Nursing Elites

1. During an admission assessment and interview, which channels of information communication should the nurse be monitoring? Select one that doesn't apply.

• A. Auditory
• B. Visual
• C. Written
• D. Tactile

Correct answer: C

Rationale: During an admission assessment and interview, nurses should monitor auditory, visual, and tactile channels of communication. Written communication is not typically monitored during a face-to-face interview or assessment, making it the correct choice that doesn't apply in this scenario.

2. Tammy, a 28-year-old with major depressive disorder and bulimia nervosa, is ready for discharge from the county hospital after 2 weeks of inpatient therapy. Tammy is taking citalopram (Celexa) and reports that it has made her feel more hopeful. With a secondary diagnosis of bulimia nervosa, what is an alternative antidepressant to consider?

• A. Fluoxetine (Prozac)
• B. Isocarboxazid (Marplan)
• C. Amitriptyline
• D. Duloxetine (Cymbalta)

Correct answer: A

Rationale: Fluoxetine (Prozac) is a suitable alternative antidepressant for Tammy due to its approval for the treatment of bulimia nervosa. It belongs to the selective serotonin reuptake inhibitor (SSRI) class of antidepressants, similar to citalopram, which Tammy is already taking. Fluoxetine has shown efficacy in treating bulimia nervosa and can be a beneficial choice for individuals with this condition.

3. According to Maslow's hierarchy of needs, which situation on an inpatient psychiatric unit would require priority intervention by a nurse?

• A. A client rudely complaining about limited visiting hours
• B. A client exhibiting aggressive behavior toward another client
• C. A client stating that no one cares
• D. A client verbalizing feelings of failure

Correct answer: B

Rationale: The correct answer is B. According to Maslow's hierarchy of needs, safety needs are considered fundamental and must be addressed before higher-level needs. When a client exhibits aggressive behavior toward another client, it poses an immediate threat to safety and requires priority intervention by the nurse to ensure the well-being of all individuals involved. Clients who are rude in their complaints (Choice A), express feelings of failure (Choice D), or state that no one cares (Choice C) are addressing higher-level needs related to social interactions, esteem, and self-actualization, respectively, which can be addressed once safety needs are secured.

4. When explaining one of the main differences between narcolepsy and obstructive sleep apnea syndrome, what should the nurse mention?

• A. Symptoms of the two diagnoses are essentially the same, making it difficult to differentiate between them.
• B. People with narcolepsy awaken from a nap feeling rested and replenished.
• C. People with obstructive sleep apnea syndrome can experience temporary paralysis during naps.
• D. Naps are contraindicated for clients with narcolepsy due to their association with catatonia.

Correct answer: B

Rationale: Narcolepsy is a sleep disorder characterized by excessive daytime sleepiness and sudden attacks of sleep, while obstructive sleep apnea syndrome involves the obstruction of the upper airway during sleep. One of the main differences is that people with narcolepsy often experience refreshing naps, feeling rested and replenished upon waking, which is not the case for obstructive sleep apnea syndrome. This distinction is important for healthcare providers to understand as it helps differentiate between these two sleep disorders.

5. A client with bipolar disorder is experiencing a depressive episode. Which of the following interventions should the nurse not implement?

• A. Agree with the client's delusions to avoid confrontation.
• B. Monitor for signs of suicidal ideation
• C. Promote a regular sleep schedule
• D. Discourage the expression of negative feelings

Correct answer: A

Rationale: During a depressive episode in bipolar disorder, it is crucial not to agree with the client's delusions to avoid reinforcing false beliefs. Monitoring for signs of suicidal ideation is essential for safety. Promoting a regular sleep schedule can help stabilize mood. Discouraging the expression of negative feelings is not recommended as it is important to allow clients to express their emotions and feel heard.

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