Nursing Elites

1. Pablo is a homeless adult who has no family connection. Pablo passed out on the street, and emergency medical services took him to the hospital where he expresses a wish to die. The physician recognizes evidence of substance use problems and mental health issues and recommends inpatient treatment for Pablo. What is the rationale for this treatment choice? Select one that doesn't apply.

• A. Intermittent supervision is available in inpatient settings.
• B. He requires stabilization of multiple symptoms.
• C. How do you feel about talking to a mental health counselor?
• D. Medication adherence will be mandated.

Correct answer: D

Rationale: The correct answer is D because medication adherence being mandated is not a primary rationale for inpatient treatment. The main reasons for recommending inpatient treatment in this scenario include the need for stabilization of multiple symptoms, addressing nutritional and self-care needs, and ensuring safety due to the imminent danger of self-harm. Inpatient settings provide a more intensive level of care and supervision to address these complex issues effectively.

2. A client with depression is experiencing anhedonia. Which statement by the client reflects this symptom?

• A. I feel so anxious all the time.
• B. I don't enjoy the things I used to love.
• C. I can't concentrate on anything.
• D. I have trouble sleeping through the night.

Correct answer: B

Rationale: Anhedonia is the inability to experience pleasure from activities usually found enjoyable. The statement 'I don't enjoy the things I used to love' directly reflects this symptom as the client is expressing a lack of pleasure from previously enjoyable activities. Choices A, C, and D do not specifically relate to anhedonia but rather indicate symptoms of anxiety, concentration difficulties, and sleep disturbances, respectively.

3. A client who experiences stress on a regular basis asks a nurse what causes these feelings. Which is the most appropriate nursing response?

• A. Genetics have no influence on your temperament.
• B. How you reacted to past experiences influences how you feel now.
• C. Maintaining good physical health always keeps stress levels low.
• D. Stress can be avoided by using appropriate coping mechanisms.

Correct answer: B

Rationale: The correct answer is B: 'How you reacted to past experiences influences how you feel now.' This response is appropriate because past experiences can shape an individual's current response to stress. It acknowledges the impact of learned patterns and coping mechanisms on one's current adaptation to stressors. Choice A is incorrect because genetics can play a role in temperament to some extent. Choice C is incorrect because while physical health can contribute to stress management, it is not the sole determinant of stress levels. Choice D is incorrect as stress is not always avoidable, but coping mechanisms can help manage and reduce its impact.

4. A patient with major depressive disorder has been prescribed an MAOI. The patient should be educated to avoid which type of food to prevent hypertensive crises?

• A. High-protein foods
• B. High-fiber foods
• C. Tyramine-rich foods
• D. Low-fat foods

Correct answer: C

Rationale: The correct answer is C: Tyramine-rich foods. Patients prescribed MAOIs should avoid tyramine-rich foods to prevent hypertensive crises. Tyramine-rich foods can interact with MAOIs, leading to a sudden and dangerous increase in blood pressure. Examples of tyramine-rich foods include aged cheeses, cured meats, pickled or fermented foods, and certain beverages like beer and wine. Choices A, B, and D are incorrect because they are not associated with causing hypertensive crises when taken with MAOIs.

5. 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.

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