Nursing Elites

1. A patient with schizophrenia is prescribed risperidone. The nurse should monitor the patient for which common side effect of this medication?

• A. Agranulocytosis
• B. Weight gain
• C. Hair loss
• D. Hyperthyroidism

Correct answer: B

Rationale: When a patient is prescribed risperidone, an atypical antipsychotic, the nurse should monitor for weight gain as it is a common side effect of this medication. Weight gain can occur due to metabolic changes and increased appetite associated with risperidone use. Agranulocytosis is a severe decrease in a type of white blood cells, and it is not a common side effect of risperidone. Hair loss and hyperthyroidism are also not typically associated with risperidone use.

2. A client with bipolar disorder is experiencing a depressive episode. Which intervention should the nurse implement to support the client's recovery?

• A. Encourage the client to engage in physical activity.
• B. Encourage the client to maintain a regular sleep schedule.
• C. Encourage the client to set realistic goals for daily activities.
• D. Encourage the client to express feelings of sadness.

Correct answer: C

Rationale: During a depressive episode in bipolar disorder, encouraging the client to set realistic goals for daily activities can be beneficial. Setting achievable goals can provide structure, a sense of accomplishment, and help in breaking tasks into manageable steps, which can support the client's recovery process. Options A and B, while important in managing bipolar disorder, may not directly address the client's depressive symptoms during this episode. Option D, encouraging the client to express feelings of sadness, is not as effective as setting achievable goals in providing structure and a sense of accomplishment during a depressive episode.

3. During a treatment team meeting, the point is made that a client with schizophrenia has recovered from the acute psychosis but continues to demonstrate apathy, avolition, and blunted affect. The nurse who relates these symptoms to serotonin excess will suggest that the client receive?

• A. Chlorpromazine
• B. Phenelzine
• C. Haloperidol
• D. Olanzapine

Correct answer: D

Rationale: In this scenario, the symptoms of apathy, avolition, and blunted affect are indicative of negative symptoms commonly seen in schizophrenia. These symptoms are often associated with dopamine and serotonin imbalances in the brain. Olanzapine, an atypical antipsychotic, is known for its efficacy in treating both positive and negative symptoms of schizophrenia. It acts by blocking serotonin and dopamine receptors, helping to alleviate the symptoms mentioned. Chlorpromazine and Haloperidol are typical antipsychotics that primarily target dopamine receptors, while Phenelzine is an MAOI used to treat depression and anxiety disorders, not schizophrenia. Therefore, the most appropriate choice for this client displaying these symptoms related to serotonin excess would be Olanzapine.

4. When attempting to determine a teenager's mental health resilience, what assessment question should the nurse ask that is not applicable?

• A. How did you cope when your father deployed with the Army for a year in Iraq?
• B. Who did you go to for advice while your father was away for a year in Iraq?
• C. How do you feel about talking to a mental health counselor?
• D. Why would you think that is a better option than meeting with me?

Correct answer: D

Rationale: Assessing a teenager's mental health resilience involves exploring coping mechanisms, support systems, and attitudes towards seeking help. Option D is not relevant to assessing resilience but rather focuses on the comparison between seeking advice from a counselor versus the nurse, which doesn't directly gauge the teenager's resilience.

5. A client with schizophrenia is experiencing auditory hallucinations. Which intervention should the nurse implement first?

• A. Ask the client to describe the content of the hallucinations.
• B. Instruct the client to ignore the hallucinations.
• C. Administer prescribed antipsychotic medication.
• D. Engage the client in reality-based activities.

Correct answer: A

Rationale: The initial intervention for a client experiencing auditory hallucinations, especially in schizophrenia, is to assess the content of the hallucinations. By asking the client to describe the hallucinations, the nurse can determine if they are command hallucinations that might pose a risk. This assessment is crucial in guiding further appropriate interventions to ensure the client's safety and well-being. Instructing the client to ignore the hallucinations (Choice B) may not be effective, as the hallucinations are real to the client. Administering antipsychotic medication (Choice C) may be necessary but should come after assessing the situation. Engaging the client in reality-based activities (Choice D) is important but not the first priority when dealing with auditory hallucinations.

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