Nursing Elites

1. A patient with generalized anxiety disorder (GAD) is prescribed escitalopram. The nurse should educate the patient that the full therapeutic effect of this medication may take:

• A. 1-2 days
• B. 1-2 weeks
• C. 2-4 weeks
• D. 6-8 weeks

Correct answer: D

Rationale: Escitalopram, an SSRI used in treating generalized anxiety disorder, typically takes 6-8 weeks to achieve its full therapeutic effect. While some improvement may be noticed earlier, the maximum benefit is usually experienced after this timeframe. Options A, B, and C are incorrect because they underestimate the time required for escitalopram to reach its full effectiveness. Educating patients about the realistic timeline for medication effectiveness is crucial in managing expectations and ensuring adherence to the prescribed treatment.

2. Which client action is an example of the defense mechanism of reaction formation?

• A. A woman who feels unattractive constantly praises the looks of others.
• B. A man who feels insecure about his masculinity exaggerates his strength.
• C. A person who feels guilty about cheating accuses others of being unfaithful.
• D. A child who feels neglected tries to win approval from teachers.

Correct answer: A

Rationale: The defense mechanism of reaction formation involves expressing the opposite of one's true feelings. In this case, the woman who feels unattractive praises the looks of others as a way to mask her own feelings of inadequacy. This behavior represents a form of overcompensation where the individual showcases an exaggerated opposite trait to conceal their true emotions. Choices B, C, and D do not align with reaction formation. Choice B describes compensation, where one overemphasizes a trait to make up for a perceived weakness. Choice C illustrates projection, where one attributes their feelings onto others. Choice D demonstrates a form of seeking attention or approval, which does not fit reaction formation.

3. A client prescribed diazepam for anxiety is receiving education from a healthcare professional. Which statement by the client indicates a need for further teaching?

• A. I can drink alcohol while taking this medication.
• B. I should avoid drinking alcohol while taking this medication.
• C. I should take this medication only when I feel anxious.
• D. I can stop taking this medication when I feel better.

Correct answer: A

Rationale: The correct answer is A. Clients should avoid alcohol while taking diazepam (Valium) as it can potentiate the effects of the medication, leading to excessive sedation and other adverse effects. Mixing alcohol with diazepam can also increase the risk of overdose and other serious complications. Therefore, it is crucial for the client to refrain from consuming alcohol while on this medication to ensure their safety and optimize the therapeutic benefits of diazepam for managing anxiety.

4. When caring for a client experiencing alcohol withdrawal, which intervention should the nurse implement to prevent complications?

• A. Provide a well-lit environment.
• B. Administer antipsychotic medication as prescribed.
• C. Monitor the client's vital signs closely.
• D. Encourage the client to express their feelings.

Correct answer: C

Rationale: Monitoring the client's vital signs closely is crucial during alcohol withdrawal as it helps detect any physiological changes early, such as hypertension, tachycardia, or fever, which can indicate potential complications like delirium tremens. Early identification and prompt intervention can prevent severe outcomes in clients experiencing alcohol withdrawal.

5. A client has generalized anxiety disorder (GAD), and a nurse is providing care. Which of the following interventions should the nurse avoid implementing?

• A. Encourage the client to express their feelings
• B. Monitor daily caloric intake and weight
• C. Promote regular physical activity
• D. Discourage the use of caffeine

Correct answer: B

Rationale: In caring for a client with generalized anxiety disorder (GAD), it is important to encourage the client to express their feelings, promote regular physical activity, and discourage the use of caffeine. Addressing weight and caloric intake monitoring may exacerbate anxiety related to body image, and focusing on these aspects can be distressing for the client. Therefore, monitoring daily caloric intake and weight should be avoided in this scenario.

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