. Fresh vegetables
• C. Grilled chicken
• D. Fruit juices

Correct answer: A

Rationale: Patients taking MAOIs should avoid aged cheese as it contains high levels of tyramine, which can lead to a hypertensive crisis. Monoamine oxidase inhibitors can inhibit the breakdown of tyramine, leading to an excess accumulation in the body and potentially dangerous increases in blood pressure.

2. Which symptom is most commonly associated with social anxiety disorder?

• A. Fear of speaking in public
• B. Recurrent, intrusive thoughts
• C. Flashbacks of traumatic events
• D. Persistent low mood

Correct answer: A

Rationale: Fear of speaking in public is a hallmark symptom of social anxiety disorder. Individuals with social anxiety disorder often experience intense fear or anxiety about social situations where they may be scrutinized or judged by others, such as speaking in public. This fear can significantly impact their daily functioning and quality of life, making it a key feature in diagnosing social anxiety disorder. Recurrent, intrusive thoughts, flashbacks of traumatic events, and persistent low mood are more commonly associated with other mental health conditions, such as obsessive-compulsive disorder, post-traumatic stress disorder, and depression, respectively. Therefore, choice A is the correct answer as it aligns with the characteristic symptom of social anxiety disorder.

3. A patient with major depressive disorder has been prescribed sertraline (Zoloft). Which statement by the patient indicates a need for further teaching?

• A. I should take my medication with food to avoid stomach upset.
• B. I should avoid alcohol while taking this medication.
• C. I can stop taking my medication once I feel better.
• D. I might experience some improvement in mood within a few weeks.

Correct answer: C

Rationale: Choice C is the correct answer. It is crucial for patients to understand that they should not stop taking their medication once they feel better. Discontinuing antidepressants abruptly can lead to a relapse of depressive symptoms. Patients should continue taking their medication as prescribed by their healthcare provider, even if they start feeling better, to ensure the best outcomes in managing major depressive disorder. Choices A, B, and D are all accurate statements. Taking medication with food can help reduce stomach upset, avoiding alcohol is essential while on sertraline to prevent interactions, and experiencing some improvement in mood within a few weeks is a common expectation when starting an antidepressant like sertraline.

4. A client in an acute mental health facility is being discharged and requires supervision due to a severe mental illness. The client’s partner works all day but is home by late afternoon. Which of the following strategies should the nurse suggest for follow-up care?

• A. Receiving daily care from a home health aide
• B. Having a weekly visit from a nurse case worker
• C. Attending a partial hospitalization program
• D. Visiting a community mental health center on a daily basis

Correct answer: C

Rationale: For clients requiring supervision due to severe mental illness, attending a partial hospitalization program provides structured care and support while allowing the client to return home in the evenings, making it a suitable option for follow-up care. The other choices are less appropriate: A home health aide may not provide the necessary level of care and supervision, a weekly visit from a nurse case worker may not be sufficient for the client's needs, and visiting a community mental health center on a daily basis may not offer the structured support required for someone with a severe mental illness.

5. In dissociative identity disorder, a patient exhibits different personalities, each with distinct behaviors and memories. The nurse recognizes that this fragmentation of identity serves as a coping mechanism for:

• A. Current stressors
• B. Developmental issues
• C. Traumatic experiences
• D. Family dynamics

Correct answer: C

Rationale: In dissociative identity disorder, the fragmentation of identity serves as a coping mechanism for traumatic experiences. Individuals may develop different identities to help them manage and cope with overwhelming and traumatic events from their past. These distinct personalities often emerge as a way to protect the individual from the emotional pain associated with their traumatic experiences. Choices A, B, and D are incorrect because dissociative identity disorder is primarily associated with coping mechanisms related to past traumatic experiences, rather than current stressors, developmental issues, or family dynamics.

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