Nursing Elites

1. A distraught, single, first-time mother cries and asks a nurse, 'How can I go to work if I can't afford childcare?' What is the nurse's initial action in assisting the client with the problem-solving process?

• A. Determine the risks and benefits for each alternative.
• B. Formulate goals for resolution of the problem.
• C. Evaluate the outcome of the implemented alternative.
• D. Assess the facts of the situation.

Correct answer: D

Rationale: In this scenario, the nurse's initial step should be to assess the facts of the situation. By gathering accurate information about the client's circumstances, the nurse can better understand the problem and make informed decisions moving forward. This foundational assessment is crucial before proceeding to formulate goals, evaluate outcomes, or consider risks and benefits. Options A, B, and C involve steps that should follow the initial assessment of the situation, making them less suitable as the initial action in this context.

2. When caring for a patient with major depressive disorder prescribed an MAOI, what type of food should the nurse educate the patient to avoid?

• A. High-protein foods
• B. High-fiber foods
• C. Tyramine-rich foods
• D. Low-fat foods

Correct answer: C

Rationale: Patients prescribed MAOIs need to avoid consuming tyramine-rich foods as these can lead to hypertensive crises. Tyramine is found in various foods like aged cheeses, cured meats, some types of beer, and fermented products. Interactions between tyramine and MAOIs can result in severe hypertension, highlighting the importance of educating patients about dietary restrictions to ensure their safety. Choices A, B, and D are incorrect because high-protein foods, high-fiber foods, and low-fat foods do not pose a significant risk of hypertensive crises when taken with MAOIs. Therefore, the correct answer is C.

3. A healthcare professional is caring for a patient with bipolar disorder who is experiencing a manic episode. Which intervention is most appropriate?

• A. Encourage group activities to increase socialization.
• B. Provide a structured environment with limited stimuli.
• C. Allow the patient to engage in physical activities freely.
• D. Give the patient detailed and complex tasks to complete.

Correct answer: B

Rationale: During a manic episode, individuals with bipolar disorder may have heightened sensitivity to stimuli and may struggle with organization and decision-making. Providing a structured environment with limited stimuli can help reduce triggers and maintain a sense of control for the patient. It is essential to create a calm and predictable setting to support the individual in managing their symptoms effectively. Choice A is incorrect as group activities may overwhelm the patient due to increased stimuli. Choice C is not the most appropriate because unstructured physical activities may exacerbate the manic symptoms. Choice D is not recommended as detailed and complex tasks can be overwhelming and may contribute to increased stress and agitation in a manic episode.

4. Which characteristic identified during an assessment serves to support a diagnosis of disruptive mood dysregulation disorder? Select one that doesn't apply.

• A. Female
• B. 7 years old
• C. Comorbid autism diagnosis
• D. Outbursts occur at least once a week

Correct answer: C

Rationale: Characteristics such as age, frequency of outbursts, and occurrence in multiple settings support a diagnosis of disruptive mood dysregulation disorder. While comorbid conditions like autism can coexist with disruptive mood dysregulation disorder, it is not a characteristic that serves to support a diagnosis of this specific disorder.

5. A client with obsessive-compulsive disorder (OCD) spends several hours each day washing her hands. Which intervention should the nurse implement?

• A. Encourage the client to wash her hands less frequently.
• B. Set a time limit for hand washing.
• C. Teach the client relaxation techniques.
• D. Discourage the client from washing her hands.

Correct answer: B

Rationale: Setting a time limit for hand washing is an appropriate intervention for a client with OCD who spends excessive time on this compulsive behavior. By setting a time limit, the nurse can help the client gradually reduce the compulsive behavior, promoting a more manageable approach to hand washing without completely discouraging it. Encouraging the client to wash her hands less frequently (Choice A) may not address the root of the issue and could lead to increased anxiety. Teaching relaxation techniques (Choice C) may be helpful for overall anxiety management but may not directly address the excessive hand washing behavior. Discouraging the client from washing her hands (Choice D) may increase anxiety and resistance, making it a less effective intervention.

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