Nursing Elites

1. Which statement by the patient indicates a need for further teaching regarding the treatment of major depressive disorder?

• A. I have been on this antidepressant for 3 days. I understand that the full effect may take weeks to occur.
• B. I am going to ask my nurse practitioner to discontinue my Prozac today and let me start taking a monoamine oxidase inhibitor tomorrow.
• C. I may ask to have my medication changed to Wellbutrin due to the problems I am having being romantic with my wife.
• D. I realize that there are many antidepressants and it might take a while until we find the one that works best for me.

Correct answer: B

Rationale: Choice B indicates a need for further teaching because the patient is planning to switch directly from Prozac, an SSRI, to a monoamine oxidase inhibitor (MAOI) without allowing for a washout period. This abrupt switch poses a risk of serotonin syndrome, which can be life-threatening. It is essential to educate the patient about the importance of consulting healthcare providers before changing medications to prevent potential adverse effects.

2. A client diagnosed with major depressive disorder is receiving cognitive-behavioral therapy (CBT). Which outcome indicates that the therapy is effective?

• A. The client identifies and challenges negative thoughts.
• B. The client reports an increase in suicidal thoughts.
• C. The client experiences an increase in anxiety.
• D. The client shows no change in behavior.

Correct answer: A

Rationale: In cognitive-behavioral therapy (CBT), one of the primary objectives is to help clients identify and challenge their negative thoughts. This process allows the individual to reframe their thinking patterns and develop more adaptive coping strategies. Reporting an increase in suicidal thoughts (Choice B) or experiencing an increase in anxiety (Choice C) are not desired outcomes and may indicate a need for further intervention. Showing no change in behavior (Choice D) suggests that the therapy has not been effective. Therefore, the correct indicator of effective therapy in this context is the client's ability to identify and challenge negative thoughts (Choice A).

3. Which of the following are common symptoms of major depressive disorder? Select one that doesn't apply.

• A. Insomnia
• B. Feelings of hopelessness
• C. Increased energy
• D. Difficulty concentrating

Correct answer: C

Rationale: Common symptoms of major depressive disorder include insomnia, feelings of hopelessness, difficulty concentrating, and appetite changes. While individuals with major depressive disorder often experience fatigue and low energy levels, increased energy is not typically associated with this condition. Therefore, 'Increased energy' is the correct choice that doesn't apply to major depressive disorder. Choices A, B, and D are all commonly seen in individuals with major depressive disorder, making them incorrect answers.

4. How do epidemiological studies contribute to improvements in care for individuals with mental disorders?

• A. Providing information about effective nursing techniques.
• B. Identifying risk factors that contribute to the development of a disorder.
• C. Identifying individuals in the general population who will develop a specific disorder.
• D. Identifying which individuals will respond favorably to a specific treatment.

Correct answer: B

Rationale: Epidemiological studies play a crucial role in identifying risk factors associated with the development of mental disorders. By pinpointing these risk factors, healthcare providers can implement preventive measures and develop more effective treatments, ultimately leading to improved care for individuals with mental disorders.

5. A client is being assessed by a nurse after being diagnosed with anorexia nervosa. Which of the following findings should the nurse expect?

• A. Weight gain and increased appetite
• B. Lanugo on the face and back
• C. Increased body temperature and tachycardia
• D. Hyperactivity and distractibility

Correct answer: B

Rationale: In anorexia nervosa, individuals often develop lanugo, fine soft hair, on the face and back. This is a physiological response to the body's attempt to conserve heat due to a lack of subcutaneous fat. It is a common physical finding in clients with anorexia nervosa and can be a sign of severe malnutrition. Choices A, C, and D are incorrect because weight gain and increased appetite, increased body temperature and tachycardia, and hyperactivity and distractibility are not typically associated with anorexia nervosa. In fact, weight loss, decreased appetite, hypothermia, and bradycardia are more commonly seen in individuals with anorexia nervosa.

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