Nursing Elites

1. A patient with generalized anxiety disorder (GAD) is prescribed sertraline. What is a common side effect the nurse should monitor for?

• A. Dry mouth
• B. Weight gain
• C. Insomnia
• D. Nausea

Correct answer: D

Rationale: Nausea is a common side effect associated with sertraline, a medication commonly used in the treatment of generalized anxiety disorder (GAD). It is essential for the nurse to monitor for nausea as it can impact the patient's adherence to the medication regimen. Educating the patient about this potential side effect and advising ways to manage it can enhance treatment compliance and overall therapeutic outcomes.

2. Which medication is often prescribed for patients with bipolar disorder to help stabilize mood?

• A. Sertraline
• B. Lithium
• C. Haloperidol
• D. Diazepam

Correct answer: B

Rationale: Lithium is the medication frequently prescribed to stabilize mood in patients with bipolar disorder. It helps to reduce the frequency and severity of manic episodes, making it a cornerstone in the treatment of bipolar disorder. Sertraline is an antidepressant commonly used for depression, while haloperidol and diazepam are not typically first-line treatments for bipolar disorder.

3. A healthcare professional is caring for a group of clients. Which of the following clients should the healthcare professional consider for referral to an assertive community treatment (ACT) group?

• A. A client in an acute care mental health facility who has fallen several times while running down the hallway
• B. A client who lives at home and keeps forgetting to come in for a scheduled monthly antipsychotic injection for schizophrenia
• C. A client in a day treatment program who reports increasing anxiety during group therapy
• D. A client in a weekly grief support group who reports still missing a deceased partner who has been dead for 3 months

Correct answer: B

Rationale: The client who lives at home and repeatedly forgets to come in for a scheduled monthly antipsychotic injection for schizophrenia should be considered for referral to an assertive community treatment (ACT) group. ACT teams provide intensive community-based treatment and support for individuals with severe mental illness who may have difficulty adhering to treatment on their own. Choices A, C, and D do not describe individuals with severe mental illness who have difficulty adhering to treatment or need intensive community-based support, which are the typical candidates for referral to an ACT group.

4. A patient with obsessive-compulsive disorder (OCD) performs hand washing repeatedly. Which nursing intervention is most appropriate?

• A. Restricting the patient from washing hands
• B. Setting strict limits on the patient's hand washing
• C. Allowing the patient to wash hands at specified times
• D. Ignoring the patient's behavior

Correct answer: C

Rationale: Allowing the patient to wash hands at specified times is the most appropriate nursing intervention for a patient with OCD who repetitively performs hand washing. This intervention provides structure by allowing the patient to engage in the behavior at designated times, helping to reduce the compulsion gradually. Restricting or setting strict limits may increase anxiety and worsen the condition, while ignoring the behavior does not address the underlying issue of OCD.

5. Which individual is likely experiencing symptoms of derealization?

• A. I just feel like I’m looking at life through a fog and that can’t be my face in the mirror.
• B. I cannot recall why I’m living in this town or how I got here.
• C. There are just too many people living in my head now.
• D. I feel like I’m going to die, I’m having a heart attack.

Correct answer: A

Rationale: The individual describing feeling like they are looking at life through a fog and questioning their reflection in the mirror is likely experiencing symptoms of derealization. Derealization involves feelings of detachment from one's surroundings, which can manifest as a sense of unreality or distortion of the environment. Choice B describes dissociative amnesia, which involves memory loss related to personal information or traumatic events. Choice C suggests dissociative identity disorder (DID), where a person experiences two or more distinct identities or personality states. Choice D indicates symptoms of a panic attack, such as fearing imminent death and physical sensations like a heart attack.

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