Nursing Elites

1. During pregnancy, a woman is in a relationship with a male who routinely abuses her. Her unborn child may engage in high-risk behavior as a teen as a result of:

• A. Maternal stress
• B. Parental nurturing
• C. Appropriate stress responses in the brain
• D. Memories of the abuse

Correct answer: A

Rationale: Maternal stress during pregnancy can have long-term effects on the child's behavior and stress responses. Research shows that exposure to high levels of stress hormones in the womb can influence the developing fetal brain and the child's future behavior, potentially leading to high-risk behaviors during adolescence.

2. A client with schizophrenia is experiencing auditory hallucinations. Which intervention should the nurse implement to address this symptom?

• A. Encourage the client to discuss the voices.
• B. Tell the client that the voices are not real.
• C. Provide reality-based feedback to the client.
• D. Distract the client from the voices.

Correct answer: C

Rationale: When a client with schizophrenia is experiencing auditory hallucinations, providing reality-based feedback is a therapeutic intervention. This helps the client differentiate between what is real and what is not, aiding in reducing the impact of hallucinations. Encouraging the client to discuss the voices may validate the hallucinations, telling the client that the voices are not real dismisses their experience, and distracting the client may not address the underlying issue of the hallucinations.

3. In the treatment of generalized anxiety disorder (GAD), what medication is frequently prescribed as a first-line treatment?

• A. Clonazepam
• B. Buspirone
• C. Propranolol
• D. Hydroxyzine

Correct answer: B

Rationale: Buspirone is often chosen as a first-line treatment for generalized anxiety disorder (GAD) due to its efficacy and favorable side effect profile. Unlike benzodiazepines such as clonazepam (A), buspirone does not carry the risk of tolerance, dependence, or withdrawal symptoms, making it a preferred choice. While propranolol (C) and hydroxyzine (D) are sometimes used for anxiety, they are not typically considered first-line treatments for GAD.

4. What information should the nurse provide in patient education for a patient prescribed sertraline for major depressive disorder?

• A. Take the medication with food.
• B. It may take several weeks to feel the full effect.
• C. Avoid consuming grapefruit while taking this medication.
• D. Regular blood tests are necessary to monitor levels.

Correct answer: B

Rationale: Patients prescribed sertraline for major depressive disorder should be educated that it may take several weeks before experiencing the full therapeutic effects of the medication. This delay in onset of action is common with antidepressants like sertraline, and patients need to be aware of this to manage their expectations and continue with the treatment regimen. It's important for the patient to understand that consistent adherence to the prescribed dosage is crucial, even if the full effects are not immediately apparent. Choices A, C, and D are incorrect because taking the medication with food, avoiding grapefruit, and regular blood tests are not specific education points related to the expected timeframe for therapeutic effects of sertraline.

5. A client with schizophrenia is experiencing delusions. Which of the following interventions should the nurse implement?

• A. Agree with the client's delusions to avoid confrontation.
• B. Challenge the client's delusions directly.
• C. Encourage the client to discuss their delusions in detail.
• D. Present reality and offer reassurance without reinforcing the delusions.

Correct answer: D

Rationale: When caring for a client with schizophrenia experiencing delusions, the nurse should present reality and offer reassurance without reinforcing the client's delusions. This approach helps the client maintain a connection to reality while feeling supported. Agreeing with the delusions may perpetuate false beliefs, while directly challenging them can lead to increased distress for the client. Encouraging the client to discuss their delusions in detail may further exacerbate their symptoms or reinforce their false beliefs. Therefore, the most therapeutic intervention is to gently present reality and provide reassurance to the client.

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