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. Which statement indicates an understanding of the DSM-5 diagnosis?

• A. The DSM-5 includes information on cultural considerations.
• B. The DSM-5 is a tool for healthcare providers.
• C. The DSM-5 is not used for legal purposes.
• D. The DSM-5 includes information on the prevalence of mental disorders.

Correct answer: A

Rationale: Option A is the correct answer as the DSM-5 not only provides specific criteria for diagnosing mental disorders but also includes information on cultural considerations. Understanding cultural factors is crucial in making accurate diagnoses and providing appropriate care, highlighting the comprehensive nature of the DSM-5 for healthcare providers. Choices B, C, and D are incorrect because while the DSM-5 is indeed a tool for healthcare providers, it is also used in legal settings, and it focuses on diagnostic criteria and not just the prevalence of mental disorders.

3. A client has been diagnosed with major depressive disorder. Which is an appropriate short-term goal for the client?

• A. The client will report a decrease in depressive symptoms.
• B. The client will establish a sleep routine.
• C. The client will improve social interactions.
• D. The client will set realistic goals for the future.

Correct answer: A

Rationale: Setting a goal for the client to report a decrease in depressive symptoms is appropriate as it is specific, measurable, and achievable in the short term. Monitoring changes in depressive symptoms provides valuable feedback on the effectiveness of the treatment plan. While establishing a sleep routine, improving social interactions, and setting realistic goals for the future are important aspects of recovery, they are more suitable as intermediate or long-term goals. In the context of short-term goals, focusing on symptom reduction can provide immediate feedback on the client's progress and help adjust the treatment plan accordingly.

4. A client has been diagnosed with generalized anxiety disorder and expresses worrying about their job, family, and health, feeling a loss of control. What should the nurse do first?

• A. Administer a prescribed antianxiety medication.
• B. Encourage the client to attend a support group.
• C. Identify triggers of the client's anxiety.
• D. Teach the client deep breathing techniques.

Correct answer: D

Rationale: The initial step for the nurse is to teach the client deep breathing techniques to aid in managing anxiety symptoms. Deep breathing exercises can help the client relax, reduce anxiety levels, and regain a sense of control. This intervention is non-invasive, empowering the client to develop a coping strategy for immediate use when feeling overwhelmed by anxiety. Administering medication (Choice A) should not be the first action unless the client is in severe distress. Encouraging attendance at a support group (Choice B) and identifying triggers of anxiety (Choice C) are important but teaching coping strategies like deep breathing comes first to help the client feel more in control of managing their anxiety.

5. A nurse is assessing a client with suspected post-traumatic stress disorder (PTSD). Which of the following findings shouldn't the nurse expect?

• A. Flashbacks
• B. Avoidance of reminders of the trauma
• C. Increased arousal and hypervigilance
• D. Manic episodes

Correct answer: D

Rationale: Findings in a client with PTSD include flashbacks, avoidance of reminders of the trauma, increased arousal and hypervigilance, and negative changes in thoughts and mood. Manic episodes are not typically associated with PTSD.

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