Nursing Elites

1. A client with bipolar disorder is experiencing a manic episode. Which of the following interventions should the nurse implement? Select one that does not apply.

• A. Provide a structured environment
• B. Encourage rest periods
• C. Limit setting on inappropriate behaviors
• D. Allow the client to engage in stimulating activities

Correct answer: D

Rationale: During a manic episode, it is essential to provide a structured environment to help the client maintain stability. Encouraging rest periods is crucial as excessive activity during mania can lead to exhaustion. Setting limits on inappropriate behaviors helps ensure the client's safety and the safety of others. Allowing the client to engage in stimulating activities can exacerbate manic symptoms by further increasing their energy levels and impulsivity. This can lead to a worsening of the manic episode and potentially risky behaviors. Therefore, allowing the client to engage in stimulating activities is not an appropriate intervention during a manic episode.

2. The client recently survived a plane crash and is assessed by the nurse. Which client statement would cause the nurse to suspect that the client may be experiencing PTSD?

• A. I believe that I was meant to survive this accident so that I can focus on the important things in life
• B. Although I have nightmares sometimes, I have started going to church to show gratitude for surviving the crash
• C. I am so afraid that I will never be able to fly again, but I know that it will take a while
• D. I keep having these thoughts about the crash that just pop into my mind at random times

Correct answer: D

Rationale: Experiencing intrusive thoughts about a traumatic event, such as a plane crash, that occur unexpectedly and repeatedly is a common symptom of Post-Traumatic Stress Disorder (PTSD). These thoughts can be distressing and are often a key indicator of PTSD. Options A, B, and C demonstrate coping mechanisms and fears related to the traumatic event but do not specifically address the hallmark symptom of intrusive thoughts. Therefore, option D is the correct choice as it aligns with a potential symptom of PTSD.

3. What information should the nurse provide in patient education for a patient prescribed sertraline for major depressive disorder?

• A. Take the medication with food.
• B. It may take several weeks to feel the full effect.
• C. Avoid consuming grapefruit while taking this medication.
• D. Regular blood tests are necessary to monitor levels.

Correct answer: B

Rationale: Patients prescribed sertraline for major depressive disorder should be educated that it may take several weeks before experiencing the full therapeutic effects of the medication. This delay in onset of action is common with antidepressants like sertraline, and patients need to be aware of this to manage their expectations and continue with the treatment regimen. It's important for the patient to understand that consistent adherence to the prescribed dosage is crucial, even if the full effects are not immediately apparent. Choices A, C, and D are incorrect because taking the medication with food, avoiding grapefruit, and regular blood tests are not specific education points related to the expected timeframe for therapeutic effects of sertraline.

4. A client displays signs and symptoms indicative of hypochondriasis. The nurse would initially expect to see:

• A. Self-preoccupation
• B. La belle indifference
• C. Fear of physicians
• D. Insight into the source of their fears

Correct answer: A

Rationale: In hypochondriasis, individuals are excessively preoccupied with and worried about having a serious illness, despite reassurance from medical professionals. This self-preoccupation is a key characteristic of hypochondriasis. 'La belle indifference' refers to a lack of concern or distress about symptoms, which is not typically seen in hypochondriasis. Fear of physicians may be present due to the individual's persistent belief in their illness despite medical reassurance. Insight into the source of their fears is usually lacking in hypochondriasis, as individuals often believe their physical symptoms are evidence of a serious illness.

5. Which of the following medications is commonly used to treat attention-deficit/hyperactivity disorder (ADHD)?

• A. Haloperidol
• B. Fluoxetine
• C. Methylphenidate
• D. Clozapine

Correct answer: C

Rationale: Methylphenidate is a central nervous system stimulant commonly used in the treatment of ADHD. It helps improve focus, attention, and impulse control in individuals with ADHD. Haloperidol and clozapine are antipsychotic medications typically used for other conditions such as schizophrenia, while fluoxetine is a selective serotonin reuptake inhibitor commonly used to treat depression and anxiety disorders. Therefore, the correct answer is Methylphenidate (Choice C).

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