Nursing Elites

1. Which of the following are cultural aspects of mental illness? Select one that doesn't apply.

• A. Local or cultural norms define pathological behavior.
• B. The higher the social class the greater the recognition of mental illness behaviors.
• C. Psychiatrists typically see patients when the family can no longer deny the illness.
• D. The greater the cultural distance from the mainstream of society, the greater the likelihood that the illness will be treated with sensitivity and compassion.

Correct answer: D

Rationale: The fewer ties that a group has with mainstream society, the greater the likelihood of a negative response by society to mental illness. Coercive treatments and involuntary hospitalizations are more common in this population.

2. A client with bipolar disorder is experiencing a depressive episode. Which of the following interventions should the nurse implement? Select one that does not apply.

• A. Encourage participation in activities
• B. Promote adequate nutrition and hydration
• C. Monitor for suicidal ideation
• D. Discourage verbalization of feelings

Correct answer: D

Rationale: Interventions for a client with bipolar disorder experiencing a depressive episode include encouraging participation in activities, promoting adequate nutrition and hydration, monitoring for suicidal ideation, and providing a structured daily schedule. Discussing feelings is an essential part of therapy for clients with bipolar disorder, thus discouraging verbalization of feelings is not therapeutic and should not be implemented. Choice D is incorrect because it goes against the principles of therapeutic communication and emotional expression, which are crucial in managing bipolar disorder.

3. Which symptom should a healthcare provider identify as typical of the fight-or-flight response?

• A. Pupil dilation
• B. Increased heart rate
• C. Decreased salivation
• D. Decreased peristalsis

Correct answer: B

Rationale: The correct answer is B: Increased heart rate. During the fight-or-flight response, the sympathetic nervous system is activated, causing the release of epinephrine. This hormone triggers an increase in heart rate to supply more blood to the muscles for a rapid response. Pupil dilation occurs to enhance vision in preparation for quick reactions. On the other hand, salivation and peristalsis decrease as the body prioritizes functions necessary for immediate action rather than digestion-related activities. Therefore, choices A, C, and D are incorrect as they do not align with the typical physiological changes associated with the fight-or-flight response.

4. A client has been prescribed fluoxetine (Prozac). What information should the nurse include in discharge teaching?

• A. Take the medication with food to avoid stomach upset.
• B. Avoid drinking alcohol while taking this medication.
• C. Take the medication only when feeling depressed.
• D. Report any unusual side effects to the healthcare provider.

Correct answer: B

Rationale: The correct answer is to advise the client to avoid drinking alcohol while taking fluoxetine (Prozac) due to potential interactions. Alcohol consumption can increase the risk of certain side effects and may reduce the effectiveness of the medication. Choice A is incorrect because fluoxetine can be taken with or without food. Choice C is incorrect as fluoxetine is usually taken daily regardless of the client's mood. Choice D is not the priority teaching point; while reporting side effects is important, avoiding alcohol is critical due to the potential interactions.

5. What is the most appropriate intervention for a patient experiencing a panic attack?

• A. Encourage deep, slow breathing.
• B. Encourage the patient to talk about their feelings.
• C. Leave the patient alone to calm down.
• D. Engage the patient in a physical activity.

Correct answer: A

Rationale: Encouraging deep, slow breathing is the most appropriate intervention for a patient experiencing a panic attack. This technique can help the patient regulate their breathing, reduce hyperventilation, and promote relaxation, which are essential in managing the symptoms of a panic attack. Choice B, encouraging the patient to talk about their feelings, may not be effective during an acute panic attack as the focus should be on calming the patient down. Choice C, leaving the patient alone, can lead to increased feelings of fear and isolation during a panic attack. Choice D, engaging the patient in physical activity, may exacerbate symptoms as it can increase the feeling of being out of control.

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