Nursing Elites

1. Cabot has multiple symptoms of depression including mood reactivity, social phobia, anxiety, and overeating. With a history of mild hypertension, which classification of antidepressants dispensed as a transdermal patch would be a safe medication?

• A. Tricyclic antidepressants
• B. Selective serotonin reuptake inhibitors
• C. Serotonin and norepinephrine reuptake inhibitors
• D. Monoamine oxidase inhibitors

Correct answer: D

Rationale: Monoamine oxidase inhibitors dispensed as transdermal patches can be a safer option for patients with mild hypertension due to reduced systemic absorption compared to other forms of antidepressants, potentially minimizing cardiovascular effects associated with hypertension.

2. When assessing a patient with generalized anxiety disorder (GAD), which symptom would the nurse most likely observe?

• A. Flashbacks
• B. Excessive worry
• C. Hallucinations
• D. Compulsive behaviors

Correct answer: B

Rationale: Excessive worry is a characteristic feature of generalized anxiety disorder (GAD). Patients with GAD experience persistent and excessive worry about various aspects of their life, such as work, health, or family, even when there is little or no reason for concern. This chronic worrying can significantly impact their daily functioning and quality of life. Flashbacks are more commonly associated with post-traumatic stress disorder (PTSD), hallucinations are more typical in conditions like schizophrenia, while compulsive behaviors are seen in obsessive-compulsive disorder (OCD). Therefore, in the context of GAD, excessive worry is the symptom that the nurse is most likely to observe.

3. A client has been prescribed sertraline for depression, and the nurse is providing discharge instructions. Which dietary instruction should the nurse include?

• A. Avoid foods high in sodium.
• B. Avoid foods high in calcium.
• C. Avoid foods high in tyramine.
• D. Avoid foods high in potassium.

Correct answer: C

Rationale: Clients prescribed sertraline should avoid foods high in tyramine to prevent a hypertensive crisis. Sertraline, an antidepressant belonging to the selective serotonin reuptake inhibitor (SSRI) class, can interact with tyramine-rich foods, potentially causing a dangerous increase in blood pressure known as a hypertensive crisis. Choices A, B, and D are incorrect because there is no specific dietary restriction related to sodium, calcium, or potassium intake when taking sertraline.

4. A healthcare provider is assessing a client with suspected post-traumatic stress disorder (PTSD). Which of the following findings should the provider expect? Select one that does not apply.

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

Correct answer: D

Rationale: Post-traumatic stress disorder (PTSD) is characterized by various symptoms, including flashbacks, avoidance of reminders of the trauma, increased arousal, and hypervigilance. Additionally, individuals with PTSD often experience negative changes in thoughts and mood. Manic episodes, which are periods of abnormally elevated mood and energy, are not typically associated with PTSD. Therefore, the correct answer is 'Manic episodes.' Choices A, B, and C are all common findings in individuals with PTSD.

5. Which of the following are common symptoms of major depressive disorder? Select one that doesn't apply.

• A. Insomnia
• B. Feelings of hopelessness
• C. Increased energy
• D. Difficulty concentrating

Correct answer: C

Rationale: Common symptoms of major depressive disorder include insomnia, feelings of hopelessness, difficulty concentrating, and appetite changes. While individuals with major depressive disorder often experience fatigue and low energy levels, increased energy is not typically associated with this condition. Therefore, 'Increased energy' is the correct choice that doesn't apply to major depressive disorder. Choices A, B, and D are all commonly seen in individuals with major depressive disorder, making them incorrect answers.

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