Nursing Elites

1. Which statement made by the patient demonstrates an understanding of the effective use of newly prescribed lithium to manage bipolar mania? Select one that doesn't apply.

• A. I remind myself to consistently drink six 12-ounce glasses of fluid every day.
• B. I discussed the diuretic prescribed by my cardiologist with my psychiatric care provider.
• C. Lithium may help me lose the few extra pounds I tend to carry around.
• D. I take my lithium on an empty stomach to help with absorption.

Correct answer: C

Rationale: Proper hydration, discussing other medications, and taking lithium with or without food are important for effective and safe use of lithium. However, lithium is not prescribed for weight loss, and its usage should not be associated with losing extra pounds.

2. A client with bipolar disorder is experiencing a depressive episode. Which intervention should the nurse implement to support the client's recovery?

• A. Encourage the client to engage in physical activity.
• B. Encourage the client to maintain a regular sleep schedule.
• C. Encourage the client to set realistic goals for daily activities.
• D. Encourage the client to express feelings of sadness.

Correct answer: C

Rationale: During a depressive episode in bipolar disorder, encouraging the client to set realistic goals for daily activities can be beneficial. Setting achievable goals can provide structure, a sense of accomplishment, and help in breaking tasks into manageable steps, which can support the client's recovery process. Options A and B, while important in managing bipolar disorder, may not directly address the client's depressive symptoms during this episode. Option D, encouraging the client to express feelings of sadness, is not as effective as setting achievable goals in providing structure and a sense of accomplishment during a depressive episode.

3. Which client statement indicates an understanding of the education provided about the antidepressant medication sertraline (Zoloft)?

• A. I should take this medication on an empty stomach.
• B. It may take several weeks for this medication to be effective.
• C. I can stop taking this medication when I feel better.
• D. I should avoid taking this medication with other medications.

Correct answer: B

Rationale: Choice B is the correct answer. It is crucial for clients to understand that sertraline (Zoloft) may take several weeks to show its full effects. Patients should be informed about this delay in onset of action to set realistic expectations and adhere to the treatment plan. This education helps prevent premature discontinuation of the medication due to perceived lack of efficacy. Choices A, C, and D are incorrect. Choice A is inaccurate because sertraline (Zoloft) should be taken with food to reduce the risk of gastrointestinal side effects. Choice C is incorrect because abruptly stopping the medication can lead to withdrawal symptoms and worsening of the condition. Choice D is inaccurate as there are specific medications that should be avoided with sertraline, but a general statement to avoid all other medications is overly broad and not necessary.

4. A client has been prescribed bupropion (Wellbutrin) for depression. Which instruction should the nurse provide during discharge?

• A. Take the medication with a full glass of water.
• B. Stop taking the medication if you feel better.
• C. Avoid drinking alcohol while taking this medication.
• D. Double the dose if you miss a dose.

Correct answer: C

Rationale: The correct instruction for the nurse to provide is to advise the client to avoid drinking alcohol while taking bupropion (Wellbutrin) due to the increased risk of side effects like seizures. Alcohol can interact with bupropion and worsen its side effects, making it important to abstain from alcohol consumption during the treatment. Option A is incorrect because taking the medication with a full glass of water is a general instruction for medications and not specific to bupropion. Option B is incorrect as abruptly stopping bupropion can lead to withdrawal symptoms and should only be done under medical supervision. Option D is incorrect as doubling the dose of bupropion is dangerous and should not be done, even if a dose is missed.

5. A healthcare provider is evaluating a client who is taking selective serotonin reuptake inhibitors (SSRIs) for depression. Which symptom should the healthcare provider identify as an adverse effect that requires immediate attention?

• A. Increased appetite
• B. Weight gain
• C. Blurred vision
• D. Suicidal thoughts

Correct answer: D

Rationale: Suicidal thoughts are a serious adverse effect associated with SSRIs and require immediate attention. This symptom is critical as it can increase the risk of self-harm or suicide in individuals taking these medications. Increased appetite and weight gain are common side effects of SSRIs but do not require immediate attention. Blurred vision is not a typical adverse effect of SSRIs, making it an incorrect choice. Healthcare providers must promptly recognize and address suicidal thoughts to ensure the safety and well-being of the client.

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