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. A patient with schizophrenia is being educated about the significance of medication adherence. Which statement by the patient indicates understanding?

• A. I will take my medication only when I feel symptoms returning.
• B. I understand that taking my medication regularly is important to manage my symptoms.
• C. I can stop taking my medication once I feel better.
• D. I should take my medication on an as-needed basis.

Correct answer: B

Rationale: The correct answer is B because acknowledging the importance of consistently taking medication is crucial for effectively managing symptoms of schizophrenia. It is essential for patients with schizophrenia to adhere to their medication regimen to stabilize their condition and prevent symptom exacerbation. Waiting for symptoms to return before taking medication, stopping medication once feeling better, or taking medications on an as-needed basis are not recommended practices for managing schizophrenia effectively.

3. James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for the day shift and anxiously reports, “Last night, demons came to my room and tried to rape me.” Which response would be most therapeutic?

• A. There are no such things as demons. What you saw were hallucinations.
• B. It is not possible for anyone to enter your room at night. You are safe here.
• C. You seem very upset. Please tell me more about what you experienced last night.
• D. That must have been very frightening, but we’ll check on you at night and you’ll be safe.

Correct answer: C

Rationale: The most therapeutic response acknowledges the patient's emotional state and invites further discussion about their experience. By saying, 'You seem very upset. Please tell me more about what you experienced last night,' the nurse shows empathy and openness, providing a supportive environment for the patient to express their feelings and perceptions.

4. A patient with bipolar disorder is being educated by a nurse on the importance of medication adherence. Which statement by the patient indicates understanding?

• A. I will take my medication only when I feel manic symptoms.
• B. I understand that I need to take my medication regularly, even if I feel well.
• C. I will stop taking my medication if I experience side effects.
• D. I will take my medication whenever I remember.

Correct answer: B

Rationale: The correct answer is B. Taking medication regularly, even when feeling well, is crucial in managing bipolar disorder. Choice A is incorrect because medication adherence should not be based on symptoms alone. Choice C is incorrect as stopping medication due to side effects should be discussed with a healthcare provider. Choice D is incorrect because relying on memory may lead to missed doses, impacting treatment effectiveness.

5. What is the priority intervention for a patient admitted for an overdose of sedatives and diagnosed with dissociative identity disorder?

• A. Conducting a suicide assessment
• B. Arranging for placement in a group home
• C. Providing a low-stimulation environment
• D. Establishing trust and rapport

Correct answer: A

Rationale: Conducting a suicide assessment is the priority intervention for a patient admitted for an overdose of sedatives and diagnosed with dissociative identity disorder. In this scenario, the immediate concern is to assess the risk of harm to the patient's life. It is crucial to determine if the overdose was intentional and if the patient has suicidal ideation or intent. Arranging for placement in a group home (choice B) may be necessary at a later stage depending on the patient's needs, but it is not the priority in this urgent situation. Providing a low-stimulation environment (choice C) and establishing trust and rapport (choice D) are important aspects of care but addressing the immediate risk of suicide takes precedence in this case.

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