Nursing Elites

1. Which response by a 15-year-old demonstrates a common symptom observed in patients diagnosed with major depressive disorder?

• A. I'm so restless. I can't seem to sit still.
• B. I spend most of my time studying. I have to get into a good college.
• C. I'm not trying to diet, but I've lost about 5 pounds in the past 5 months.
• D. I go to sleep around 11 p.m. but I'm always up by 3 a.m. and can't go back to sleep.

Correct answer: D

Rationale: Sleep disturbances, such as early morning awakening, are common symptoms of major depressive disorder.

2. A patient with posttraumatic stress disorder (PTSD) is experiencing flashbacks. The most appropriate intervention is to:

• A. Encourage the patient to talk about the trauma.
• B. Help the patient reorient to the present.
• C. Leave the patient alone to process the flashback.
• D. Remind the patient that the flashback is not real.

Correct answer: B

Rationale: When a patient with PTSD is experiencing flashbacks, the most appropriate intervention is to help them reorient to the present. This intervention can assist in reducing the intensity of the flashback and providing a sense of safety for the patient. Choice A is incorrect because encouraging the patient to talk about the trauma during a flashback may exacerbate their distress. Choice C is incorrect as leaving the patient alone can increase their feelings of isolation and fear. Choice D is incorrect because reminding the patient that the flashback is not real may invalidate their experience and increase their sense of disconnection.

3. When caring for a patient with major depressive disorder prescribed an MAOI, what type of food should the nurse educate the patient to avoid?

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

Correct answer: C

Rationale: Patients prescribed MAOIs need to avoid consuming tyramine-rich foods as these can lead to hypertensive crises. Tyramine is found in various foods like aged cheeses, cured meats, some types of beer, and fermented products. Interactions between tyramine and MAOIs can result in severe hypertension, highlighting the importance of educating patients about dietary restrictions to ensure their safety. Choices A, B, and D are incorrect because high-protein foods, high-fiber foods, and low-fat foods do not pose a significant risk of hypertensive crises when taken with MAOIs. Therefore, the correct answer is C.

4. When caring for a client with major depressive disorder, what is the most appropriate short-term goal for the client?

• A. The client will report a decrease in depressive symptoms.
• B. The client will establish a sleep routine.
• C. The client will improve social interactions.
• D. The client will set realistic goals for the future.

Correct answer: A

Rationale: The most appropriate short-term goal for a client with major depressive disorder is for them to report a decrease in depressive symptoms. This goal is specific, measurable, and achievable, focusing on the primary symptoms of the disorder. By monitoring and assessing the client's self-reported improvement in depressive symptoms, the healthcare team can track progress and adjust interventions accordingly.

5. Before discharge from the chemical dependency unit, clients are introduced to different community resources. Which of the following resources would be best for a teenage client, who has been abusing over-the-counter sedatives and is ready for discharge in two days?

• A. Detoxification center
• B. Home care
• C. Assertive community team
• D. Twelve-step recovery group

Correct answer: A

Rationale: For a teenage client who has been abusing over-the-counter sedatives and is ready for discharge in two days, the best resource would be a detoxification center. This specialized facility can provide the necessary medical and psychological support to safely manage the withdrawal symptoms associated with substance abuse. It is crucial to ensure a safe and supervised detox process for the client's well-being and successful recovery.

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