Nursing Elites

1. When discussing the main differences between narcolepsy and obstructive sleep apnea syndrome, what should the nurse highlight?

• A. Symptoms of the two diagnoses are essentially the same, making it challenging to differentiate between them
• B. Naps are contraindicated for clients with narcolepsy due to their association with cataplexy
• C. People with narcolepsy awaken from a nap feeling rested and replenished
• D. People with obstructive sleep apnea syndrome may experience temporary paralysis during sleep

Correct answer: C

Rationale: Narcolepsy is characterized by excessive daytime sleepiness and sudden attacks of sleep, while individuals with narcolepsy often feel refreshed after a brief nap. In contrast, obstructive sleep apnea syndrome is marked by pauses in breathing or shallow breathing during sleep, leading to fragmented sleep and excessive daytime sleepiness. Therefore, the correct answer is that individuals with narcolepsy awaken from a nap feeling rested and replenished, which is a key distinguishing feature from obstructive sleep apnea syndrome.

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

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

Correct answer: D

Rationale: During alcohol withdrawal, the nurse should expect to observe symptoms such as tremors, hallucinations, and diaphoresis. Seizures may also occur during severe withdrawal. Bradycardia is not typically associated with alcohol withdrawal; instead, tachycardia (an increased heart rate) is more commonly observed due to the stimulant effects of alcohol withdrawal on the sympathetic nervous system.

3. A nurse is reviewing prescriptions for a patient with major depression at the county clinic. Since the patient has a mild intellectual disability, the nurse would question which classification of antidepressant drugs:

• A. Selective serotonin reuptake inhibitors
• B. Monoamine oxidase inhibitors
• C. Serotonin and norepinephrine reuptake inhibitors
• D. All of the above

Correct answer: B

Rationale: Monoamine oxidase inhibitors are less suitable for patients with intellectual disabilities due to the need for dietary restrictions and close monitoring. These restrictions can be challenging for patients with mild intellectual disabilities to follow, making this drug class a concern for this patient population.

4. A client displays signs and symptoms indicative of hypochondriasis. The nurse would initially expect to see:

• A. Self-preoccupation
• B. La belle indifference
• C. Fear of physicians
• D. Insight into the source of their fears

Correct answer: A

Rationale: In hypochondriasis, individuals are excessively preoccupied with and worried about having a serious illness, despite reassurance from medical professionals. This self-preoccupation is a key characteristic of hypochondriasis. 'La belle indifference' refers to a lack of concern or distress about symptoms, which is not typically seen in hypochondriasis. Fear of physicians may be present due to the individual's persistent belief in their illness despite medical reassurance. Insight into the source of their fears is usually lacking in hypochondriasis, as individuals often believe their physical symptoms are evidence of a serious illness.

5. A patient with major depressive disorder has been prescribed an MAOI. The patient should be educated to avoid which type of food to prevent hypertensive crises?

• A. High-protein foods
• B. High-fiber foods
• C. Tyramine-rich foods
• D. Low-fat foods

Correct answer: C

Rationale: The correct answer is C: Tyramine-rich foods. Patients prescribed MAOIs should avoid tyramine-rich foods to prevent hypertensive crises. Tyramine-rich foods can interact with MAOIs, leading to a sudden and dangerous increase in blood pressure. Examples of tyramine-rich foods include aged cheeses, cured meats, pickled or fermented foods, and certain beverages like beer and wine. Choices A, B, and D are incorrect because they are not associated with causing hypertensive crises when taken with MAOIs.

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