Nursing Elites

1. A patient with generalized anxiety disorder (GAD) is prescribed buspirone. The nurse understands that buspirone is different from benzodiazepines because it:

• A. Has a high potential for abuse.
• B. Works immediately to relieve anxiety.
• C. Does not cause sedation.
• D. Is used for short-term treatment only.

Correct answer: C

Rationale: Buspirone is different from benzodiazepines because it does not cause sedation. Unlike benzodiazepines, buspirone has a lower potential for abuse and does not cause the sedative effects commonly seen with benzodiazepines. While benzodiazepines may work immediately to relieve anxiety, buspirone may take longer to show its therapeutic effects. Additionally, buspirone is not limited to short-term treatment only, making it a preferred choice in patients where sedation is a concern or in those with a history of substance abuse.

2. Ted, a former executive, is now unemployed due to manic episodes at work. He was diagnosed with bipolar I 8 years ago. Ted has a history of IV drug abuse, which resulted in hepatitis C. He is taking his lithium exactly as scheduled, a fact that both Ted's wife and his blood tests confirm. To reduce Ted's mania, the psychiatric nurse practitioner recommends:

• A. Clonazepam (Klonopin)
• B. Fluoxetine (Prozac)
• C. Electroconvulsive therapy (ECT)
• D. Lurasidone (Latuda)

Correct answer: C

Rationale: Electroconvulsive therapy (ECT) can be an effective treatment for reducing mania in patients with bipolar disorder who have not responded to medication. In Ted's case, where he has a history of bipolar I disorder, lithium treatment, and manic episodes, ECT may be recommended by the psychiatric nurse practitioner to help manage his symptoms.

3. 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.

4. In evaluating a client's response to stress, what would indicate a secondary appraisal of the stressful event?

• A. When the individual judges the event to be benign
• B. When the individual judges the event to be irrelevant
• C. When the individual judges the resources and skills needed to deal with the event
• D. When the individual judges the event to be pleasurable

Correct answer: C

Rationale: A secondary appraisal occurs when an individual evaluates the resources and skills required to cope with a stressful event. This type of appraisal focuses on the person's perceived ability to manage the situation. In contrast, choices A, B, and D do not involve the assessment of resources and skills. Choice A relates to a benign judgment of the event, choice B to an irrelevant judgment, and choice D to a pleasurable judgment, which are aspects of primary rather than secondary appraisals.

5. Which medication is commonly prescribed for the treatment of attention-deficit/hyperactivity disorder (ADHD)?

• A. Haloperidol
• B. Fluoxetine
• C. Methylphenidate
• D. Clozapine

Correct answer: C

Rationale: Methylphenidate is a stimulant medication commonly prescribed to manage symptoms of attention-deficit/hyperactivity disorder (ADHD). It works by affecting certain chemicals in the brain to improve focus, attention span, and impulse control. Haloperidol, fluoxetine, and clozapine are not typically used as first-line treatments for ADHD. Haloperidol is an antipsychotic, fluoxetine is an antidepressant, and clozapine is an atypical antipsychotic, each with different mechanisms of action and primary indications.

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