Nursing Elites

1. After 1 week of continuous mental confusion, an elderly African American client is admitted with a preliminary diagnosis of a neurocognitive disorder due to dementia. Which statement would cause the nurse to question this diagnosis?

• A. There has been no triiodothyronine or thyroxine level evaluation ordered
• B. Neurocognitive disorders do not typically occur in African American clients
• C. The symptoms presented are more indicative of parkinsonism
• D. Dementia does not develop suddenly

Correct answer: Dementia does not develop suddenly

Rationale:

2. In addition to antianxiety agents, which classification of drugs is commonly prescribed to treat anxiety and anxiety disorders?

• A. Antipsychotics
• B. Mood stabilizers
• C. Antidepressants
• D. Cholinesterase inhibitors

Correct answer: C

Rationale: Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are frequently used in the treatment of anxiety disorders. These medications help alleviate symptoms by affecting neurotransmitters in the brain associated with mood regulation and anxiety.

3. Which intervention focuses on managing a common characteristic of major depressive disorder associated with the older population?

• A. Conducting routine suicide screenings at a senior center.
• B. Identifying depression as a natural, but treatable outcome of aging.
• C. Identifying males as at a greater risk for developing depression.
• D. Stressing that most individuals experience only a single episode of major depression in a lifetime.

Correct answer: A

Rationale: Conducting routine suicide screenings at senior centers is crucial in managing major depressive disorder in the older population. Screening helps identify individuals at risk, allows for timely intervention, and contributes to the overall well-being of older adults.

4. A client with bipolar disorder is experiencing a manic episode. Which of the following interventions should the nurse implement? Select one that does not apply.

• A. Provide a structured environment
• B. Encourage rest periods
• C. Limit setting on inappropriate behaviors
• D. Allow the client to engage in stimulating activities

Correct answer: D

Rationale: During a manic episode, it is essential to provide a structured environment to help the client maintain stability. Encouraging rest periods is crucial as excessive activity during mania can lead to exhaustion. Setting limits on inappropriate behaviors helps ensure the client's safety and the safety of others. Allowing the client to engage in stimulating activities can exacerbate manic symptoms by further increasing their energy levels and impulsivity. This can lead to a worsening of the manic episode and potentially risky behaviors. Therefore, allowing the client to engage in stimulating activities is not an appropriate intervention during a manic episode.

5. A patient being treated for insomnia is prescribed ramelteon (Rozerem). Which comorbid mental health condition would make this medication the hypnotic of choice for this particular patient?

• A. Obsessive-compulsive disorder
• B. Generalized anxiety disorder
• C. Persistent depressive disorder
• D. Substance use disorder

Correct answer: D

Rationale: The correct answer is D, Substance use disorder. Ramelteon is preferred for patients with substance use disorder because it lacks abuse potential. This makes it a safer choice for individuals with a history of substance misuse. Choosing a medication with a lower risk of abuse in this population is crucial to prevent potential misuse or dependence issues.

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