Nursing Elites

1. A patient with major depressive disorder is started on fluoxetine. What is a common side effect the nurse should monitor for?

• A. Weight gain
• B. Increased appetite
• C. Nausea
• D. Dry mouth

Correct answer: C

Rationale: Nausea is a common side effect of fluoxetine and should be monitored.

2. When developing a care plan for a patient with borderline personality disorder, which intervention should be included to address self-harm behaviors?

• A. Encouraging the patient to keep a journal of their thoughts and feelings.
• B. Setting clear and consistent boundaries with the patient.
• C. Providing the patient with coping skills to manage their emotions.
• D. Developing a safety plan with the patient.

Correct answer: D

Rationale: Developing a safety plan with the patient is crucial when addressing self-harm behaviors in individuals with borderline personality disorder. This intervention helps outline steps to take during a crisis, identifies triggers, and provides strategies to prevent self-harm incidents. It involves collaboratively creating a plan between the patient and the healthcare team to ensure a structured and supportive approach to managing potentially dangerous situations.

3. Gilbert, age 19, is described by his parents as a 'moody child' with an onset of odd behavior at age 14, which caused Gilbert to suffer academically and socially. Gilbert has lost the ability to complete household chores, is reluctant to leave the house, and is obsessed with the locks on the windows and doors. Due to Gilbert’s early and slow onset of what is now recognized as schizophrenia, his prognosis is considered:

• A. Favorable with medication
• B. In the relapse stage
• C. Improvable with psychosocial interventions
• D. To have a less positive outcome

Correct answer: D

Rationale: Individuals with an early and slow onset of schizophrenia typically have a less positive outcome or prognosis. This is because early onset schizophrenia is often associated with a more severe form of the illness and can lead to greater functional impairment in various aspects of life, including academic and social functioning. Therefore, the prognosis for Gilbert, given his presentation and age of onset, would be considered to have a less positive outcome.

4. A client is discussing free associations as a therapeutic tool with a nurse. Which of the following client statements indicates an understanding of this technique?

• A. “I will write down my dreams as soon as I wake up.”
• B. “I might begin to associate my therapist with important people in my life.”
• C. “I can learn to express myself in a nonaggressive manner.”
• D. “I should say the first thing that comes to my mind.”

Correct answer: D

Rationale: Free association is a psychoanalytic technique where the client is encouraged to say the first thing that comes to their mind without censoring or filtering. This technique helps uncover unconscious thoughts and emotions. Choice D, “I should say the first thing that comes to my mind,” indicates an understanding of free association as it aligns with the principle of allowing thoughts to flow freely without inhibition. Choices A, B, and C do not reflect an understanding of free association and its purpose, making them incorrect. A, focusing on writing down dreams, does not relate to the immediate expression of thoughts. B, associating the therapist with important people, and C, learning to express oneself nonaggressively, do not capture the essence of free association as a technique for exploring unconscious processes.

5. What medication is frequently prescribed for patients with generalized anxiety disorder (GAD)?

• A. Fluoxetine
• B. Sertraline
• C. Buspirone
• D. Diazepam

Correct answer: C

Rationale: Buspirone is a medication commonly prescribed for generalized anxiety disorder (GAD) due to its effectiveness and lower risk of dependency compared to benzodiazepines like diazepam. While fluoxetine and sertraline are selective serotonin reuptake inhibitors (SSRIs) often used for various anxiety disorders, buspirone is specifically indicated for GAD.

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