Nursing Elites

1. A patient with generalized anxiety disorder (GAD) is prescribed escitalopram. The nurse should educate the patient that the full therapeutic effect of this medication may take:

• A. 1-2 days
• B. 1-2 weeks
• C. 2-4 weeks
• D. 6-8 weeks

Correct answer: D

Rationale: Escitalopram, an SSRI used in treating generalized anxiety disorder, typically takes 6-8 weeks to achieve its full therapeutic effect. While some improvement may be noticed earlier, the maximum benefit is usually experienced after this timeframe. Options A, B, and C are incorrect because they underestimate the time required for escitalopram to reach its full effectiveness. Educating patients about the realistic timeline for medication effectiveness is crucial in managing expectations and ensuring adherence to the prescribed treatment.

2. A healthcare professional is conducting education on anxiety and stress management. Which of the following should be identified as the most important initial step in learning how to manage anxiety?

• A. Diagnostic blood tests
• B. Awareness of factors creating stress
• C. Relaxation exercises
• D. Identifying support systems

Correct answer: B

Rationale: The correct answer is B: Awareness of factors creating stress. In managing anxiety, the first crucial step is recognizing and being aware of the factors that contribute to stress. Without this awareness, it becomes challenging to effectively address and manage anxiety. Diagnostic blood tests are not typically the initial step in managing anxiety; they may be used to rule out other medical conditions but are not the primary focus. While relaxation exercises can be helpful in managing anxiety, understanding the root causes of stress takes precedence. Identifying support systems is important but comes after recognizing the stress factors to develop a comprehensive management plan.

3. A client prescribed lithium for bipolar disorder is receiving education from a healthcare provider. Which statement by the client indicates a need for further teaching?

• A. I should avoid eating aged cheeses and processed meats.
• B. I need to maintain a consistent sodium intake.
• C. I should drink plenty of fluids to stay hydrated.
• D. I can take over-the-counter medications without consulting my healthcare provider.

Correct answer: D

Rationale: The correct answer is D. Taking over-the-counter medications without consulting the healthcare provider is not recommended for clients on lithium therapy as there can be potential interactions between lithium and certain medications. It is crucial for clients on lithium to always consult their healthcare provider before taking any over-the-counter medications to ensure the safety and effectiveness of their treatment. Choices A, B, and C are all correct statements that align with managing lithium therapy, emphasizing the importance of dietary restrictions and adequate hydration, as well as monitoring sodium intake to maintain the therapeutic effects of lithium.

4. During an intake assessment, a nurse asks both physiological and psychosocial questions. The client angrily responds, 'I'm here for my heart, not my head problems.' What is the nurse'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 nurse should educate the client about the impact of psychological factors, such as excessive stress, on medical conditions. Understanding this connection is crucial in providing holistic care. It is essential to address both physiological and psychosocial aspects during the assessment to obtain a comprehensive understanding of the client's health status and needs. Choice A is incorrect as it doesn't address the importance of psychosocial aspects on medical conditions. Choice B is not the best response as it does not provide valuable information about the connection between psychological factors and medical conditions. Choice D is incorrect because skipping these questions could lead to missing crucial information that may impact the client's overall well-being and treatment plan.

5. Which statement made by the patient demonstrates an understanding of the effective use of newly prescribed lithium to manage bipolar mania? Select one that doesn't apply.

• A. I remind myself to consistently drink six 12-ounce glasses of fluid every day.
• B. I discussed the diuretic prescribed by my cardiologist with my psychiatric care provider.
• C. Lithium may help me lose the few extra pounds I tend to carry around.
• D. I take my lithium on an empty stomach to help with absorption.

Correct answer: C

Rationale: Proper hydration, discussing other medications, and taking lithium with or without food are important for effective and safe use of lithium. However, lithium is not prescribed for weight loss, and its usage should not be associated with losing extra pounds.

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