Nursing Elites

1. 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.

2. When assessing a client with bipolar disorder who is experiencing a depressive episode, which of the following findings should the nurse not expect?

• A. Low energy
• B. Feelings of hopelessness
• C. Insomnia or hypersomnia
• D. Difficulty concentrating

Correct answer: D

Rationale: In a client experiencing a depressive episode in bipolar disorder, common findings include low energy, feelings of hopelessness, insomnia or hypersomnia, and decreased appetite. Difficulty concentrating is more indicative of attention deficit disorders or cognitive impairment rather than a typical presentation of a depressive episode in bipolar disorder.

3. A client is diagnosed with generalized anxiety disorder (GAD). Which of the following interventions should the nurse implement? Select one that does not apply.

• A. Encourage the client to express their feelings
• B. Teach the client relaxation techniques
• C. Promote regular physical activity
• D. Encourage the use of caffeine

Correct answer: D

Rationale: Interventions for a client with GAD should include encouraging the client to express their feelings, teaching relaxation techniques, and promoting regular physical activity. Caffeine should be avoided as it can exacerbate anxiety symptoms. Stimulants like caffeine can increase feelings of restlessness and nervousness, making it counterproductive in managing anxiety. Choices A, B, and C are appropriate interventions for managing generalized anxiety disorder by promoting emotional expression, relaxation, and physical well-being, respectively. Choice D, encouraging the use of caffeine, is incorrect as it can worsen anxiety symptoms rather than alleviate them.

4. Carolina is surprised when her patient does not show for a regularly scheduled appointment. When contacted, the patient states, <I don't need to come see you anymore. I have found a therapy app on my phone that I love.= How should Carolina respond to this news?

• A. That sounds exciting, would you be willing to visit and show me the app?
• B. At this time, there is no real evidence that the app can replace our therapy.
• C. I am not sure that is a good idea right now, we are so close to progress.
• D. Why would you think that is a better option than meeting with me?

Correct answer: A

Rationale: Showing interest in the app can build rapport and allow for evaluation of its effectiveness.

5. Which approach involves surgically implanting electrodes into specific areas of the brain to stimulate regions identified as underactive in depression?

• A. Transcranial magnetic stimulation
• B. Deep brain stimulation
• C. Vagus nerve stimulation
• D. Electroconvulsive therapy

Correct answer: B

Rationale: Deep brain stimulation is a treatment approach that involves the surgical implantation of electrodes into specific areas of the brain to stimulate regions identified as underactive in depression. This method aims to modulate brain activity and has shown effectiveness in treating certain cases of depression.

Similar Questions