Nursing Elites

1. A client has been prescribed fluoxetine (Prozac). What information should the nurse include in discharge teaching?

• A. Take the medication with food to avoid stomach upset.
• B. Avoid drinking alcohol while taking this medication.
• C. Take the medication only when feeling depressed.
• D. Report any unusual side effects to the healthcare provider.

Correct answer: B

Rationale: The correct answer is to advise the client to avoid drinking alcohol while taking fluoxetine (Prozac) due to potential interactions. Alcohol consumption can increase the risk of certain side effects and may reduce the effectiveness of the medication. Choice A is incorrect because fluoxetine can be taken with or without food. Choice C is incorrect as fluoxetine is usually taken daily regardless of the client's mood. Choice D is not the priority teaching point; while reporting side effects is important, avoiding alcohol is critical due to the potential interactions.

2. How do psychiatrists determine which diagnosis to give a patient?

• A. Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
• B. Hospital policy dictates how psychiatrists diagnose mental disorders.
• C. Psychiatrists assess the patient and identify diagnoses based on the patient's unhealthy responses and contributing factors.
• D. The American Medical Association identifies 10 diagnostic labels that psychiatrists can choose from.

Correct answer: A

Rationale: The correct answer is A. Psychiatrists use the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association (APA) to determine diagnoses. The DSM-5 provides standardized criteria for the classification of mental disorders, ensuring accurate and reliable diagnosis and treatment. Choices B and D are inaccurate as hospital policy does not dictate psychiatric diagnoses, and the American Medical Association is not responsible for psychiatric diagnostic criteria. Choice C describes a more general approach to assessment and does not specifically address the standardized criteria used in psychiatric diagnosis.

3. A nursing student new to psychiatric-mental health nursing asks a peer what resources he can use to identify the symptoms present in a specific psychiatric disorder. The best answer would be:

• A. Nursing Interventions Classification (NIC)
• B. Nursing Outcomes Classification (NOC)
• C. NANDA-I nursing diagnoses
• D. DSM-5

Correct answer: D

Rationale: The DSM-5 is the standard classification of mental disorders used by mental health professionals in the U.S. It provides criteria for diagnosing different psychiatric disorders based on symptoms and clinical observations. Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC) are focused on nursing interventions and outcomes, respectively, while NANDA-I nursing diagnoses are related to identifying nursing problems and their contributing factors.

4. Which of the following is not a common side effect of selective serotonin reuptake inhibitors (SSRIs)?

• A. Nausea
• B. Insomnia
• C. Weight loss
• D. Sexual dysfunction

Correct answer: C

Rationale: Common side effects of SSRIs include nausea, insomnia, weight gain, and sexual dysfunction. Weight loss is not a common side effect associated with SSRIs; instead, weight gain is more frequently observed. Therefore, the correct answer is C.

5. In a patient with schizophrenia, which of the following symptoms would indicate a poor prognosis?

• A. Auditory hallucinations
• B. Paranoia
• C. Flat affect
• D. Delusions of grandeur

Correct answer: C

Rationale: A flat affect, characterized by a lack of emotional expression, is often linked to a poorer prognosis in schizophrenia. It can hinder social interactions and affect the individual's ability to engage in therapy or express emotions, thereby impacting the overall treatment outcomes. Auditory hallucinations (Choice A) and delusions of grandeur (Choice D) are common symptoms in schizophrenia but may not always indicate a poor prognosis. Paranoia (Choice B) can also vary in its impact on prognosis depending on the individual and the severity of the symptom.

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