Nursing Elites

1. A healthcare provider is providing care for a patient with major depressive disorder who is prescribed a tricyclic antidepressant (TCA). Which common side effect should the healthcare provider educate the patient about?

• A. Hypertension
• B. Diarrhea
• C. Dry mouth
• D. Weight loss

Correct answer: C

Rationale: Dry mouth is a common side effect associated with tricyclic antidepressants (TCAs). TCAs can cause anticholinergic side effects, such as dry mouth, due to their mechanism of action. Educating the patient about dry mouth can help them stay informed and manage this common side effect effectively during treatment. Hypertension (Choice A) is not a common side effect of TCAs. Diarrhea (Choice B) is more commonly associated with selective serotonin reuptake inhibitors (SSRIs) than with TCAs. Weight loss (Choice D) is not a common side effect of TCAs; in fact, TCAs are more likely to cause weight gain.

2. In the care plan of a male patient diagnosed with a dissociative disorder, the nursing diagnosis of ineffective coping is included. Which behavior demonstrated by the patient supports this nursing diagnosis?

• A. Has no memory of the physical abuse he endured.
• B. Using both alcohol and marijuana.
• C. Often reports being unaware of surroundings.
• D. Reports feelings of 'not really being here.'

Correct answer: B

Rationale: The correct answer is B because using substances like alcohol and marijuana can be a sign of ineffective coping mechanisms in patients with dissociative disorders. Substance abuse is often used as a maladaptive way to cope with stress, trauma, or other underlying issues. Choices A, C, and D may be related to dissociative symptoms but do not directly reflect ineffective coping behaviors as substance abuse does.

3. 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.

4. When providing care for 10-year-old Harper diagnosed with posttraumatic stress disorder (PTSD), which goal should be addressed initially?

• A. Harper will be able to identify feelings through the use of play therapy.
• B. Harper and her parents will have access to protective resources available through social services.
• C. Harper will demonstrate the effective use of relaxation techniques to restore a sense of control over disturbing thoughts.
• D. Harper and her parents will demonstrate an understanding of the personal human response to traumatic events.

Correct answer: C

Rationale: The initial goal when caring for a child with PTSD like Harper is to address restoring a sense of control over disturbing thoughts by teaching relaxation techniques. This approach helps the child manage their distressing emotions and promotes a feeling of empowerment in dealing with their condition.

5. What assessment question will provide information to the healthcare provider regarding the effects of a woman's circadian rhythms on her quality of life?

• A. How much sleep do you usually get each night?
• B. Does your heart ever seem to skip a beat?
• C. When was the last time you had a fever?
• D. Do you have problems urinating?

Correct answer: A

Rationale: The correct assessment question to understand the effects of a woman's circadian rhythms on her quality of life is to inquire about her sleep duration. Circadian rhythms significantly influence sleep patterns, so knowing how much sleep she usually gets each night can provide valuable insight into potential circadian rhythm disturbances and their impact on her overall well-being.

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