Nursing Elites

1. A client has been diagnosed with paranoid personality disorder. Which of the following behaviors should the nurse expect?

• A. Distrust of others
• B. Reluctance to confide in others
• C. Suspiciousness of others
• D. Jealousy of others

Correct answer: A

Rationale: Individuals with paranoid personality disorder commonly display a pervasive distrust of others. They often interpret benign actions of others as hostile or malicious, leading to suspicion and a belief that others have malevolent intentions. While choices B, C, and D may be present in individuals with different personality disorders or issues, distrust of others is a hallmark feature of paranoid personality disorder, making it the correct behavior to expect in these clients.

2. A client with bipolar disorder is experiencing a depressive episode. Which nursing intervention is most appropriate?

• A. Encourage the client to avoid physical activity.
• B. Encourage the client to engage in social activities.
• C. Encourage the client to participate in group therapy.
• D. Encourage the client to set realistic goals.

Correct answer: C

Rationale: Encouraging the client to participate in group therapy is the most appropriate nursing intervention for a client with bipolar disorder experiencing a depressive episode. Group therapy provides a supportive environment where the client can share experiences, learn coping strategies, and receive emotional support from peers and mental health professionals. It can help reduce feelings of isolation, improve social skills, and enhance overall well-being. Group therapy also promotes a sense of belonging and understanding, which are essential for individuals dealing with bipolar disorder and depressive symptoms. Choices A, B, and D are not the most appropriate interventions for a client experiencing a depressive episode in bipolar disorder. Encouraging the client to avoid physical activity may worsen their symptoms, promoting social activities may not address the underlying issues effectively, and setting goals may be overwhelming during a depressive episode.

3. Which of the following interventions are appropriate for a client experiencing a panic attack? Select one that does not apply.

• A. Stay with the client and remain calm
• B. Encourage deep breathing
• C. Move the client to a quiet environment
• D. Mindfulness meditation

Correct answer: D

Rationale: During a panic attack, it is crucial to provide immediate support to the client. Appropriate interventions include staying with the client and remaining calm, encouraging deep breathing, and moving the client to a quiet environment. However, mindfulness meditation, which involves focusing on the present moment and may require a certain level of concentration, may not be feasible or effective during an acute panic attack. The priority is to help the client feel safe and supported, which the other interventions address more directly. Mindfulness meditation might not be suitable during a panic attack due to the heightened state of anxiety and the need for immediate calming techniques.

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. When a patient with major depressive disorder is started on fluoxetine, what is the most important side effect for the nurse to monitor?

• A. Weight gain
• B. Suicidal ideation
• C. Hypertension
• D. Hyperglycemia

Correct answer: B

Rationale: When initiating fluoxetine therapy in a patient with major depressive disorder, monitoring for suicidal ideation is crucial due to the increased risk of suicidal thoughts or behaviors that can occur, especially in the initial phase of treatment. This close monitoring is essential to ensure patient safety and intervene promptly if such symptoms arise. Weight gain, hypertension, and hyperglycemia are potential side effects of some medications used to treat depression, but suicidal ideation is the most critical and immediate side effect to monitor for when starting fluoxetine.

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