Nursing Elites

1. In schizophrenia, a patient is experiencing negative symptoms. Which of the following is a negative symptom?

• A. Hallucinations
• B. Delusions
• C. Apathy
• D. Disorganized speech

Correct answer: C

Rationale: In schizophrenia, negative symptoms refer to deficits in normal emotional responses or other thought processes. Apathy is a negative symptom characterized by a lack of interest, enthusiasm, or concern. Hallucinations (seeing or hearing things that aren't there), delusions (false beliefs), and disorganized speech are positive symptoms, which involve the presence of abnormal behaviors or thoughts.

2. A healthcare professional is assessing a patient with bipolar disorder. Which finding suggests the patient is experiencing a manic episode?

• A. Decreased need for sleep
• B. Feelings of worthlessness
• C. Increased need for sleep
• D. Avoidance of social interactions

Correct answer: A

Rationale: During a manic episode in patients with bipolar disorder, they often experience a decreased need for sleep. This symptom is characterized by feeling rested after only a few hours of sleep, or even feeling like they can go without sleep for extended periods without feeling tired. The increased energy levels and racing thoughts during a manic episode contribute to the decreased need for sleep.

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 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.

5. What is an important aspect of patient education regarding buspirone when prescribed for generalized anxiety disorder (GAD)?

• A. Buspirone is an as-needed medication for anxiety.
• B. Buspirone has a high risk of addiction and dependence.
• C. Buspirone may not become effective until 2-4 weeks after starting the medication.
• D. Buspirone should be taken with food to increase absorption.

Correct answer: C

Rationale: The correct answer is C. When educating a patient about buspirone for generalized anxiety disorder, it is crucial to highlight that buspirone may take 2-4 weeks to become effective. Patients need to be aware of this delayed onset of action to manage their expectations and continue the medication as prescribed. This information helps patients understand that they may not experience immediate relief and should not discontinue the medication prematurely. Choices A, B, and D are incorrect because buspirone is typically taken regularly, not as-needed, it has a lower risk of addiction compared to other anxiety medications, and it does not need to be taken with food for increased absorption.

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