Nursing Elites

1. A patient with schizophrenia is prescribed clozapine. Which potential side effect requires regular monitoring?

• A. Weight loss
• B. Hypertension
• C. Agranulocytosis
• D. Hyperthyroidism

Correct answer: C

Rationale: When a patient with schizophrenia is prescribed clozapine, regular monitoring for agranulocytosis is essential. Agranulocytosis is a severe reduction in white blood cells that can be life-threatening. Monitoring white blood cell counts is crucial to detect this side effect early and prevent serious complications. Weight loss (Choice A) is not a common side effect of clozapine. Hypertension (Choice B) and hyperthyroidism (Choice D) are also not typically associated with clozapine use, making them incorrect choices for regular monitoring.

2. Which client action is an example of the defense mechanism of displacement?

• A. A man kicks his dog after an argument with his boss.
• B. A woman yells at her children after a stressful day at work.
• C. A student immerses herself in studying to avoid thinking about a recent breakup.
• D. A person channels aggressive impulses into playing a sport.

Correct answer: B

Rationale: Displacement involves redirecting emotions, often anger or aggression, from their original source to a less threatening target. In this scenario, the woman redirects her frustration from work towards her children, who are perceived as less threatening and safer to express anger towards.

3. A patient with schizophrenia is prescribed olanzapine. The nurse should monitor the patient for which common side effect?

• A. Weight gain
• B. Hypotension
• C. Hair loss
• D. Hyperthyroidism

Correct answer: A

Rationale: Weight gain is a common side effect of olanzapine, an atypical antipsychotic. Olanzapine is known to cause metabolic changes that can lead to weight gain. Monitoring weight regularly is essential to detect and manage this side effect to prevent associated health risks such as diabetes and cardiovascular issues. Hypotension (choice B) is not a common side effect of olanzapine. Olanzapine is more likely to cause orthostatic hypotension, which is a sudden drop in blood pressure when changing positions. Hair loss (choice C) and hyperthyroidism (choice D) are not typically associated with olanzapine use.

4. Which statement indicates an understanding of the DSM-5 diagnosis?

• A. The DSM-5 includes information on cultural considerations.
• B. The DSM-5 is a tool for healthcare providers.
• C. The DSM-5 is not used for legal purposes.
• D. The DSM-5 includes information on the prevalence of mental disorders.

Correct answer: A

Rationale: Option A is the correct answer as the DSM-5 not only provides specific criteria for diagnosing mental disorders but also includes information on cultural considerations. Understanding cultural factors is crucial in making accurate diagnoses and providing appropriate care, highlighting the comprehensive nature of the DSM-5 for healthcare providers. Choices B, C, and D are incorrect because while the DSM-5 is indeed a tool for healthcare providers, it is also used in legal settings, and it focuses on diagnostic criteria and not just the prevalence of mental disorders.

5. Which is a correct evaluation of the new psychiatric nurse's statement regarding a client's use of defense mechanisms?

• A. Defense mechanisms can be self-protective responses to stress and need not be eliminated.
• B. Defense mechanisms are a maladaptive attempt by the ego to manage anxiety and should always be eliminated.
• C. Defense mechanisms, used by individuals with weak ego integrity, should be discouraged but not eliminated.
• D. Defense mechanisms cause disintegration of the ego and should be fostered and encouraged.

Correct answer: A

Rationale: The correct evaluation is that defense mechanisms can be self-protective responses to stress and do not necessarily need to be eliminated. These mechanisms serve the purpose of reducing anxiety during times of stress. While some defense mechanisms may be maladaptive, they can also help individuals cope with challenging situations. It is essential for the nurse to recognize that addressing defense mechanisms should be done sensitively, as they may be crucial for the client's emotional regulation. Encouraging the development of healthy coping skills while acknowledging the role of defense mechanisms in managing stress is a balanced approach in psychiatric care. Choice B is incorrect because completely eliminating defense mechanisms is not always feasible or beneficial. Choice C is incorrect as it oversimplifies the relationship between defense mechanisms and ego integrity. Choice D is incorrect as it misrepresents the role of defense mechanisms in ego functions.

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