Nursing Elites

1. During a manic episode, which nursing intervention is most appropriate?

• A. Encourage group activities to increase socialization.
• B. Provide a structured environment with limited stimuli.
• C. Allow the patient to engage in physical activities freely.
• D. Give the patient detailed and complex tasks to complete.

Correct answer: B

Rationale: During a manic episode, individuals may experience heightened energy levels and reduced impulse control. Providing a structured environment with limited stimuli is the most appropriate nursing intervention. This approach helps reduce excessive stimulation and potential triggers for further escalation of manic behavior. It promotes a calming and controlled setting, assisting in managing symptoms and promoting the patient's well-being. Encouraging group activities (Choice A) may lead to overstimulation, allowing the patient to engage in physical activities freely (Choice C) could be risky due to impulsivity, and giving detailed tasks (Choice D) might overwhelm the individual.

2. Before discharge from the chemical dependency unit, clients are introduced to different community resources. Which of the following resources would be best for a teenage client, who has been abusing over-the-counter sedatives and is ready for discharge in two days?

• A. Detoxification center
• B. Home care
• C. Assertive community team
• D. Twelve-step recovery group

Correct answer: A

Rationale: For a teenage client who has been abusing over-the-counter sedatives and is ready for discharge in two days, the best resource would be a detoxification center. This specialized facility can provide the necessary medical and psychological support to safely manage the withdrawal symptoms associated with substance abuse. It is crucial to ensure a safe and supervised detox process for the client's well-being and successful recovery.

3. What assessment question will provide information to the healthcare provider regarding the effects of a woman's circadian rhythms on her quality of life?

• A. How much sleep do you usually get each night?
• B. Does your heart ever seem to skip a beat?
• C. When was the last time you had a fever?
• D. Do you have problems urinating?

Correct answer: A

Rationale: The correct assessment question to understand the effects of a woman's circadian rhythms on her quality of life is to inquire about her sleep duration. Circadian rhythms significantly influence sleep patterns, so knowing how much sleep she usually gets each night can provide valuable insight into potential circadian rhythm disturbances and their impact on her overall well-being.

4. A patient with obsessive-compulsive disorder (OCD) is prescribed paroxetine. The nurse should educate the patient about which potential side effect?

• A. Insomnia
• B. Weight loss
• C. Sexual dysfunction
• D. Hypertension

Correct answer: C

Rationale: The correct answer is C, 'Sexual dysfunction.' Paroxetine, an SSRI commonly prescribed for OCD, can lead to sexual dysfunction as a side effect. Patients should be educated about this potential adverse effect to ensure they are aware and can seek appropriate management if needed. Choices A, B, and D are incorrect because insomnia, weight loss, and hypertension are not typically associated with paroxetine use as common side effects in patients with OCD.

5. 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.

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