Nursing Elites

1. A client has been prescribed a monoamine oxidase inhibitor (MAOI). Which dietary restriction should the nurse emphasize during discharge instructions?

• A. Avoid foods high in potassium.
• B. Avoid foods high in calcium.
• C. Avoid foods high in tyramine.
• D. Avoid foods high in sodium.

Correct answer: C

Rationale: The correct answer is C: Avoid foods high in tyramine. Clients taking MAOIs should avoid foods high in tyramine to prevent hypertensive crisis. Tyramine is found in aged, fermented, or spoiled foods. Choices A, B, and D are incorrect because potassium, calcium, and sodium restrictions are not specifically required for clients taking MAOIs.

2. Which of the following is identified as a psychoneurotic response to severe anxiety as it appears in the DSM-5?

• A. Somatic symptom disorder
• B. Grief responses
• C. Psychosis
• D. Bipolar disorder

Correct answer: A

Rationale: The correct answer is A: Somatic symptom disorder. Somatic symptom disorder is characterized by preoccupation with physical symptoms for which there is no demonstrable organic pathology. One of the diagnostic criteria is a high level of anxiety about health concerns or illness. In the DSM-5, somatic symptom disorders are classified under the category of somatic symptom and related disorders, which encompass conditions where psychological factors play a significant role in the development, exacerbation, or maintenance of physical symptoms. Choices B, C, and D are incorrect. Grief responses, psychosis, and bipolar disorder are not specifically categorized as psychoneurotic responses to severe anxiety in the DSM-5.

3. Which of the following is an uncommon symptom of schizophrenia?

• A. Delusions
• B. Fatigue
• C. Disorganized speech
• D. Catatonia

Correct answer: B

Rationale: Common symptoms of schizophrenia include delusions, hallucinations, disorganized speech, and catatonia. Fatigue is not typically considered a direct symptom of schizophrenia. It is important to focus on symptoms directly related to the disorder when identifying schizophrenia.

4. A client is experiencing progressive changes in memory that have interfered with personal, social, and occupational functioning. The client exhibits poor judgment and has a short attention span. The nurse recognizes these as classic signs of which condition?

• A. Delirium
• B. Mania
• C. Parkinsonism
• D. Alzheimer’s

Correct answer: D

Rationale: The client's presentation of progressive memory changes, poor judgment, and attention deficits align with classic signs of Alzheimer's disease. Alzheimer's is a neurodegenerative disorder characterized by cognitive decline that significantly impacts daily functioning. While delirium and mania may present with cognitive changes, Alzheimer's is specifically associated with progressive memory loss and cognitive impairment over time.

5. A client has a history of excessive drinking, which has led to multiple arrests for driving under the influence (DUI). The client states, 'I work hard to provide for my family. I don't see why I can't drink to relax.' The nurse recognizes the use of which defense mechanism?

• A. Projection
• B. Rationalization
• C. Regression
• D. Sublimation

Correct answer: B

Rationale: The nurse should recognize that the client is using rationalization, a common defense mechanism. Rationalization involves creating logical reasons to justify unacceptable feelings or behaviors. In this scenario, the client is justifying excessive drinking by linking it to hard work and the need for relaxation, masking the true underlying issue of alcohol abuse. Projection involves attributing one's thoughts or feelings to others, regression involves reverting to an earlier stage of development, and sublimation involves channeling unacceptable impulses into socially acceptable activities, none of which are demonstrated in the client's statement.

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