Nursing Elites

1. Maggie, a child in protective custody, is found to have an imaginary friend, Holly. Her foster family shares this information with the nurse. The nurse teaches the family members about children who have suffered trauma and knows her teaching was effective when the foster mother states:

• A. I understand that imaginary friends are abnormal.
• B. I understand that imaginary friends are a maladaptive behavior.
• C. I understand that imaginary friends are a coping mechanism.
• D. I understand that we should tell the child that imaginary friends are unacceptable.

Correct answer: C

Rationale: Imaginary friends can serve as a coping mechanism for children, especially those who have experienced trauma. They can provide comfort and a sense of control in challenging situations. Acknowledging and supporting the child's imaginary friend can be beneficial in their emotional healing and development.

2. A client prescribed fluoxetine for depression is receiving education from a healthcare provider. Which statement by the client indicates an accurate understanding of the medication?

• A. I should take this medication at bedtime to avoid nausea.
• B. I should avoid driving until I know how this medication affects me.
• C. I should take this medication with food to avoid stomach upset.
• D. I should take this medication as needed for anxiety.

Correct answer: B

Rationale: The correct answer is B. Fluoxetine can cause drowsiness, affecting a person's ability to drive safely. It is essential to avoid driving until the client knows how the medication affects them to ensure safety. Choice A is incorrect because fluoxetine is usually taken in the morning due to its potential to cause insomnia. Choice C is incorrect as fluoxetine is recommended to be taken with food to minimize gastrointestinal side effects, not specifically to avoid stomach upset. Choice D is incorrect because fluoxetine is typically prescribed for depression or other mood disorders on a daily basis, not as needed for anxiety.

3. Which of the following is not a common symptom of major depressive disorder?

• A. Insomnia
• B. Feelings of hopelessness
• C. Increased energy
• D. Difficulty concentrating

Correct answer: C

Rationale: Common symptoms of major depressive disorder include insomnia, feelings of hopelessness, difficulty concentrating, and appetite changes. Increased energy is not typically associated with major depressive disorder; instead, fatigue is more commonly observed. This symptom differentiation helps in diagnosing major depressive disorder accurately.

4. A nurse is providing education to a client who has been prescribed lithium for bipolar disorder. Which statement by the client indicates an accurate understanding of the medication?

• A. I should avoid eating aged cheeses and processed meats.
• B. I need to maintain a consistent sodium intake.
• C. I should drink plenty of fluids to stay hydrated.
• D. I can take over-the-counter medications without consulting my doctor.

Correct answer: B

Rationale: Clients taking lithium should maintain a consistent sodium intake to avoid fluctuations in lithium levels.

5. A client has been diagnosed with depersonalization/derealization disorder. Which of the following behaviors should the nurse expect?

• A. Feelings of detachment from one's body
• B. Fear of gaining weight
• C. Paralysis of a limb
• D. Episodes of hypomania

Correct answer: A

Rationale: Depersonalization/derealization disorder is characterized by feelings of detachment from one's body or surroundings. Individuals with this disorder may feel like they are observing themselves from outside their body or that the world around them is unreal. Therefore, the nurse should expect behaviors such as feelings of detachment from one's body (A). Fear of gaining weight (B) is more indicative of an eating disorder, paralysis of a limb (C) could be related to neurological issues, and episodes of hypomania (D) are associated with mood disorders like bipolar disorder, but not specifically with depersonalization/derealization disorder.

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