Nursing Elites

1. Which diet selection by a client who is depressed and taking the MAO inhibitor tranylcypromine sulfate (Parnate) indicates to the nurse that the client understands the dietary restrictions imposed by this medication regimen?

• A. Hamburger, French fries, and chocolate milkshake.
• B. Liver and onions, broccoli, and decaffeinated coffee.
• C. Pepperoni and cheese pizza, tossed salad, and a soft drink.
• D. Roast beef, baked potato with butter, and iced tea.

Correct answer: D

Rationale: The correct answer is (D) Roast beef, baked potato with butter, and iced tea. This diet selection indicates that the client understands the dietary restrictions imposed by taking tranylcypromine sulfate (Parnate) because it does not contain tyramine. Tyramine in foods can interact with MAO inhibitors like Parnate, leading to a hypertensive crisis, which is life-threatening. Choices (A, B, and C) contain foods high in tyramine like cheese, pepperoni, and chocolate, which are contraindicated for clients taking MAO inhibitors.

2. A female client with schizophrenia tells the nurse that she believes her brain is controlled by the CIA. The nurse recognizes this as which type of delusion?

• A. Somatic delusion
• B. Paranoid delusion
• C. Persecutory delusion
• D. Grandiose delusion

Correct answer: C

Rationale: The correct answer is C: Persecutory delusion. Persecutory delusions involve beliefs of being conspired against, watched, or harassed by others, which is a common symptom in schizophrenia. In this scenario, the client's belief that her brain is controlled by the CIA aligns with persecutory delusions as she feels targeted or manipulated by an external entity. Choices A, B, and D are incorrect. Somatic delusions involve false beliefs about one's body functions or sensations, paranoid delusions involve irrational suspicions and mistrust of others, and grandiose delusions involve exaggerated beliefs of one's importance or abilities.

3. A client with bipolar disorder is started on a regimen of valproic acid (Depakote). Which laboratory test is most important for the nurse to monitor?

• A. Liver function tests
• B. Kidney function tests
• C. Blood glucose levels
• D. Serum sodium levels

Correct answer: A

Rationale: The correct answer is A: Liver function tests. Valproic acid can cause hepatotoxicity, leading to liver damage. Monitoring liver function tests is crucial to detect any early signs of liver impairment. Kidney function tests (Choice B) are not the most important to monitor in this case. Blood glucose levels (Choice C) and serum sodium levels (Choice D) are not directly affected by valproic acid and are not the priority for monitoring in a client taking this medication.

4. A client with schizophrenia is being discharged with a prescription for risperidone (Risperdal). What is the most important instruction for the nurse to provide?

• A. Stop taking the medication if you start feeling better.
• B. Be aware of the potential for weight gain with this medication.
• C. Report any unusual muscle movements immediately.
• D. You can drive as soon as you feel ready.

Correct answer: C

Rationale: The correct answer is C: "Report any unusual muscle movements immediately." Unusual muscle movements may indicate extrapyramidal symptoms (EPS) or tardive dyskinesia, which are serious side effects of antipsychotic medications like risperidone. It is crucial to address these symptoms promptly to prevent long-term effects. Choice A is incorrect because stopping the medication suddenly can be dangerous and should only be done under medical supervision. Choice B, while important, is not the most critical instruction in this scenario. Choice D is also incorrect as the ability to drive may be affected by the medication and should be discussed with a healthcare provider.

5. A client who is diagnosed with schizophrenia is admitted to the hospital. The nurse assesses the client's mental status. Which assessment finding is most characteristic of a client with schizophrenia?

• A. Mood swings.
• B. Extreme sadness.
• C. Manipulative behavior.
• D. Flat affect.

Correct answer: D

Rationale: The correct answer is D: Flat affect. Flat affect, which is a lack of emotional expression, is highly characteristic of schizophrenia. Mood swings (choice A) are more indicative of mood disorders rather than schizophrenia. Extreme sadness (choice B) could be seen in depression but is not as specific to schizophrenia. Manipulative behavior (choice C) is not a defining characteristic of schizophrenia; it may be seen in various psychiatric conditions but is not the most characteristic feature of schizophrenia.

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