Nursing Elites

1. 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.

2. Which intervention is particularly well chosen for addressing a population at high risk for developing schizophrenia?

• A. Screening a group of males aged 15 to 25 for early symptoms.
• B. Forming a support group for females aged 25 to 35 with substance use issues.
• C. Providing coping skills information to a group aged 45 to 55.
• D. Educating parents of developmentally delayed 5- to 6-year-olds on early intervention importance.

Correct answer: A

Rationale: Screening males aged 15 to 25 for early symptoms of schizophrenia is a well-chosen intervention as this age group is at a higher risk for developing the condition. Early identification can lead to timely treatment and better outcomes, making this intervention particularly effective in addressing the population at risk for schizophrenia.

3. A client has been diagnosed with post-traumatic stress disorder (PTSD). Which intervention should the nurse implement to reduce the client's anxiety?

• A. Encourage the client to avoid discussing the traumatic event.
• B. Encourage the client to participate in group therapy sessions.
• C. Encourage the client to engage in relaxation techniques.
• D. Encourage the client to maintain a daily journal.

Correct answer: C

Rationale: Engaging in relaxation techniques, such as deep breathing, mindfulness, or progressive muscle relaxation, can help reduce anxiety for clients with PTSD. These techniques promote relaxation and help manage stress responses, contributing to a sense of calmness and improved coping mechanisms in dealing with anxiety triggers associated with PTSD. Avoiding discussing the traumatic event (Choice A) may hinder the client's progress in processing and coping with the trauma. While group therapy (Choice B) can be beneficial, relaxation techniques are more specific for reducing anxiety in this context. Maintaining a daily journal (Choice D) may be helpful for some clients but might not directly address anxiety reduction as effectively as relaxation techniques.

4. During an intake assessment, a healthcare professional asks both physiological and psychosocial questions. The client angrily responds, 'I'm here for my heart, not my head problems.' What is the healthcare professional's best response?

• A. It's just a routine part of our assessment. All clients are asked these same questions.
• B. Why are you concerned about these types of questions?
• C. Psychological factors, like excessive stress, have been found to affect medical conditions.
• D. We can skip these questions, if you like. It isn't imperative that we complete this section.

Correct answer: C

Rationale: The healthcare professional should educate the client on the negative effects of excessive stress on medical conditions. Understanding the interconnectedness of physical and mental health is crucial for providing holistic care. Choice A is incorrect because it doesn't address the importance of psychosocial aspects. Choice B is wrong as it doesn't provide relevant information about the impact of psychological factors on health. Choice D is incorrect because skipping questions would lead to an incomplete assessment, potentially missing crucial information affecting the client's overall health outcomes.

5. A client with obsessive-compulsive disorder (OCD) spends several hours each day washing her hands. Which intervention should the nurse implement?

• A. Encourage the client to wash her hands less frequently.
• B. Set a time limit for hand washing.
• C. Teach the client relaxation techniques.
• D. Discourage the client from washing her hands.

Correct answer: B

Rationale: Setting a time limit for hand washing is an appropriate intervention for a client with OCD who spends excessive time on this compulsive behavior. By setting a time limit, the nurse can help the client gradually reduce the compulsive behavior, promoting a more manageable approach to hand washing without completely discouraging it. Encouraging the client to wash her hands less frequently (Choice A) may not address the root of the issue and could lead to increased anxiety. Teaching relaxation techniques (Choice C) may be helpful for overall anxiety management but may not directly address the excessive hand washing behavior. Discouraging the client from washing her hands (Choice D) may increase anxiety and resistance, making it a less effective intervention.

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