Nursing Elites

1. A nurse is providing discharge teaching to a client with major depressive disorder who is prescribed fluoxetine (Prozac). What is the most important teaching point for the nurse to include?

• A. You may experience dizziness, so avoid driving.
• B. It may take several weeks to feel the full effect of the medication.
• C. Avoid foods high in tyramine while taking this medication.
• D. Take this medication only when you feel depressed.

Correct answer: B

Rationale: The correct answer is B because SSRIs like fluoxetine typically take several weeks to reach their full therapeutic effect, so it's important to set realistic expectations for the client. Choice A is incorrect as dizziness is a common side effect but not the most important teaching point. Choice C is incorrect as avoiding tyramine-rich foods is more relevant for MAOIs. Choice D is incorrect as fluoxetine should be taken consistently, not only when the client feels depressed, to maintain therapeutic blood levels.

2. A client with panic disorder is prescribed sertraline (Zoloft). What is the most important information for the nurse to provide?

• A. You should take this medication at the same time every day.
• B. It may take several weeks for you to feel the full effect.
• C. This medication may cause a significant increase in appetite.
• D. You may experience dizziness, so avoid driving.

Correct answer: B

Rationale: The correct answer is B. SSRIs like sertraline may take several weeks to reach their full therapeutic effect, so it's important to inform the client to be patient with the treatment. Choice A is not the most crucial information regarding sertraline. Choice C is not a common side effect of sertraline. Choice D is important but not as crucial as informing about the delayed onset of action.

3. A client is scheduled to complete a positron emission tomography (PET) scan. The client asks the nurse to explain the reason the test was prescribed. How should the nurse respond?

• A. Images indicate the presence of tumors and scars.
• B. The scan clearly outlines structures of the brain.
• C. Results show activity in various portions of the brain.
• D. PET shows biochemical levels of neurotransmitters.

Correct answer: C

Rationale: The correct answer is C. PET scans are primarily used to detect and observe the metabolic activity in various parts of the brain. This helps in diagnosing conditions related to brain function, such as tumors, brain disorders, and overall brain activity. Choices A, B, and D are incorrect because PET scans focus on metabolic activity and functions in the brain rather than solely indicating the presence of tumors, outlining brain structures, or showing biochemical levels of neurotransmitters.

4. A male client is brought to the emergency department by a police officer, who reports the client was disturbing the peace by running naked in the street, striking out at others, and smashing car windows. Which behaviors should the client demonstrate to determine if he should be evaluated for involuntary commitment?

• A. Threats to kill his friend.
• B. Disruptive behaviors in a community setting.
• C. Hears voices telling him to kill himself.
• D. Reports he has not needed a bath in 4 months.

Correct answer: D

Rationale: The client's dangerous and disruptive behaviors, along with auditory hallucinations of self-harm, suggest a need for involuntary commitment for his safety and that of others. Involuntary commitment may be warranted based on the client's poor hygiene and self-neglect, as it indicates an inability to care for himself, which can pose a risk to his well-being.

5. The nurse is planning the care for a 32-year-old male client with acute depression. Which nursing intervention would be best in helping this client deal with his depression?

• A. Ensure that the client's day is filled with group activities.
• B. Assist the client in exploring feelings of shame, anger, and guilt.
• C. Allow the client to initiate and determine activities of daily living.
• D. Encourage the client to explore the rationale for his depression.

Correct answer: B

Rationale: Assisting the client in exploring feelings of shame, anger, and guilt (B) is the most appropriate intervention for acute depression as it helps address core emotions that may be contributing to the condition. Focusing on these emotions can aid the client in processing and coping with their feelings. Ensuring that the client's day is filled with group activities (A) might overwhelm the client, as they may not be ready for social interactions during this sensitive time. Allowing the client to initiate and determine activities of daily living (C) is more suitable for chronic cases where the client needs to regain autonomy. Encouraging the client to explore the rationale for his depression (D) is less effective in acute cases, as the focus should be on immediate emotional support and understanding rather than cognitive analysis.

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