Nursing Elites

1. When assessing a patient with major depressive disorder, which of the following is a common cognitive symptom?

• A. Hallucinations
• B. Delusions
• C. Lack of appetite
• D. Negative self-talk

Correct answer: D

Rationale: Negative self-talk is a common cognitive symptom of major depressive disorder. It involves a pattern of negative thoughts and beliefs about oneself, which can significantly impact a patient's self-esteem and overall outlook on life. Hallucinations and delusions are more commonly associated with other mental health conditions like schizophrenia, while lack of appetite is typically considered a physical symptom of depression rather than a cognitive one.

2. A patient with a diagnosis of panic disorder is prescribed an SSRI. Which side effect should the nurse monitor for when the patient starts this medication?

• A. Increased heart rate
• B. Increased appetite
• C. Gastrointestinal disturbances
• D. Dry mouth

Correct answer: C

Rationale: When a patient with panic disorder is prescribed an SSRI, the nurse should monitor for gastrointestinal disturbances as a common side effect. SSRIs can cause gastrointestinal symptoms such as nausea, diarrhea, or abdominal discomfort, especially at the beginning of treatment. Increased heart rate (Choice A) is not a common side effect of SSRIs; it is more commonly associated with medications like stimulants. Increased appetite (Choice B) is not a typical side effect of SSRIs, as they are more likely to cause weight loss or appetite suppression. Dry mouth (Choice D) is a side effect seen more commonly with medications that have anticholinergic properties, not typically with SSRIs.

3. A patient is being discharged with a prescription for an antidepressant for their depression. Which instruction is most important?

• A. Take the medication with food to prevent stomach upset.
• B. Refrain from driving until you understand the effects of the medication.
• C. Do not discontinue the medication suddenly.
• D. Avoid alcohol consumption while taking this medication.

Correct answer: C

Rationale: The most critical instruction is to not discontinue the antidepressant medication suddenly. Abrupt discontinuation can lead to withdrawal symptoms and potentially trigger a relapse of depression. Options A, B, and D are important but not as crucial as ensuring the patient follows the prescribed regimen and consults with a healthcare provider before making any changes to the medication routine.

4. A 32-year-old female patient is diagnosed with generalized anxiety disorder (GAD). Which behavior would the nurse expect to observe?

• A. Complains of persistent and excessive worry.
• B. Frequently fidgets and has difficulty sitting still.
• C. Exhibits ritualistic behaviors.
• D. Reports periods of derealization.

Correct answer: A

Rationale: In generalized anxiety disorder (GAD), individuals often experience persistent and excessive worry about various aspects of their life. This worry is difficult to control and is disproportionate to the actual source of concern. The other options describe behaviors more commonly associated with other anxiety disorders like social anxiety disorder (frequent fidgeting and difficulty sitting still), obsessive-compulsive disorder (ritualistic behaviors), and depersonalization/derealization disorder (periods of derealization). Therefore, the correct behavior to expect in a patient with GAD is persistent and excessive worry.

5. The school nurse has been alerted to the fact that an 8-year-old boy routinely playacts as a police officer, 'locking up' other children on the playground to the point where the children get scared. The nurse recognizes that this behavior is most likely an indication of:

• A. The need to dominate others
• B. Inventing traumatic events
• C. A need to develop close relationships
• D. A potential symptom of traumatization

Correct answer: D

Rationale: When an 8-year-old boy engages in playacting as a police officer that instills fear in other children, it can be indicative of a potential symptom of traumatization. This behavior may reflect the child's attempt to process or express experiences of trauma, leading to a manifestation of such distress in his play interactions with others.

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