Nursing Elites

1. A patient with major depressive disorder is started on fluoxetine. What is a common side effect the nurse should monitor for?

• A. Weight gain
• B. Increased appetite
• C. Nausea
• D. Dry mouth

Correct answer: C

Rationale: Nausea is a common side effect of fluoxetine and should be monitored.

2. Gilbert, age 19, is described by his parents as a ‘moody child’ with an onset of odd behavior at age 14, which caused Gilbert to suffer academically and socially. Gilbert has lost the ability to complete household chores, is reluctant to leave the house, and is obsessed with the locks on the windows and doors. Due to Gilbert’s early and slow onset of what is now recognized as schizophrenia, his prognosis is considered:

• A. Favorable with medication
• B. In the relapse stage
• C. Improvable with psychosocial interventions
• D. To have a less positive outcome

Correct answer: D

Rationale: A person like Gilbert, with an early and slow onset of schizophrenia along with severe symptoms such as loss of daily functioning and obsessions, is likely to have a less positive outcome. Early and severe symptoms are often associated with a more chronic and debilitating course of schizophrenia, which can make treatment and recovery more challenging. Therefore, Gilbert's prognosis is considered to have a less positive outcome. Choices A, B, and C are incorrect because Gilbert's condition, with its early onset and severe symptoms impacting daily life, suggests a more challenging prognosis that is less likely to be favorable with just medication or psychosocial interventions. Being in the relapse stage is not the primary concern here; the focus is on the overall outcome which is expected to be less positive given the early and severe nature of Gilbert's symptoms.

3. During an intake assessment, a healthcare professional is evaluating a patient diagnosed with obsessive-compulsive disorder (OCD). Which question would be most appropriate?

• A. Do you often experience periods of sadness?
• B. Do you have difficulty controlling your worrying?
• C. Do you find yourself repeating behaviors or thoughts?
• D. Do you experience sudden, unexpected panic attacks?

Correct answer: C

Rationale: The most appropriate question when assessing a patient with obsessive-compulsive disorder (OCD) is to inquire about repeating behaviors or thoughts. This is a hallmark feature of OCD, where individuals often engage in repetitive actions or mental rituals to alleviate anxiety or distress. This behavior distinguishes OCD from other mental health conditions such as generalized anxiety disorder (choice B), major depressive disorder (choice A), and panic disorder (choice D). Therefore, recognizing repetitive behaviors or thoughts helps in identifying the presence of OCD and tailoring appropriate interventions for the patient.

4. Which symptom is most commonly associated with generalized anxiety disorder (GAD)?

• A. Frequent panic attacks
• B. Persistent and excessive worry
• C. Recurrent, intrusive thoughts
• D. Compulsive behaviors

Correct answer: B

Rationale: The correct answer is B: Persistent and excessive worry. Generalized anxiety disorder (GAD) is characterized by persistent and excessive worry about a variety of things, even when there is little or no reason to worry. This worry is difficult to control and can significantly impact daily life. While panic attacks, recurrent intrusive thoughts, and compulsive behaviors can occur in other anxiety disorders, persistent and excessive worry is the hallmark symptom of GAD. Therefore, choices A, C, and D are incorrect as they do not represent the primary symptom associated with GAD.

5. A patient with obsessive-compulsive disorder (OCD) is prescribed fluvoxamine. What is a common side effect of this medication?

• A. Increased appetite
• B. Dry mouth
• C. Weight gain
• D. Nausea

Correct answer: D

Rationale: Nausea is a common side effect of fluvoxamine, a selective serotonin reuptake inhibitor (SSRI) commonly used in the treatment of OCD. Patients should be advised to monitor and report any gastrointestinal disturbances, including nausea, to their healthcare provider.

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