Nursing Elites

1. When evaluating a client's progress in psychotherapy, which outcome is appropriate for the client?

• A. The client will identify triggers for anxiety.
• B. The client will develop coping strategies.
• C. The client will decrease avoidance behaviors.
• D. The client will express feelings of anger.

Correct answer: A

Rationale: In psychotherapy, identifying triggers for anxiety is a crucial step towards understanding and managing one's anxiety symptoms. By recognizing these triggers, clients can work on developing coping strategies and addressing the root cause of their anxiety, leading to improved mental health outcomes. Decreasing avoidance behaviors and expressing feelings of anger are also important aspects of therapy. However, identifying triggers for anxiety is a more specific and foundational goal in addressing anxiety disorders, making it the most appropriate outcome to evaluate a client's progress in psychotherapy.

2. A patient with generalized anxiety disorder (GAD) is prescribed venlafaxine. The nurse should educate the patient about which potential side effect?

• A. Hypertension
• B. Hypotension
• C. Bradycardia
• D. Hyperglycemia

Correct answer: A

Rationale: The correct answer is A: Hypertension. Venlafaxine, an SNRI, can lead to hypertension as a side effect. This medication can cause an increase in blood pressure, particularly at higher doses. Educating the patient about this potential adverse effect is crucial to enhance awareness and monitoring for any signs or symptoms of elevated blood pressure. Choices B, C, and D are incorrect because venlafaxine is more likely to cause hypertension rather than hypotension, bradycardia, or hyperglycemia.

3. A client prescribed lithium for bipolar disorder is receiving education from a healthcare provider. Which statement by the client indicates a need for further teaching?

• A. I should avoid eating aged cheeses and processed meats.
• B. I need to maintain a consistent sodium intake.
• C. I should drink plenty of fluids to stay hydrated.
• D. I can take over-the-counter medications without consulting my healthcare provider.

Correct answer: D

Rationale: The correct answer is D. Taking over-the-counter medications without consulting the healthcare provider is not recommended for clients on lithium therapy as there can be potential interactions between lithium and certain medications. It is crucial for clients on lithium to always consult their healthcare provider before taking any over-the-counter medications to ensure the safety and effectiveness of their treatment. Choices A, B, and C are all correct statements that align with managing lithium therapy, emphasizing the importance of dietary restrictions and adequate hydration, as well as monitoring sodium intake to maintain the therapeutic effects of lithium.

4. When assessing a client with bipolar disorder who is experiencing a depressive episode, which of the following findings should the nurse not expect?

• A. Low energy
• B. Feelings of hopelessness
• C. Insomnia or hypersomnia
• D. Difficulty concentrating

Correct answer: D

Rationale: In a client experiencing a depressive episode in bipolar disorder, common findings include low energy, feelings of hopelessness, insomnia or hypersomnia, and decreased appetite. Difficulty concentrating is more indicative of attention deficit disorders or cognitive impairment rather than a typical presentation of a depressive episode in bipolar disorder.

5. A client who experiences stress on a regular basis asks a nurse what causes these feelings. Which is the most appropriate nursing response?

• A. Genetics have no influence on your temperament.
• B. How you reacted to past experiences influences how you feel now.
• C. Maintaining good physical health always keeps stress levels low.
• D. Stress can be avoided by using appropriate coping mechanisms.

Correct answer: B

Rationale: The correct answer is B: 'How you reacted to past experiences influences how you feel now.' This response is appropriate because past experiences can shape an individual's current response to stress. It acknowledges the impact of learned patterns and coping mechanisms on one's current adaptation to stressors. Choice A is incorrect because genetics can play a role in temperament to some extent. Choice C is incorrect because while physical health can contribute to stress management, it is not the sole determinant of stress levels. Choice D is incorrect as stress is not always avoidable, but coping mechanisms can help manage and reduce its impact.

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