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NCLEX® Review Questions
NCLEX® Review Questions
This activity contains 10 questions.
At 10:00 P.M., the nurse offers trazodone (Desyrel) 150 milligrams to a newly admitted client experiencing mania. The client responds, “I feel great, and I don’t need to sleep.” The nurse’s most therapeutic response is:
“The medication will potentiate your mood stabilizer so that you’ll be discharged sooner.”
“You and your family stated you did not sleep at all last night. That can be tough on your system.”
“Remember that unit rules are to be quiet with lights out by 11:00 P.M.”
“The medication should help you get to sleep so that you’re at your best tomorrow.”
During family support group, a family member asks: “How is bipolar disorder different from depression?” Which of the following is the best response?
“People with bipolar disorder do not seek help. People with depression readily seek treatment from health care providers.”
“Individuals with bipolar disorder start out happy enough, but they eventually develop irritability.”
“Often, individuals with bipolar disorder can feel elated, are productive, and do not think there is anything wrong when they have manic feelings.”
“Sleep patterns, self-care, and intake are affected only in depression.”
Your client states, “Many of the people in my family experience similar symptoms with each depressive episode. Does that mean that we have the same genetic defect?” Your best response includes which of the following? (Select all that apply.)
“Related symptoms are probably due to being raised in the same family and learning the same behavioral responses.”
“There are probably several genetic or biologic abnormalities associated with depression.”
“With the wide variety of mood disorders, a biological basis is not likely. Therefore, pharmacological treatments for your family members should be individualized.”
“Heredity does seem to play a role in mood disorders. You and your family members may have the same biologic predisposition.”
“Most current theories focus on electrolyte disturbances, particularly the reversal of sodium and potassium in the neurons of depressed individuals.”
Your client states, “I’m going to participate in an experimental brain imaging study. My primary health care provider thinks I have bipolar I disorder. Are there lab tests that can help diagnose mood disorders?” Your first response is:
“You should probably ask your primary health care provider.”
“Although some abnormal results are found in individuals with mood disorders, there are no diagnostic lab tests specific to mood disorders at this time.”
“There’s the dexamethasone suppression test, but we don’t know whether mood disorder causes the nonsuppression or whether the nonsuppression causes the disorder.”
“Are you hoping for diagnosis based on the imaging study?”
You administer the first dose of an antidepressant to your inpatient client with major depression. The client asks, “Is this medicine going to fix my depression?” Your accurate response includes which of the following? (Select all that apply.)
“It should help your depression, and you should feel the full therapeutic effect in 2 to 3 weeks.”
“This medication should increase the availability of neurotransmitters in your brain.”
“This medication should increase the production of serotonin in your brain.”
“The medication will decrease the available dopamine, which is associated with psychotic thinking in major depression.”
“In addition, we are going to assist you in regulating your circadian rhythms, which should improve your depression.”
Based on your knowledge of circadian rhythms, discharge teaching for clients with mood disorders should include which of the following?
Disruption of the client’s usual diurnal pattern does not influence the course of illness.
Antidepressants and mood stabilizers can help restore circadian rhythms.
Nonprescription medications and dietary supplements do not alter activity and rest cycles.
Particularly during times of decreased stress, the client should do everything possible to maintain similar routines.
You are the triage nurse in an emergency room. Your initial assessment indicates that depression may be part of the client’s problem. Which of the following nursing actions is essential?
Explore the client’s perceptions regarding the severity of the stated reason for the visit.
Redirect the client to discuss the stated reason for the visit.
Within 1 week, telephone the client to ensure that the client’s mood has improved.
Ask about depression and suicidal ideation directly.
Your client with intense suicidal ideation has been hospitalized for 1 week, during which time he has received a selective serotonin reuptake inhibitor (SSRI). He reports “no change” in suicidal ideation, although he demonstrates a wider range of affect and takes more initiative in self-care. The health care team is considering his imminent discharge. It is essential to consider which of the following factors?
The client will continue to improve because the medication has not yet exerted full therapeutic effect.
The health care team has to plan for discharge from the day of admission.
The client may have enough energy to plan and complete a suicide attempt.
For 1 week of pharmacotherapy, the client has been free of untoward side effects.
A colleague expresses frustration with a client with bipolar disorder on his seventh admission within 2 years. “I wish he would try taking his medication. Instead he keeps stopping the medicine and coming back here.” Your best initial response is:
“He stays on his meds. He is a rapid cycler and he has more episodes anyway.”
“Get control of your anger so that you do not take it out on the client.”
“It can be frustrating to care for chronically ill clients.”
“Maybe you would rather work in the NICU, where all of your clients adhere to the prescribed treatment regimen.”
Frequent countertransference reactions in caring for clients with mood disorders include (select all that apply):
Frustration with continued depression.
Indifference in response to the client’s criticisms.
Rescue fantasy with a depressed client.
Anger at help-rejecting behavior.
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