Nursing Elites

1. A client is under a great deal of stress. Which nursing recommendation would be least helpful in assisting the client in coping with stress? Select one that doesn't apply.

• A. Enjoy a pet.
• B. Spend time with a loved one.
• C. Listen to music.
• D. Focus on the stressors.

Correct answer: D

Rationale: Focusing on the stressors can exacerbate stress levels in the client's life rather than helping to cope with it. Engaging in activities such as enjoying a pet, spending time with loved ones, and listening to music are known to be stress-relieving and can aid in coping with stress. It is essential to encourage strategies that promote relaxation and positive emotions, rather than fixating on the stressors that may worsen the client's condition. Therefore, 'Focus on the stressors' is the least helpful recommendation as it does not contribute to stress management.

2. A client is experiencing alcohol withdrawal. Which symptom should the nurse identify as a priority to address?

• A. Tremors
• B. Nausea and vomiting
• C. Increased blood pressure
• D. Insomnia

Correct answer: C

Rationale: During alcohol withdrawal, increased blood pressure is a critical symptom that requires immediate attention. Elevated blood pressure can lead to serious complications such as cardiovascular events or stroke. Monitoring and managing blood pressure in clients experiencing alcohol withdrawal is crucial to prevent adverse outcomes. Tremors, nausea and vomiting, and insomnia are common symptoms of alcohol withdrawal, but they are not as immediately life-threatening as increased blood pressure. Therefore, addressing increased blood pressure takes precedence in the management of a client experiencing alcohol withdrawal.

3. 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.

4. A healthcare provider is evaluating the effectiveness of medication therapy for a client diagnosed with bipolar disorder. Which outcome should indicate that the medication has been effective?

• A. The client reports a decrease in manic episodes.
• B. The client experiences fewer mood swings.
• C. The client sleeps for 8 hours each night.
• D. The client maintains a stable weight.

Correct answer: A

Rationale: A decrease in manic episodes is a key indicator of the effectiveness of medication therapy for bipolar disorder. Manic episodes are a hallmark of bipolar disorder, and a decrease in their frequency or intensity suggests that the medication is helping to stabilize the client's mood and manage their symptoms. While choices B, C, and D are important aspects of overall health and well-being, they are not specific indicators of the effectiveness of medication therapy for bipolar disorder. Choice B focuses on mood swings in general, which may include depressive episodes as well, while choice C addresses sleep patterns and choice D relates to weight stability, which can be influenced by various factors unrelated to bipolar disorder treatment.

5. A client is experiencing severe anxiety. Which of the following is an appropriate intervention?

• A. Encourage the client to participate in group therapy sessions.
• B. Encourage the client to verbalize feelings of anxiety.
• C. Encourage the client to limit caffeine intake.
• D. Encourage the client to avoid stressful situations.

Correct answer: B

Rationale: Encouraging the client to verbalize feelings of anxiety is an appropriate intervention for severe anxiety. Verbalizing emotions can help the client process their feelings and reduce the intensity of anxiety. It promotes emotional expression and may lead to a better understanding of the underlying causes of anxiety, paving the way for effective coping strategies. Choices A, C, and D are not the most appropriate interventions for severe anxiety. While group therapy can be beneficial, it may not be suitable for someone experiencing severe anxiety. Limiting caffeine intake and avoiding stressful situations are helpful strategies but may not address the root of the severe anxiety or provide immediate relief.

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