Nursing Elites

1. A patient with bipolar disorder is prescribed lithium. Which dietary advice should the nurse include?

• A. Avoid foods high in tyramine.
• B. Maintain a consistent salt intake.
• C. Increase protein intake.
• D. Avoid foods high in fat.

Correct answer: B

Rationale: Patients prescribed lithium should maintain a consistent salt intake. Fluctuations in salt intake can impact lithium levels, potentially leading to toxicity or reduced effectiveness of the medication. It is crucial for patients to adhere to a stable salt intake while taking lithium to ensure optimal treatment outcomes. Choices A, C, and D are incorrect. Avoiding foods high in tyramine is more relevant for patients on MAOIs, not lithium. Increasing protein intake or avoiding foods high in fat are not specific dietary recommendations for patients taking lithium.

2. A female patient diagnosed with schizophrenia has been prescribed a first-generation antipsychotic medication. What information should the nurse provide to the patient regarding her signs and symptoms?

• A. Her memory problems will likely decrease.
• B. Depressive episodes should be less severe.
• C. She will probably enjoy social interactions more.
• D. She should experience a reduction in hallucinations.

Correct answer: D

Rationale: First-generation antipsychotic medications are effective in reducing hallucinations in patients with schizophrenia. These medications primarily target positive symptoms such as hallucinations and delusions. Therefore, the nurse should inform the patient that she should experience a reduction in hallucinations with the prescribed first-generation antipsychotic medication.

3. A healthcare professional is assessing a client diagnosed with narcissistic personality disorder. Which of the following behaviors should the healthcare professional expect?

• A. Grandiose sense of self-importance
• B. Lack of empathy
• C. Need for excessive admiration
• D. Envy of others

Correct answer: A

Rationale: Clients with narcissistic personality disorder often exhibit a grandiose sense of self-importance, believing they are special and unique. This behavior is characterized by an exaggerated sense of achievements and talents, expecting to be recognized as superior without commensurate achievements. While individuals with this disorder may lack empathy and have a need for excessive admiration, the prominent feature of grandiosity is a core aspect of narcissistic personality disorder. Therefore, the correct behavior expected in this case is a grandiose sense of self-importance (Choice A). Lack of empathy (Choice B) and need for excessive admiration (Choice C) are also common traits in narcissistic personality disorder, but they are not the primary behavior associated with the disorder. Envy of others (Choice D) is not a characteristic behavior typically seen in individuals with narcissistic personality disorder.

4. When an individual's stress response is sustained over a long period of time, which physiological effect of the endocrine system should one anticipate?

• A. Decreased resistance to disease
• B. Increased libido
• C. Decreased blood pressure
• D. Increased inflammatory response

Correct answer: A

Rationale: When stress is prolonged, the body reaches the stage of exhaustion in the general adaptation syndrome, where compensatory mechanisms fail, and diseases of adaptation may occur. One physiological effect includes a decreased immune response, leading to decreased resistance to disease. Therefore, the correct answer is A. Increased libido (choice B) is not a typical physiological effect related to prolonged stress. Decreased blood pressure (choice C) is not commonly associated with sustained stress. Increased inflammatory response (choice D) may occur in the short term due to stress, but over a prolonged period, the immune system's function weakens, leading to decreased resistance to disease.

5. Therapeutic communication is the foundation of a patient-centered interview. Which of the following techniques is not considered therapeutic?

• A. Restating
• B. Encouraging description of perception
• C. Summarizing
• D. Asking 'why' questions

Correct answer: D

Rationale: Asking 'why' questions is not considered a therapeutic technique in patient-centered communication as it can make patients feel defensive or judged. 'Why' questions may imply criticism or put the patient on the spot, potentially hindering open and honest communication. Instead, focusing on open-ended questions that encourage patients to express their feelings and thoughts without feeling judged or interrogated is more conducive to therapeutic communication.

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