Nursing Elites

1. A nurse is providing education to a client diagnosed with generalized anxiety disorder (GAD). Which of the following statements by the client indicates a need for further teaching? Select one that does not apply.

• A. I should avoid caffeine because it can increase my anxiety.
• B. I can stop taking my medication once I feel better.
• C. Practicing deep breathing exercises can help reduce my anxiety.
• D. I should gradually face situations that cause me anxiety.

Correct answer: B

Rationale: Statements indicating a need for further teaching include stopping medication once feeling better and believing that medication will always be needed. Medication should be continued as prescribed, and the need for it should be regularly re-evaluated by a healthcare provider.

2. In assessing a client with major depressive disorder, which of the following findings shouldn't the nurse expect?

• A. Anhedonia
• B. Hypersomnia
• C. Fatigue
• D. Flight of ideas

Correct answer: D

Rationale: In major depressive disorder, common findings include anhedonia (loss of interest or pleasure), hypersomnia (excessive sleepiness), fatigue, and feelings of worthlessness. Flight of ideas, characterized by racing thoughts and rapid speech, is typically associated with bipolar disorder during manic episodes, not major depressive disorder.

3. A client has been prescribed lithium for the treatment of bipolar disorder. Which of the following instructions should the nurse include?

• A. Avoid driving until you know how the medication affects you.
• B. Take the medication with food to prevent stomach upset.
• C. You may experience mild nausea when initiating the medication.
• D. Do not double the next dose if you miss one.

Correct answer: A

Rationale: The correct instruction for the nurse to provide is to advise the client to avoid driving until they know how the medication affects them. Lithium can lead to side effects like dizziness and drowsiness, which could impair one's ability to drive safely. Choice B is incorrect because lithium is usually taken on an empty stomach. Choice C may be true but is not as critical as the potential side effects affecting driving. Choice D is important but not as immediate as ensuring the client's safety while driving.

4. A healthcare provider is assessing a client who has been diagnosed with conversion disorder. Which of the following findings should the provider expect?

• A. Paralysis of a limb
• B. Auditory hallucinations
• C. Dissociative amnesia
• D. Compulsive behaviors

Correct answer: A

Rationale: Conversion disorder is characterized by the development of neurological symptoms, such as paralysis of a limb, that cannot be explained by medical evaluation. The paralysis is typically due to a psychological conflict or stress rather than a physical issue. Auditory hallucinations, dissociative amnesia, and compulsive behaviors are not commonly associated with conversion disorder, making them incorrect choices. Therefore, the healthcare provider should expect to find paralysis of a limb in a client with conversion disorder.

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

• A. Encourage the client to set a time limit for washing hands.
• B. Encourage the client to wash hands only when necessary.
• C. Encourage the client to use hand sanitizer instead of washing.
• D. Encourage the client to explore the reasons behind the hand washing.

Correct answer: A

Rationale: Setting a time limit for hand washing is an effective intervention in managing obsessive-compulsive disorder (OCD) symptoms. By establishing boundaries around the behavior, the client can gradually work towards reducing the excessive hand washing and regaining control over the compulsion. Choice B is not as effective because it does not address the underlying compulsion. Choice C may not be helpful as it may not satisfy the client's need for cleanliness and could reinforce the behavior. Choice D, while important in therapy, may not be the most immediate intervention needed to address the excessive hand washing behavior.

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