Nursing Elites

1. Tomas is a 21-year-old male with a recent diagnosis of schizophrenia. Tomas's nurse recognizes that self-medicating with excessive alcohol is common in this disease and can co-occur along with:

• A. Generally good health despite the mental illness.
• B. An aversion to drinking fluids.
• C. Anxiety and depression.
• D. The ability to express his needs.

Correct answer: C

Rationale: Individuals with schizophrenia often turn to excessive alcohol consumption as a way to manage symptoms of anxiety and depression. This maladaptive coping mechanism can exacerbate the challenges associated with schizophrenia and may hinder effective treatment outcomes. Recognizing the presence of anxiety and depression alongside alcohol abuse is crucial for providing holistic care and support to individuals with schizophrenia.

2. Identical twins vary in their responses to stress. One twin may become anxious and irritable, while the other may withdraw and cry. How should the nurse explain these different reactions to stress to the parents?

• A. Reactions to stress are relative rather than absolute; individual responses to stress vary.
• B. It is abnormal for identical twins to react differently to similar stressors.
• C. Identical twins should share the same temperament and respond similarly to stress.
• D. Environmental influences weigh more heavily than genetic influences on reactions to stress.

Correct answer: A

Rationale: Individual responses to stress can vary significantly due to factors such as perception, past experiences, and environmental influences, in addition to genetic factors. It is not unusual for identical twins to exhibit different reactions to stress as their individual personalities and coping mechanisms play a significant role in how they respond to stressful situations. Choice A is the correct answer because it acknowledges the variability in responses to stress among individuals. Choice B is incorrect because it wrongly labels differing reactions in identical twins as abnormal, when in reality, it is a natural phenomenon. Choice C is incorrect as it assumes that identical twins should always have the same temperament and response to stress, which is not always the case. Choice D is incorrect because it oversimplifies the complex interplay between genetic and environmental factors in shaping responses to stress.

3. A male patient calls to tell the nurse that his monthly lithium level is 1.7 mEq/L. Which nursing intervention will the nurse implement initially?

• A. Reinforce that the level is above the therapeutic range.
• B. Instruct the patient to hold the next dose of medication and contact the prescriber.
• C. Advise the patient to go to the hospital emergency room immediately.
• D. Inform the patient about the possibility of seizures and appropriate precautions.

Correct answer: B

Rationale: A lithium level of 1.7 mEq/L is above the therapeutic range, indicating a potential risk of toxicity. The initial nursing intervention should be to instruct the patient to hold the next dose of medication and promptly contact the prescriber for further guidance and management. This action aims to prevent adverse effects and ensure the patient's safety by addressing the elevated lithium level appropriately.

4. A client with generalized anxiety disorder is prescribed buspirone (Buspar). Which statement by the client indicates an accurate understanding of the medication?

• A. I should take this medication as needed for anxiety.
• B. I need to avoid eating aged cheeses.
• C. It may take several weeks for this medication to take effect.
• D. I can stop taking this medication abruptly if I feel better.

Correct answer: C

Rationale: Buspirone (Buspar) may take several weeks to take effect, so clients should continue taking it as prescribed.

5. A client has been prescribed sertraline for depression, and the nurse is providing discharge instructions. Which dietary instruction should the nurse include?

• A. Avoid foods high in sodium.
• B. Avoid foods high in calcium.
• C. Avoid foods high in tyramine.
• D. Avoid foods high in potassium.

Correct answer: C

Rationale: Clients prescribed sertraline should avoid foods high in tyramine to prevent a hypertensive crisis. Sertraline, an antidepressant belonging to the selective serotonin reuptake inhibitor (SSRI) class, can interact with tyramine-rich foods, potentially causing a dangerous increase in blood pressure known as a hypertensive crisis. Choices A, B, and D are incorrect because there is no specific dietary restriction related to sodium, calcium, or potassium intake when taking sertraline.

Similar Questions