Nursing Elites

1. A healthcare professional is conducting education on anxiety and stress management. Which of the following should be identified as the most important initial step in learning how to manage anxiety?

• A. Diagnostic blood tests
• B. Awareness of factors creating stress
• C. Relaxation exercises
• D. Identifying support systems

Correct answer: B

Rationale: The correct answer is B: Awareness of factors creating stress. In managing anxiety, the first crucial step is recognizing and being aware of the factors that contribute to stress. Without this awareness, it becomes challenging to effectively address and manage anxiety. Diagnostic blood tests are not typically the initial step in managing anxiety; they may be used to rule out other medical conditions but are not the primary focus. While relaxation exercises can be helpful in managing anxiety, understanding the root causes of stress takes precedence. Identifying support systems is important but comes after recognizing the stress factors to develop a comprehensive management plan.

2. A client diagnosed with major depressive disorder is prescribed an SSRI. Which side effect should the nurse monitor for in the initial weeks of treatment?

• A. Weight loss
• B. Increased risk of suicide
• C. Hypertension
• D. Photosensitivity

Correct answer: B

Rationale: When a client is prescribed an SSRI for major depressive disorder, the nurse should closely monitor for an increased risk of suicide, especially in younger patients, during the initial weeks of treatment. SSRIs may initially increase energy levels before improving mood, which can lead to a higher risk of suicide in some individuals. Weight loss is not a common side effect of SSRIs and may actually be a concern for some patients with major depressive disorder who experience appetite changes. Hypertension is not typically associated with SSRIs, and photosensitivity is not a common side effect of this class of medications.

3. A nurse is assessing a client with suspected post-traumatic stress disorder (PTSD). Which of the following findings shouldn't the nurse expect?

• A. Flashbacks
• B. Avoidance of reminders of the trauma
• C. Increased arousal and hypervigilance
• D. Manic episodes

Correct answer: D

Rationale: Findings in a client with PTSD include flashbacks, avoidance of reminders of the trauma, increased arousal and hypervigilance, and negative changes in thoughts and mood. Manic episodes are not typically associated with PTSD.

4. What information should the nurse include in patient education for a patient prescribed valproic acid for bipolar disorder?

• A. Avoid consuming dairy products while taking this medication.
• B. Regular blood tests are necessary to monitor medication levels.
• C. Take the medication on an empty stomach for better absorption.
• D. It is safe to stop the medication abruptly if side effects occur.

Correct answer: B

Rationale: The correct answer is B: Regular blood tests are crucial when taking valproic acid to monitor the medication levels in the bloodstream. This monitoring helps ensure that the patient is receiving the correct dosage for effective treatment and to prevent adverse effects associated with either subtherapeutic or toxic levels of the medication. Choice A is incorrect because there is no specific interaction between valproic acid and dairy products. Choice C is incorrect as valproic acid can generally be taken with food to reduce gastrointestinal side effects. Choice D is incorrect as abruptly stopping valproic acid can lead to withdrawal symptoms and worsening of the condition.

5. A male patient calls to tell the nurse that his monthly lithium level is 1.7 mEq/L. Which nursing intervention will the nurse implement initially?

• A. Reinforce that the level is above the therapeutic range.
• B. Instruct the patient to hold the next dose of medication and contact the prescriber.
• C. Advise the patient to go to the hospital emergency room immediately.
• D. Inform the patient about the possibility of seizures and appropriate precautions.

Correct answer: B

Rationale: A lithium level of 1.7 mEq/L is above the therapeutic range, indicating a potential risk of toxicity. The initial nursing intervention should be to instruct the patient to hold the next dose of medication and promptly contact the prescriber for further guidance and management. This action aims to prevent adverse effects and ensure the patient's safety by addressing the elevated lithium level appropriately.

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