Nursing Elites

1. A client with schizophrenia is experiencing auditory hallucinations. Which intervention should the nurse implement to address this symptom?

• A. Encourage the client to discuss the voices.
• B. Tell the client that the voices are not real.
• C. Provide reality-based feedback to the client.
• D. Distract the client from the voices.

Correct answer: C

Rationale: When a client with schizophrenia is experiencing auditory hallucinations, providing reality-based feedback is a therapeutic intervention. This helps the client differentiate between what is real and what is not, aiding in reducing the impact of hallucinations. Encouraging the client to discuss the voices may validate the hallucinations, telling the client that the voices are not real dismisses their experience, and distracting the client may not address the underlying issue of the hallucinations.

2. Which of the following is a common side effect of benzodiazepines prescribed for anxiety?

• A. Insomnia
• B. Weight gain
• C. Drowsiness
• D. Increased appetite

Correct answer: C

Rationale: Drowsiness is a common side effect of benzodiazepines prescribed for anxiety. Benzodiazepines work by depressing the central nervous system, which can lead to drowsiness as a side effect. This sedative effect is often desired in the treatment of anxiety disorders, but individuals should be cautious when engaging in activities that require alertness, such as driving, while taking these medications. Insomnia, weight gain, and increased appetite are not typically associated with benzodiazepines; instead, drowsiness and sedation are more common side effects.

3. A client with major depressive disorder is prescribed an antidepressant. Which of the following instructions should the nurse include in the teaching? Select the one that does not apply.

• A. It may take several weeks for the medication to take effect
• B. Avoid alcohol while taking this medication
• C. Discontinue the medication abruptly
• D. You may experience an increase in energy before your mood improves

Correct answer: C

Rationale: Teaching for a client prescribed an antidepressant should include several key instructions. Firstly, it's important to inform the client that it may take several weeks for the medication to take effect, so they should be patient. Secondly, they should be advised to avoid alcohol while taking the medication as it can interact negatively with antidepressants. Additionally, abrupt discontinuation of antidepressants can lead to withdrawal symptoms and should be avoided. Lastly, clients may experience an increase in energy before their mood improves, which is a common effect of some antidepressants. Regular blood tests are not typically required for most antidepressants, but adherence to the prescribed regimen and reporting any concerning side effects to the healthcare provider are crucial.

4. Which of the following are common side effects of selective serotonin reuptake inhibitors (SSRIs)? Select one that does not apply.

• A. Nausea
• B. Insomnia
• C. Weight loss
• D. Sexual dysfunction

Correct answer: C

Rationale: Common side effects of selective serotonin reuptake inhibitors (SSRIs) include nausea, insomnia, weight gain, and sexual dysfunction. Weight loss is not a common side effect associated with SSRIs. Therefore, the correct answer is C. While some individuals may experience weight changes while taking SSRIs, weight loss is less common compared to weight gain as a side effect of these medications.

5. How should the nurse characterize the client's appraisal of the job loss stressor?

• A. Irrelevant
• B. Harm/loss
• C. Threatening
• D. Challenging

Correct answer: D

Rationale: The client's statement reflects a positive outlook on the job loss, viewing it as a challenge and an opportunity for personal growth. This perspective suggests that the client is resilient and adaptive, focusing on new possibilities rather than dwelling on the negative aspects of the situation. Choice D, 'Challenging,' is the correct characterization as it aligns with the client's positive appraisal. Choices A, 'Irrelevant,' B, 'Harm/loss,' and C, 'Threatening,' are incorrect as they do not capture the client's adaptive response to the stressor.

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