Nursing Elites

1. Which statement by the patient indicates a need for further teaching regarding the treatment of major depressive disorder?

• A. I have been on this antidepressant for 3 days. I understand that the full effect may take weeks to occur.
• B. I am going to ask my nurse practitioner to discontinue my Prozac today and let me start taking a monoamine oxidase inhibitor tomorrow.
• C. I may ask to have my medication changed to Wellbutrin due to the problems I am having being romantic with my wife.
• D. I realize that there are many antidepressants and it might take a while until we find the one that works best for me.

Correct answer: B

Rationale: Choice B indicates a need for further teaching because the patient is planning to switch directly from Prozac, an SSRI, to a monoamine oxidase inhibitor (MAOI) without allowing for a washout period. This abrupt switch poses a risk of serotonin syndrome, which can be life-threatening. It is essential to educate the patient about the importance of consulting healthcare providers before changing medications to prevent potential adverse effects.

2. A nurse is providing discharge instructions to a client who has been prescribed fluoxetine (Prozac). Which information should the nurse include?

• A. Take the medication with food to avoid stomach upset.
• B. Avoid drinking alcohol while taking this medication.
• C. Report any unusual side effects to the healthcare provider.
• D. It may take several weeks for this medication to take effect.

Correct answer: B

Rationale: Clients taking fluoxetine (Prozac) should avoid alcohol to prevent adverse interactions.

3. Which intervention is most appropriate for a patient with a phobia of flying?

• A. Exposure therapy
• B. Cognitive restructuring
• C. Medication management
• D. Psychoeducation

Correct answer: A

Rationale: Exposure therapy is considered the most appropriate intervention for a patient with a phobia of flying. This therapeutic approach involves gradually exposing the individual to the feared stimulus, in this case, flying, in a controlled and supportive environment. By facing the fear in a structured manner, the patient can learn to manage their anxiety response and eventually reduce their phobia-related symptoms. While cognitive restructuring may help change negative thought patterns and medication management can alleviate symptoms, exposure therapy is specifically designed to address phobias through systematic desensitization, making it the most suitable intervention in this scenario. Psychoeducation aims to provide information and support but may not directly target the phobia itself.

4. Which intervention would be appropriate for assisting a client diagnosed with major depressive disorder?

• A. Encourage discussion of feelings
• B. Offer family therapy sessions
• C. Discuss childhood events
• D. Teach alternate coping skills

Correct answer: B

Rationale: Offering family therapy sessions would be the most appropriate intervention for a client diagnosed with major depressive disorder. Family therapy can be beneficial as it addresses interpersonal relationships within the family system, which is crucial in managing major depressive disorder effectively. This approach aligns with Sullivan's interpersonal theory, which emphasizes the impact of interpersonal relationships on individual behavior and personality development. In contrast, encouraging discussion of feelings, discussing childhood events, or teaching alternate coping skills may not directly address the interpersonal dynamics contributing to the client's major depressive disorder.

5. In a client with obsessive-compulsive disorder (OCD) undergoing cognitive-behavioral therapy, which outcome indicates that the therapy is effective?

• A. The client reports a decrease in the frequency of compulsive behaviors.
• B. The client reports a decrease in the intensity of obsessive thoughts.
• C. The client reports an improvement in overall mood.
• D. The client reports an improvement in sleep patterns.

Correct answer: A

Rationale: In clients with OCD undergoing cognitive-behavioral therapy, a decrease in the frequency of compulsive behaviors is a key indicator of treatment effectiveness. This reduction signifies progress in managing and controlling the compulsions associated with OCD, which is a primary goal of the therapy. Choices B, C, and D may also be positive outcomes of therapy, but the most critical aspect in treating OCD with cognitive-behavioral therapy is targeting and reducing the frequency of compulsive behaviors.

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