Nursing Elites

1. When patients diagnosed with schizophrenia suffer from anosognosia, they often refuse medication, believing that:

• A. Medications provided are ineffective.
• B. Nurses are trying to control their minds.
• C. The medications will make them sick.
• D. They are not actually ill.

Correct answer: D

Rationale: Anosognosia is a lack of insight that affects patients with schizophrenia, leading them to deny or lack awareness of their illness. This lack of awareness often results in patients refusing medication because they genuinely believe they are not ill and do not need treatment. It is crucial for healthcare providers to approach such situations with understanding and empathy, recognizing the impact of anosognosia on treatment adherence.

2. A client with generalized anxiety disorder is prescribed buspirone (Buspar). Which statement by the client indicates a need for further teaching?

• A. I should avoid driving while taking this medication.
• B. I can stop taking this medication abruptly if I feel better.
• C. It may take several weeks for this medication to take effect.
• D. I should avoid using this medication during pregnancy.

Correct answer: B

Rationale: The correct answer is B. Clients should not stop taking buspirone (Buspar) abruptly as it may cause withdrawal symptoms. Choice A is correct as buspirone can cause dizziness and drowsiness, so avoiding driving is important. Choice C is also accurate because buspirone may take several weeks to reach its full effectiveness. Choice D is valid as buspirone is not recommended during pregnancy due to potential risks to the fetus.

3. A client with borderline personality disorder is receiving care. Which of the following interventions should be included in the plan of care?

• A. Set clear and consistent boundaries
• B. Encourage independence
• C. Avoid discussing the client's feelings
• D. Use a firm, authoritative approach

Correct answer: B

Rationale: When caring for a client with borderline personality disorder, it is essential to encourage independence rather than dependency. This helps promote autonomy and self-reliance, which are important aspects of treatment. Setting clear and consistent boundaries is also crucial, as it provides structure and predictability. Avoiding discussing the client's feelings is not recommended, as addressing emotions and promoting emotional awareness is a key part of therapy. Using a firm, authoritative approach may not be the most effective strategy as it can lead to power struggles and conflicts in individuals with borderline personality disorder.

4. A client has been prescribed fluoxetine (Prozac) for the treatment of depression. Which of the following instructions should the nurse include in the discharge instructions?

• A. Take the medication at bedtime to avoid daytime drowsiness.
• B. Avoid drinking alcohol while taking this medication.
• C. Take the medication with a full glass of water.
• D. Stop taking the medication if you feel better.

Correct answer: B

Rationale: The correct answer is B. The nurse should instruct the client to avoid drinking alcohol while taking fluoxetine (Prozac) because alcohol can increase the risk of side effects such as drowsiness and dizziness. It is important to follow this instruction to ensure the safe and effective use of the medication in the treatment of depression. Choice A is incorrect because fluoxetine (Prozac) is usually taken in the morning to prevent insomnia. Choice C is not a crucial instruction for this medication. Choice D is incorrect as abruptly stopping fluoxetine can lead to withdrawal symptoms and should only be done under medical supervision.

5. A client with bipolar disorder is experiencing a depressive episode. Which nursing intervention is most appropriate?

• A. Encourage the client to avoid physical activity.
• B. Encourage the client to engage in social activities.
• C. Encourage the client to participate in group therapy.
• D. Encourage the client to set realistic goals.

Correct answer: C

Rationale: Encouraging the client to participate in group therapy is the most appropriate nursing intervention for a client with bipolar disorder experiencing a depressive episode. Group therapy provides a supportive environment where the client can share experiences, learn coping strategies, and receive emotional support from peers and mental health professionals. It can help reduce feelings of isolation, improve social skills, and enhance overall well-being. Group therapy also promotes a sense of belonging and understanding, which are essential for individuals dealing with bipolar disorder and depressive symptoms. Choices A, B, and D are not the most appropriate interventions for a client experiencing a depressive episode in bipolar disorder. Encouraging the client to avoid physical activity may worsen their symptoms, promoting social activities may not address the underlying issues effectively, and setting goals may be overwhelming during a depressive episode.

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