Nursing Elites

1. Which of the following symptoms shouldn't a healthcare professional expect to assess in a client diagnosed with generalized anxiety disorder (GAD)?

• A. Excessive worry
• B. Muscle tension
• C. Increased energy
• D. Restlessness

Correct answer: C

Rationale: In generalized anxiety disorder (GAD), common symptoms include excessive worry, muscle tension, restlessness, and irritability. Increased energy is not typically associated with GAD; instead, clients often experience fatigue due to the persistent anxiety and worry that characterize the disorder.

2. A client diagnosed with major depressive disorder is prescribed an SSRI. Which side effect should the nurse monitor for in the initial weeks of treatment?

• A. Weight loss
• B. Increased risk of suicide
• C. Hypertension
• D. Photosensitivity

Correct answer: B

Rationale: When a client is prescribed an SSRI for major depressive disorder, the nurse should closely monitor for an increased risk of suicide, especially in younger patients, during the initial weeks of treatment. SSRIs may initially increase energy levels before improving mood, which can lead to a higher risk of suicide in some individuals. Weight loss is not a common side effect of SSRIs and may actually be a concern for some patients with major depressive disorder who experience appetite changes. Hypertension is not typically associated with SSRIs, and photosensitivity is not a common side effect of this class of medications.

3. A client with generalized anxiety disorder is prescribed buspirone. Which statement by the client indicates a need for further teaching?

• A. I can stop taking this medication once I feel less anxious.
• B. I should avoid drinking alcohol while taking this medication.
• C. It may take several weeks for this medication to take full effect.
• D. This medication can cause dependency.

Correct answer: A

Rationale: The correct answer is A because it indicates a misunderstanding about buspirone. Buspirone should not be abruptly stopped, and patients should follow the prescribed regimen consistently. Stopping the medication without proper guidance can lead to adverse effects or a return of anxiety symptoms. Choices B, C, and D demonstrate an understanding of important aspects of buspirone therapy: avoiding alcohol due to interactions, being patient for the medication to reach full effectiveness, and being aware of the potential for dependency with this medication.

4. When caring for a client with anorexia nervosa in a psychiatric unit, which intervention should the nurse implement to address the client's nutritional needs?

• A. Provide small, frequent meals throughout the day.
• B. Monitor the client's weight daily.
• C. Offer a liquid supplement if the client refuses solid food.
• D. Encourage the client to choose from a variety of food options.

Correct answer: A

Rationale: Providing small, frequent meals throughout the day is a crucial intervention when caring for a client with anorexia nervosa. This approach helps in gradually increasing caloric intake and meeting the client's nutritional needs. Offering large meals can be overwhelming and may contribute to anxiety in these clients. By providing small, frequent meals, the nurse supports the client in establishing a healthier eating pattern and aids in the restoration of adequate nutrition levels. Monitoring the client's weight daily (Choice B) may exacerbate anxiety related to body image and weight, which are common concerns in anorexia nervosa. Offering a liquid supplement if the client refuses solid food (Choice C) may not address the underlying issues related to food aversion and may not provide the necessary nutrients in a balanced way. Encouraging the client to choose from a variety of food options (Choice D) may be overwhelming for someone with anorexia nervosa and could lead to increased anxiety around food choices.

5. When discussing the main differences between narcolepsy and obstructive sleep apnea syndrome, what should the nurse highlight?

• A. Symptoms of the two diagnoses are essentially the same, making it challenging to differentiate between them
• B. Naps are contraindicated for clients with narcolepsy due to their association with cataplexy
• C. People with narcolepsy awaken from a nap feeling rested and replenished
• D. People with obstructive sleep apnea syndrome may experience temporary paralysis during sleep

Correct answer: C

Rationale: Narcolepsy is characterized by excessive daytime sleepiness and sudden attacks of sleep, while individuals with narcolepsy often feel refreshed after a brief nap. In contrast, obstructive sleep apnea syndrome is marked by pauses in breathing or shallow breathing during sleep, leading to fragmented sleep and excessive daytime sleepiness. Therefore, the correct answer is that individuals with narcolepsy awaken from a nap feeling rested and replenished, which is a key distinguishing feature from obstructive sleep apnea syndrome.

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