Nursing Elites

1. A client with obsessive-compulsive disorder (OCD) is receiving a new prescription for fluoxetine (Prozac). Which statement by the client indicates an understanding of this medication?

• A. “I should begin feeling less anxious within a few weeks.”
• B. “The drug will help me control my compulsive behaviors.”
• C. “I will need to have a weekly blood test to check my liver function.”
• D. “I should avoid foods that contain tyramine while taking this medication.”

Correct answer: B

Rationale: The correct answer is B. Fluoxetine, an SSRI, can help manage symptoms of OCD by assisting in controlling compulsive behaviors rather than directly reducing anxiety. The improvement in symptoms usually occurs over a few weeks. Choice A is incorrect as it provides a timeframe for anxiety improvement, which is not the primary goal of fluoxetine in OCD treatment. Choice C is incorrect as routine blood tests are not typically required with fluoxetine. Choice D is incorrect as avoiding tyramine-containing foods is more relevant for MAOIs, not SSRIs like fluoxetine.

2. A client with depression and a history of a recent suicide attempt is being discharged from the hospital. Which statement by the client indicates a need for further follow-up?

• A. “I will take my medication as prescribed.”
• B. “I have a plan to attend weekly therapy sessions.”
• C. “I feel that I am completely recovered now.”
• D. “I will avoid people who make me feel worse.”

Correct answer: C

Rationale: The correct answer is C. When a client with depression and a history of a recent suicide attempt states, “I feel that I am completely recovered now,” it indicates a need for further follow-up. This statement suggests a potential lack of insight into the ongoing nature of depression and may lead to discontinuation of necessary treatment and support. Choices A, B, and D demonstrate positive and proactive attitudes towards managing depression and suicidal ideation, indicating a willingness to engage in treatment, therapy, and self-care practices.

3. The client is being educated by the healthcare provider about starting a prescribed abstinence therapy with disulfiram (Antabuse). What information should the client understand?

• A. Maintain complete abstinence from alcohol consumption.
• B. Stay alcohol-free for at least 12 hours before the first dose.
• C. Participate in monthly therapy sessions.
• D. Disclose to others that he is receiving disulfiram therapy.

Correct answer: B

Rationale: The correct answer is B. Before starting disulfiram therapy (Antabuse), the client must comprehend the need to remain alcohol-free for a minimum of 12 hours. This is crucial to prevent the unpleasant and potentially dangerous reactions that can occur with concurrent alcohol consumption while on disulfiram. Choice A is incorrect because it mentions heroin or cocaine use, which is not the primary focus when initiating disulfiram therapy. Choice C is incorrect as it suggests therapy sessions, which are not specifically required before starting disulfiram. Choice D is incorrect as there is no need to disclose disulfiram therapy to others, but rather to adhere to the abstinence requirement.

4. A female client with a history of major depressive disorder is experiencing a worsening of symptoms. Which statement by the client indicates a potential risk for suicide?

• A. “I’ve been feeling more tired than usual.”
• B. “I’ve been thinking about how much better everyone would be without me.”
• C. “I’ve been having trouble sleeping lately.”
• D. “I feel like I can’t handle everything.”

Correct answer: B

Rationale: The client’s statement about thinking that everyone would be better off without her indicates suicidal ideation. This statement is a significant warning sign for suicide risk and requires immediate intervention. Choices A, C, and D reflect common symptoms of depression but do not directly indicate suicidal thoughts or intentions. Feeling tired, having trouble sleeping, and feeling overwhelmed are typical symptoms of major depressive disorder but do not necessarily suggest an imminent risk of suicide like the statement in option B does.

5. A client with borderline personality disorder is admitted to the psychiatric unit. Which behavior should the nurse prioritize in the care plan?

• A. Self-harming behavior.
• B. Difficulty with interpersonal relationships.
• C. Impulsive spending and substance abuse.
• D. Inconsistent adherence to the treatment regimen.

Correct answer: A

Rationale: Self-harming behavior is the priority in the care plan for a client with borderline personality disorder. This behavior poses an immediate risk to the client's safety and requires prompt intervention. Difficulty with interpersonal relationships, impulsive spending, and substance abuse are also common in borderline personality disorder; however, self-harming behavior takes precedence due to its potential for severe harm. Inconsistent adherence to the treatment regimen, though important, is not as urgent as addressing the immediate safety concerns related to self-harm.

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