Nursing Elites

1. How should the nurse characterize the client's appraisal of the job loss stressor?

• A. Irrelevant
• B. Harm/loss
• C. Threatening
• D. Challenging

Correct answer: D

Rationale: The client's statement reflects a positive outlook on the job loss, viewing it as a challenge and an opportunity for personal growth. This perspective suggests that the client is resilient and adaptive, focusing on new possibilities rather than dwelling on the negative aspects of the situation. Choice D, 'Challenging,' is the correct characterization as it aligns with the client's positive appraisal. Choices A, 'Irrelevant,' B, 'Harm/loss,' and C, 'Threatening,' are incorrect as they do not capture the client's adaptive response to the stressor.

2. Cabot has multiple symptoms of depression including mood reactivity, social phobia, anxiety, and overeating. With a history of mild hypertension, which classification of antidepressants dispensed as a transdermal patch would be a safe medication?

• A. Tricyclic antidepressants
• B. Selective serotonin reuptake inhibitors
• C. Serotonin and norepinephrine reuptake inhibitors
• D. Monoamine oxidase inhibitors

Correct answer: D

Rationale: Monoamine oxidase inhibitors dispensed as transdermal patches can be a safer option for patients with mild hypertension due to reduced systemic absorption compared to other forms of antidepressants, potentially minimizing cardiovascular effects associated with hypertension.

3. When assessing a patient with generalized anxiety disorder (GAD), which symptom would the nurse most likely observe?

• A. Flashbacks
• B. Excessive worry
• C. Hallucinations
• D. Compulsive behaviors

Correct answer: B

Rationale: Excessive worry is a characteristic feature of generalized anxiety disorder (GAD). Patients with GAD experience persistent and excessive worry about various aspects of their life, such as work, health, or family, even when there is little or no reason for concern. This chronic worrying can significantly impact their daily functioning and quality of life. Flashbacks are more commonly associated with post-traumatic stress disorder (PTSD), hallucinations are more typical in conditions like schizophrenia, while compulsive behaviors are seen in obsessive-compulsive disorder (OCD). Therefore, in the context of GAD, excessive worry is the symptom that the nurse is most likely to observe.

4. A client with generalized anxiety disorder (GAD) is being discharged. Which of the following instructions should the nurse not include in the discharge teaching?

• A. Practice relaxation techniques daily
• B. Avoid caffeine and alcohol
• C. Engage in regular physical activity
• D. Use benzodiazepines as the first-line treatment

Correct answer: D

Rationale: Discharge instructions for a client with GAD should include practicing relaxation techniques daily, avoiding caffeine and alcohol, engaging in regular physical activity, and seeking support from friends and family. Benzodiazepines are not recommended as the first-line treatment due to their potential for dependence and should not be included in the discharge teaching.

5. A nurse is caring for a client who has been diagnosed with schizoaffective disorder. The client states, 'I am the president of the United States.' Which of the following responses should the nurse make?

• A. You are not the president. You are a client in the hospital.
• B. Tell me more about being the president.
• C. Why do you think you are the president?
• D. Let's talk about something else.

Correct answer: C

Rationale: The nurse should avoid challenging the client's delusions directly. Asking for more information can help the nurse understand the client's experience and build rapport.

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