Nursing Elites

1. What should the nurse include in patient education for a patient starting on bupropion for major depressive disorder?

• A. Avoid consuming alcohol while taking this medication.
• B. Take the medication in the morning to prevent insomnia.
• C. It may cause significant weight gain.
• D. It is used as a first-line treatment for anxiety.

Correct answer: A

Rationale: Patients prescribed bupropion should be educated to avoid consuming alcohol while on this medication to reduce the risk of seizures. Bupropion lowers the seizure threshold, and alcohol can further increase this risk. It is important for patients to understand the potential consequences of combining bupropion with alcohol to ensure their safety and treatment effectiveness. Choices B, C, and D are incorrect. Taking bupropion in the morning does not prevent insomnia; it is not associated with significant weight gain; and it is not a first-line treatment for anxiety.

2. During a mental status examination, which of the following components should be included in the assessment? Select one that doesn't apply.

• A. Appearance and behavior
• B. Thought processes
• C. Mood and affect
• D. The greater the cultural distance from the mainstream of society, the greater the likelihood that the illness will be treated with sensitivity and compassion.

Correct answer: D

Rationale: During a mental status examination, key components to be assessed include the client's appearance and behavior, thought processes, mood and affect, and cognitive function. These components help in evaluating the client's mental health status. The statement about cultural distance and illness treatment is not a part of a mental status examination and is not relevant to the assessment of mental health. Choices A, B, and C are essential components of a mental status examination and contribute to a comprehensive evaluation of an individual's mental well-being.

3. Which should the individual recognize as an example of the defense mechanism of repression?

• A. A student aware of the need to study for tomorrow's test goes to a movie instead.
• B. A woman whose son was killed in Iraq does not believe the military report.
• C. A man who is unhappily married goes to school to become a marriage counselor.
• D. A woman was raped when she was 12 and no longer remembers the incident.

Correct answer: D

Rationale: Repression is a defense mechanism where distressing thoughts, feelings, or memories are pushed out of conscious awareness to protect the individual from emotional pain. In this scenario, the woman's inability to recall the traumatic event of being raped at the age of 12 indicates repression in action. Choices A, B, and C do not represent repression. Choice A reflects procrastination, choice B suggests denial, and choice C indicates sublimation as the man is channeling his unhappiness into a constructive pursuit.

4. A patient with panic disorder is prescribed a benzodiazepine. The nurse should educate the patient that this medication is typically used for:

• A. For long-term maintenance therapy.
• B. As a first-line treatment.
• C. For short-term use due to the risk of dependence.
• D. To treat depression symptoms.

Correct answer: C

Rationale: The correct answer is C: 'For short-term use due to the risk of dependence.' Benzodiazepines are usually prescribed for short-term relief of anxiety symptoms due to the risk of dependence. Prolonged use can lead to tolerance, dependence, and other adverse effects, so they are not typically used for long-term maintenance therapy (choice A). They are not considered first-line treatments for panic disorder (choice B) and are not primarily used to treat depression symptoms (choice D), as their main indication is for anxiety and panic disorders.

5. 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.

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