Nursing Elites

1. A client with major depressive disorder expresses feelings of hopelessness. Which nursing intervention should the nurse implement to address these feelings?

• A. Encourage the client to engage in physical activity.
• B. Provide opportunities for the client to make decisions.
• C. Help the client identify positive aspects of their life.
• D. Encourage the client to verbalize feelings of hopelessness.

Correct answer: C

Rationale: When a client with major depressive disorder expresses feelings of hopelessness, helping them identify positive aspects of their life can be an effective nursing intervention. This approach can assist in shifting their focus from negativity to positivity, promoting a sense of hope and potentially improving their overall outlook and well-being. By highlighting the positive aspects, the nurse can support the client in recognizing reasons for hope and encourage a more optimistic perspective, which can aid in addressing and alleviating feelings of hopelessness. Encouraging physical activity (Choice A) may be beneficial for overall well-being but may not directly address feelings of hopelessness. Providing opportunities for decision-making (Choice B) can empower the client but may not specifically target feelings of hopelessness. Encouraging verbalization of feelings (Choice D) is important but may not be as effective as helping the client shift their focus to positive aspects of life.

2. Why is the DSM-5 useful in the practice of psychiatric nursing?

• A. It guides the nurse in making accurate and reliable medical diagnoses.
• B. It represents progress toward a more holistic view of mind and body.
• C. It provides a framework for interdisciplinary communication.
• D. It provides a template for nursing care plans.

Correct answer: A

Rationale: The DSM-5 is a crucial tool in psychiatric nursing as it guides nurses in making accurate and reliable medical diagnoses of mental health conditions. Using the DSM-5 ensures that diagnoses are standardized, improving the quality and precision of care for clients. While the DSM-5 also supports a holistic view, interdisciplinary communication, and care plan development, its primary role in psychiatric nursing is to assist clinicians in diagnosing mental health conditions accurately.

3. A healthcare provider is providing care for a patient with major depressive disorder who is prescribed a tricyclic antidepressant (TCA). Which common side effect should the healthcare provider educate the patient about?

• A. Hypertension
• B. Diarrhea
• C. Dry mouth
• D. Weight loss

Correct answer: C

Rationale: Dry mouth is a common side effect associated with tricyclic antidepressants (TCAs). TCAs can cause anticholinergic side effects, such as dry mouth, due to their mechanism of action. Educating the patient about dry mouth can help them stay informed and manage this common side effect effectively during treatment. Hypertension (Choice A) is not a common side effect of TCAs. Diarrhea (Choice B) is more commonly associated with selective serotonin reuptake inhibitors (SSRIs) than with TCAs. Weight loss (Choice D) is not a common side effect of TCAs; in fact, TCAs are more likely to cause weight gain.

4. A client with schizophrenia is experiencing delusions. Which of the following interventions should the nurse implement?

• A. Agree with the client's delusions to avoid confrontation.
• B. Challenge the client's delusions directly.
• C. Encourage the client to discuss their delusions in detail.
• D. Present reality and offer reassurance without reinforcing the delusions.

Correct answer: D

Rationale: When caring for a client with schizophrenia experiencing delusions, the nurse should present reality and offer reassurance without reinforcing the client's delusions. This approach helps the client maintain a connection to reality while feeling supported. Agreeing with the delusions may perpetuate false beliefs, while directly challenging them can lead to increased distress for the client. Encouraging the client to discuss their delusions in detail may further exacerbate their symptoms or reinforce their false beliefs. Therefore, the most therapeutic intervention is to gently present reality and provide reassurance to the client.

5. Which medication would the nurse least likely use to provide immediate intervention for an angry psychotic client?

• A. Lithium
• B. Alprazolam
• C. Diphenhydramine
• D. Haloperidol

Correct answer: B

Rationale: Alprazolam is a benzodiazepine commonly used for anxiety disorders. While it may help calm an individual, it is not typically the first-line choice for managing acute agitation in a psychotic client. Haloperidol, on the other hand, is a typical antipsychotic medication often used for immediate intervention in psychiatric emergencies involving aggression or psychosis.

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