Nursing Elites

1. 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.

2. After fasting from 10 p.m. the previous evening, a client finds out that the blood test has been canceled. The client swears at the nurse and states, 'You are incompetent!' Which is the nurse's best response?

• A. Do you believe that I was the cause of your blood test being canceled?
• B. I see that you are upset, but I feel uncomfortable when you swear at me.
• C. Have you ever thought about ways to express anger appropriately?
• D. I'll give you some space. Let me know if you need anything.

Correct answer: B

Rationale: In this scenario, the most appropriate response for the nurse is option B. By acknowledging the client's feelings and setting a boundary regarding inappropriate behavior, the nurse addresses the situation with empathy. This response demonstrates understanding of the client's emotions while also maintaining a professional standard by expressing discomfort with swearing. Option A could come off as defensive and may escalate the situation. Option C may be perceived as condescending and not immediately address the client's behavior. Option D, although offering space, does not directly address the inappropriate behavior and misses an opportunity to set a professional boundary.

3. For a patient diagnosed with borderline personality disorder exhibiting self-harming behavior, which therapeutic approach is most appropriate?

• A. Dialectical behavior therapy
• B. Psychoanalysis
• C. Supportive therapy
• D. Pharmacotherapy

Correct answer: A

Rationale: The most appropriate therapeutic approach for a patient diagnosed with borderline personality disorder exhibiting self-harming behavior is dialectical behavior therapy (DBT). DBT is specifically designed to address the core symptoms of borderline personality disorder, including self-harming behaviors. It focuses on teaching patients skills to manage emotions, improve interpersonal relationships, and enhance distress tolerance. Psychoanalysis (Choice B) is not the most appropriate for immediate symptom management in this case. Supportive therapy (Choice C) may not provide the structured approach needed to address self-harming behaviors effectively. Pharmacotherapy (Choice D) may be used as an adjunct in some cases, but DBT is the frontline therapy for managing self-harming behaviors in borderline personality disorder.

4. Luc's family comes home one evening to find him extremely agitated, and they suspect he is in a full manic episode. The family calls emergency medical services. While one medic is talking with Luc and his family, the other medic is counting something on his desk. What is the medic most likely counting?

• A. Hypodermic needles
• B. Fast food wrappers
• C. Empty soda cans
• D. Energy drink containers

Correct answer: D

Rationale: Energy drink containers are often associated with exacerbating manic episodes due to their high caffeine content, which can worsen symptoms of agitation and restlessness.

5. A patient with schizophrenia is experiencing auditory hallucinations. Which nursing intervention is most appropriate?

• A. Encourage the patient to ignore the voices.
• B. Provide a structured and safe environment.
• C. Engage the patient in a debate about the reality of the voices.
• D. Ask the patient to describe the content of the hallucinations.

Correct answer: D

Rationale: The most appropriate nursing intervention when a patient with schizophrenia is experiencing auditory hallucinations is to ask the patient to describe the content of the hallucinations. This intervention helps assess the risk associated with the hallucinations and provides valuable insight into the patient's condition, aiding in developing an effective care plan. Encouraging the patient to ignore the voices (Choice A) may not address the underlying issues or risks associated with the hallucinations. Providing a structured and safe environment (Choice B) is important but does not directly address the hallucinations. Engaging the patient in a debate about the reality of the voices (Choice C) may worsen the situation by invalidating the patient's experiences.

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