Nursing Elites

1. A client has been diagnosed with borderline personality disorder, and a nurse is providing care. Which intervention should the nurse implement to promote the client's safety?

• A. Implement a no-harm contract with the client.
• B. Monitor the client closely for signs of self-harm.
• C. Encourage the client to participate in recreational activities.
• D. Encourage the client to maintain a structured daily routine.

Correct answer: A

Rationale: Implementing a no-harm contract is a crucial intervention for clients with borderline personality disorder as it helps establish an agreement between the client and the healthcare provider to abstain from self-harming behaviors. This contract aims to promote the client's safety by enhancing awareness and providing a structured approach in managing impulses and emotions.

2. A healthcare provider is assessing a client with generalized anxiety disorder (GAD). Which of the following findings should the healthcare provider expect? Select one that does not apply.

• A. Restlessness
• B. Fatigue
• C. Excessive worry
• D. Mania

Correct answer: D

Rationale: In generalized anxiety disorder (GAD), common symptoms include restlessness, fatigue, and excessive worry. These symptoms are typical in individuals with GAD due to persistent and excessive anxiety. Mania, on the other hand, is not a characteristic symptom of GAD. Mania is associated with bipolar disorder and is characterized by distinct features like elevated mood, grandiosity, and impulsivity. Therefore, the correct answer is 'D: Mania,' as it does not align with the expected findings in generalized anxiety disorder.

3. A client has been prescribed sertraline (Zoloft) for depression. Which of the following instructions should the nurse include in the discharge teaching?

• A. Take the medication in the morning to avoid daytime drowsiness.
• B. Avoid drinking alcohol while taking this medication.
• C. Take the medication with a full glass of water.
• D. Stop taking the medication if you feel better.

Correct answer: B

Rationale: The correct instruction for the nurse to include in the discharge teaching is to advise the client to avoid drinking alcohol while taking sertraline (Zoloft). Alcohol can exacerbate the side effects of the medication, such as drowsiness and dizziness, and may also decrease the effectiveness of the treatment for depression. Choice A is incorrect as sertraline is usually taken in the morning. Choice C is not a specific instruction related to the medication. Choice D is incorrect as abruptly stopping sertraline can lead to withdrawal symptoms and should only be done under medical supervision.

4. Which statement is an example of reflection?

• A. I think this feeling will pass.
• B. So you are saying that life has no meaning.
• C. I'm not sure I understand what you mean.
• D. You look sad.

Correct answer: B

Rationale: The correct answer is B. Reflection involves restating the patient's words or feelings to show understanding and encourage further discussion. Choice B restates the patient's statement, demonstrating active listening and empathy.

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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