Nursing Elites

1. A patient with bipolar disorder has been prescribed lithium. Which dietary advice is important for the nurse to include?

• A. Avoid foods high in tyramine.
• B. Maintain a consistent salt intake.
• C. Increase protein intake.
• D. Avoid foods high in fat.

Correct answer: B

Rationale: Patients prescribed lithium should maintain a consistent salt intake to prevent fluctuations in lithium levels. Salt intake can impact lithium levels, and sudden changes in salt intake can affect how the body absorbs and excretes lithium. Therefore, advising the patient to maintain a stable salt intake is crucial for the effectiveness and safety of lithium therapy. Choices A, C, and D are incorrect. Avoiding foods high in tyramine is more relevant for patients taking MAOIs, not lithium. Increasing protein intake or avoiding foods high in fat are not specific dietary recommendations for patients on lithium therapy.

2. A client diagnosed with major depressive disorder is prescribed an SSRI. Which side effect should the nurse monitor for in the initial weeks of treatment?

• A. Weight loss
• B. Increased risk of suicide
• C. Hypertension
• D. Photosensitivity

Correct answer: B

Rationale: When a client is prescribed an SSRI for major depressive disorder, the nurse should closely monitor for an increased risk of suicide, especially in younger patients, during the initial weeks of treatment. SSRIs may initially increase energy levels before improving mood, which can lead to a higher risk of suicide in some individuals. Weight loss is not a common side effect of SSRIs and may actually be a concern for some patients with major depressive disorder who experience appetite changes. Hypertension is not typically associated with SSRIs, and photosensitivity is not a common side effect of this class of medications.

3. An individual who has survived incest and is receiving treatment at the mental health clinic feels relief upon understanding that her anxiety and depression are:

• A. Going to be eradicated with treatment
• B. Normal and will soon pass
• C. Abnormal but will pass
• D. A normal reaction to posttraumatic events

Correct answer: D

Rationale: It is important to recognize that anxiety and depression are common responses to traumatic events like incest. Understanding that these feelings are normal reactions can help validate the individual's experiences and reduce stigma. By acknowledging that anxiety and depression are expected outcomes of posttraumatic events, the mental health clinic can provide appropriate support and treatment to help the survivor cope and heal. Therefore, option D is the correct choice as it reflects a compassionate and informed approach to addressing the survivor's emotional struggles.

4. 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.

5. When interviewing a distressed client who was fired after 15 years of loyal employment, which of the following questions would best assist in determining the client's appraisal of the situation? Select all that apply.

• A. What caused the stressful situation?
• B. Have you ever experienced a similar stressful situation?
• C. Who do you think is to blame for this situation?
• D. Why do you think you were fired from your job?

Correct answer: B

Rationale: The question 'Have you ever experienced a similar stressful situation?' is the most appropriate as it assesses the client's coping resources and encourages reflection on past experiences. This question can help the client consider alternative ways to deal with stress. Asking about the cause of the stressful situation may provide insight into the current situation but does not directly assess coping abilities. Inquiring about blame does not focus on coping strategies but may encourage negative thinking and a sense of victimization. Questioning why the client was fired is a nontherapeutic approach that can hinder communication by putting the client on the defensive.

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