Nursing Elites

1. Which intervention is most appropriate for a patient experiencing a severe manic episode?

• A. Providing a structured and low-stimulation environment
• B. Encouraging the patient to engage in group activities
• C. Providing detailed information about the patient's condition
• D. Allowing the patient to have unsupervised time

Correct answer: A

Rationale: During a severe manic episode, it is crucial to provide a structured and low-stimulation environment to help manage the symptoms effectively. This environment aims to reduce stimuli that can exacerbate manic behavior and provide a sense of predictability and safety for the individual. Group activities, detailed information provision, or unsupervised time may not be suitable during a severe manic episode as they can potentially worsen the condition or pose safety risks.

2. A patient with a diagnosis of panic disorder is prescribed an SSRI. Which side effect should the nurse monitor for when the patient starts this medication?

• A. Increased heart rate
• B. Increased appetite
• C. Gastrointestinal disturbances
• D. Dry mouth

Correct answer: C

Rationale: When a patient with panic disorder is prescribed an SSRI, the nurse should monitor for gastrointestinal disturbances as a common side effect. SSRIs can cause gastrointestinal symptoms such as nausea, diarrhea, or abdominal discomfort, especially at the beginning of treatment. Increased heart rate (Choice A) is not a common side effect of SSRIs; it is more commonly associated with medications like stimulants. Increased appetite (Choice B) is not a typical side effect of SSRIs, as they are more likely to cause weight loss or appetite suppression. Dry mouth (Choice D) is a side effect seen more commonly with medications that have anticholinergic properties, not typically with SSRIs.

3. What is a priority intervention for a patient with severe anxiety?

• A. Encouraging the patient to discuss their feelings in detail.
• B. Providing a calm and quiet environment.
• C. Encouraging the patient to participate in group activities.
• D. Providing detailed information about their treatment plan.

Correct answer: B

Rationale: When dealing with a patient experiencing severe anxiety, providing a calm and quiet environment is a priority intervention. This approach helps reduce stimuli and anxiety levels, creating a more soothing atmosphere for the individual. Encouraging the patient to discuss their feelings in detail or participate in group activities may be beneficial in certain situations, but establishing a peaceful setting takes precedence when managing severe anxiety. Providing detailed information about their treatment plan, although important, may not be the immediate priority when the patient is in a state of severe anxiety and needs a calming environment first.

4. A nurse is planning care for several clients attending community-based mental health programs. Which of the following clients should the nurse visit first?

• A. A client who received a burn on the arm while using a hot iron at home
• B. A client who requests a change of antipsychotic medication due to new adverse effects
• C. A client who reports hearing a voice saying that life is not worth living anymore
• D. A client who tells the nurse about experiencing manifestations of severe anxiety before and during a job interview

Correct answer: C

Rationale: The nurse should visit the client who reports hearing a voice saying that life is not worth living anymore first. This statement indicates potential suicidal ideation, which requires immediate intervention to ensure the client's safety. Choices A, B, and D do not present an immediate threat to the client's life. While burns, adverse effects of medication, and severe anxiety are important concerns, they do not pose an immediate risk of self-harm or suicide.

5. A patient with anorexia nervosa is being treated in an inpatient facility. Which intervention should be included in the care plan?

• A. Allowing the patient to eat alone to reduce stress
• B. Monitoring the patient's weight weekly
• C. Encouraging the patient to exercise daily
• D. Providing the patient with a high-calorie diet

Correct answer: B

Rationale: Monitoring the patient's weight weekly is crucial in the care of individuals with anorexia nervosa as it allows healthcare providers to track changes in weight, which is a key indicator of nutritional status. Regular weight monitoring helps in identifying any significant weight loss or gain, enabling prompt intervention and adjustment of the treatment plan to address the patient's nutritional needs effectively.

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