Nursing Elites

1. Ted, a former executive, is now unemployed due to manic episodes at work. He was diagnosed with bipolar I 8 years ago. Ted has a history of IV drug abuse, which resulted in hepatitis C. He is taking his lithium exactly as scheduled, a fact that both Ted's wife and his blood tests confirm. To reduce Ted's mania, the psychiatric nurse practitioner recommends:

• A. Clonazepam (Klonopin)
• B. Fluoxetine (Prozac)
• C. Electroconvulsive therapy (ECT)
• D. Lurasidone (Latuda)

Correct answer: C

Rationale: Electroconvulsive therapy (ECT) can be an effective treatment for reducing mania in patients with bipolar disorder who have not responded to medication. In Ted's case, where he has a history of bipolar I disorder, lithium treatment, and manic episodes, ECT may be recommended by the psychiatric nurse practitioner to help manage his symptoms.

2. According to Maslow's hierarchy of needs, which situation on an inpatient psychiatric unit would require priority intervention by a nurse?

• A. A client rudely complaining about limited visiting hours
• B. A client exhibiting aggressive behavior toward another client
• C. A client stating that no one cares
• D. A client verbalizing feelings of failure

Correct answer: B

Rationale: The correct answer is B. According to Maslow's hierarchy of needs, safety needs are considered fundamental and must be addressed before higher-level needs. When a client exhibits aggressive behavior toward another client, it poses an immediate threat to safety and requires priority intervention by the nurse to ensure the well-being of all individuals involved. Clients who are rude in their complaints (Choice A), express feelings of failure (Choice D), or state that no one cares (Choice C) are addressing higher-level needs related to social interactions, esteem, and self-actualization, respectively, which can be addressed once safety needs are secured.

3. Which of the following is a common side effect of selective serotonin reuptake inhibitors (SSRIs)?

• A. Hypotension
• B. Sexual dysfunction
• C. Increased appetite
• D. Tachycardia

Correct answer: B

Rationale: Corrected Rationale: Sexual dysfunction is a commonly reported side effect of selective serotonin reuptake inhibitors (SSRIs). SSRIs can affect sexual function by causing issues such as decreased libido, delayed ejaculation, erectile dysfunction, or anorgasmia. Patients should be educated about these potential side effects when starting SSRIs to facilitate informed decision-making and appropriate management strategies. Incorrect Choices: A) Hypotension is not a common side effect of SSRIs. C) Increased appetite is not a common side effect of SSRIs. D) Tachycardia is not a common side effect of SSRIs.

4. Which assessment question asked by the nurse demonstrates an understanding of comorbid mental health conditions associated with major depressive disorder? Select one that doesn't apply.

• A. Do rules apply to you?
• B. What do you do to manage anxiety?
• C. Do you have a history of disordered eating?
• D. Do you think that you drink too much?

Correct answer: A

Rationale: Questions about anxiety management, disordered eating, and alcohol use are relevant to identifying comorbid conditions with major depressive disorder, but the question 'Do rules apply to you?' does not directly address common comorbid mental health conditions associated with major depressive disorder.

5. Which activity is most appropriate for a child with ADHD?

• A. Reading an adventure novel
• B. Monopoly
• C. Checkers
• D. Tennis

Correct answer: D

Rationale: Engaging in physical activities like tennis is beneficial for children with ADHD as it allows them to release excess energy and enhance concentration. Exercise can help improve focus and reduce hyperactivity in children with ADHD.

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