Nursing Elites

1. A healthcare professional is assessing a client with bipolar disorder who is experiencing a depressive episode. Which of the following findings should the healthcare professional expect? Select one that does not apply.

• A. High energy
• B. Feelings of hopelessness
• C. Insomnia or hypersomnia
• D. Decreased appetite

Correct answer: A

Rationale: During a depressive episode in bipolar disorder, clients typically exhibit low energy levels, feelings of hopelessness, insomnia or hypersomnia, and decreased appetite. High energy levels are more commonly seen in manic episodes of bipolar disorder.

2. A client with a history of alcohol use disorder is admitted to the hospital for detoxification. Which of the following symptoms should the nurse expect to observe during withdrawal? Select one that doesn't apply.

• A. Tremors
• B. Hallucinations
• C. Diaphoresis
• D. Bradycardia

Correct answer: D

Rationale: During alcohol withdrawal, symptoms such as tremors, hallucinations, diaphoresis, and seizures are commonly observed. Bradycardia is not typically associated with alcohol withdrawal; instead, tachycardia, an increased heart rate, is more commonly seen. Therefore, bradycardia is the correct answer as it is not an expected symptom during alcohol withdrawal. Tremors, hallucinations, and diaphoresis are all common manifestations of alcohol withdrawal, while bradycardia is not typically seen in this context.

3. A client with generalized anxiety disorder is prescribed buspirone. Which statement by the client indicates a need for further teaching?

• A. I can stop taking this medication once I feel less anxious.
• B. I should avoid drinking alcohol while taking this medication.
• C. It may take several weeks for this medication to take full effect.
• D. This medication can cause dependency.

Correct answer: A

Rationale: The correct answer is A because it indicates a misunderstanding about buspirone. Buspirone should not be abruptly stopped, and patients should follow the prescribed regimen consistently. Stopping the medication without proper guidance can lead to adverse effects or a return of anxiety symptoms. Choices B, C, and D demonstrate an understanding of important aspects of buspirone therapy: avoiding alcohol due to interactions, being patient for the medication to reach full effectiveness, and being aware of the potential for dependency with this medication.

4. During a mental status examination, which of the following components should not be included in the assessment?

• A. Appearance and behavior
• B. Giving advice
• C. Mood and affect
• D. Cognitive function

Correct answer: B

Rationale: During a mental status examination, components such as appearance and behavior, mood and affect, and cognitive function are assessed. Giving advice is not a component of a mental status examination as it focuses on evaluating the client's mental state rather than providing guidance or recommendations.

5. A client diagnosed with major depressive disorder is receiving cognitive-behavioral therapy (CBT). Which outcome indicates that the therapy is effective?

• A. The client identifies and challenges negative thoughts.
• B. The client reports an increase in suicidal thoughts.
• C. The client experiences an increase in anxiety.
• D. The client shows no change in behavior.

Correct answer: A

Rationale: In cognitive-behavioral therapy (CBT), one of the primary objectives is to help clients identify and challenge their negative thoughts. This process allows the individual to reframe their thinking patterns and develop more adaptive coping strategies. Reporting an increase in suicidal thoughts (Choice B) or experiencing an increase in anxiety (Choice C) are not desired outcomes and may indicate a need for further intervention. Showing no change in behavior (Choice D) suggests that the therapy has not been effective. Therefore, the correct indicator of effective therapy in this context is the client's ability to identify and challenge negative thoughts (Choice A).

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