Nursing Elites

1. Tomas is a 21-year-old male with a recent diagnosis of schizophrenia. Tomas's nurse recognizes that self-medicating with excessive alcohol is common in this disease and can co-occur along with:

• A. Generally good health despite the mental illness.
• B. An aversion to drinking fluids.
• C. Anxiety and depression.
• D. The ability to express his needs.

Correct answer: C

Rationale: Individuals with schizophrenia often turn to excessive alcohol consumption as a way to manage symptoms of anxiety and depression. This maladaptive coping mechanism can exacerbate the challenges associated with schizophrenia and may hinder effective treatment outcomes. Recognizing the presence of anxiety and depression alongside alcohol abuse is crucial for providing holistic care and support to individuals with schizophrenia.

2. 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.

3. Which of the following symptoms should a healthcare professional expect to assess in a client diagnosed with major depressive disorder? Select one that does not apply.

• A. Loss of interest or pleasure
• B. Decreased ability to concentrate
• C. Significant weight loss or gain
• D. Increased energy

Correct answer: D

Rationale: Symptoms of major depressive disorder include a loss of interest or pleasure, decreased ability to concentrate, significant weight loss or gain, and feelings of worthlessness or excessive guilt. Increased energy is not typically associated with major depressive disorder; instead, fatigue is more common. Clients with major depressive disorder often experience a lack of energy, motivation, or enthusiasm, leading to feelings of lethargy and fatigue. Therefore, increased energy is an atypical symptom in major depressive disorder, making it the correct answer.

4. A client diagnosed with schizophrenia is prescribed an antipsychotic medication. Which of the following side effects should the nurse not monitor for? Select all that apply.

• A. Tardive dyskinesia
• B. Neuroleptic malignant syndrome
• C. Orthostatic hypotension
• D. Hyperglycemia

Correct answer: A

Rationale: The nurse should not monitor for tardive dyskinesia as it is a potential long-term side effect of antipsychotic medications. However, the nurse should monitor for neuroleptic malignant syndrome, orthostatic hypotension, and hyperglycemia as these are common side effects associated with antipsychotic medications. Tardive dyskinesia is characterized by involuntary movements of the face, tongue, and extremities and may develop after prolonged use of antipsychotic drugs.

5. A patient presents in the Emergency Department immediately following a shooting incident in a school where she has been teaching. There is no evidence of physical injury, but she appears very hyperactive and talkative. Which of these symptoms manifested by the patient is an uncommon initial biological response to stress?

• A. Constricted pupils
• B. Watery eyes
• C. Palpitations
• D. Increased heart rate

Correct answer: A

Rationale: Increased lacrimal secretions, palpitations, and increased heart rate are common initial biological responses to stress. Constricted pupils are not typical in the initial response to stress and are more associated with the opposite response, the Rest and Digest system. Watery eyes, palpitations, and increased heart rate are indicative of the body's fight or flight response to stress. Unusual food cravings are not a typical biological response to stress.

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