Nursing Elites

1. 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.

2. How do psychiatrists determine which diagnosis to give a patient?

• A. Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
• B. Hospital policy dictates how psychiatrists diagnose mental disorders.
• C. Psychiatrists assess the patient and identify diagnoses based on the patient's symptoms and contributing factors.
• D. The American Medical Association identifies 10 diagnostic labels that psychiatrists can choose from.

Correct answer: A

Rationale: Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to determine which diagnosis to give a patient. The DSM-5 is a comprehensive manual published by the American Psychiatric Association (APA) that outlines specific criteria for diagnosing mental disorders. It aims to ensure accurate and consistent diagnosis and treatment. Choices B and D provide inaccurate information. Hospital policy does not dictate psychiatric diagnoses, and the American Medical Association does not provide diagnostic labels for mental disorders. Choice C, although mentioning the assessment of patients, does not highlight the specific criteria and guidelines provided by the DSM-5 that psychiatrists use to assign diagnoses.

3. A psychiatric nurse observes that a client diagnosed with schizophrenia is pacing up and down the corridor. The client is muttering to himself, and his hands are trembling. Which of the following actions should the nurse take first?

• A. Ask the client if he is hearing voices.
• B. Offer the client a PRN medication for anxiety.
• C. Encourage the client to participate in a relaxation exercise.
• D. Remove the client to a quieter environment.

Correct answer: D

Rationale: The first action the nurse should take is to remove the client to a quieter environment. This intervention aims to reduce stimuli that may be contributing to the client's agitation and help create a calmer and more supportive setting for the client. Choices A, B, and C are not the priority in this situation as addressing the environmental factors should come first before exploring symptoms, offering medication, or engaging in relaxation exercises.

4. When explaining suicide precautions to a client, what would be the best explanation?

• A. You need to control yourself. If you cannot, we will do it for you.
• B. This can seem embarrassing, but we want you to be safe.
• C. You will stay on these precautions for one week.
• D. When you feel you are safer, then we will not need to observe you.

Correct answer: D

Rationale: Choice D provides a supportive and empowering explanation to the client on suicide precautions. It emphasizes the client's own sense of safety and control, indicating that the observation is temporary and can be removed when the client feels safer. This approach promotes autonomy and encourages the client to actively participate in their own well-being, fostering a therapeutic relationship based on trust and collaboration.

5. In what order should the following goals be approached for a client being treated for alcoholism?

• A. Learning about dependence and recovery; abstinence and development of a support system; attaining physiological stabilization; developing alternative coping skills
• B. Developing alternative coping skills; attaining physiological stabilization; learning about dependence and recovery; abstinence and development of a support system
• C. Abstinence and development of a support system; attaining physiological stabilization; learning about dependence and recovery; developing alternative coping skills
• D. Abstinence and development of a support system; learning about dependence and recovery; attaining physiological stabilization; developing alternative coping skills

Correct answer: B

Rationale: When treating a client for alcoholism, it is important to follow a structured approach to maximize treatment effectiveness. The correct order of approaching goals is to first help the client in developing alternative coping skills to manage triggers and stressors without relying on alcohol. This is followed by attaining physiological stabilization, which involves addressing any physical health issues related to alcoholism. Next, the client should learn about dependence and recovery to understand the nature of their condition and the process of recovery. Finally, the goals of abstinence and developing a support system come into play to ensure long-term sobriety and a reliable network of support. Therefore, the correct order is: Developing alternative coping skills; attaining physiological stabilization; learning about dependence and recovery; abstinence and development of a support system.

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