Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
Which of the following medication orders should the nurse question?
A. A benzodiazepine for an elderly patient with agitation.
B. Quetiapine for a patient with refractory anxiety.
Quetiapine, an atypical antipsychotic, is often used to manage refractory anxiety. While it might not be the first-line option, it can be effective in certain cases. Therefore, this choice does not need to be questioned as it aligns with current treatment guidelines.
C. A low starting dose of an SSRI.
A low starting dose of a selective serotonin reuptake inhibitor (SSRI) is an appropriate approach when initiating treatment for depression or anxiety. It helps minimize the risk of side effects, especially in the early stages of therapy when the patient is adjusting to the medication. Therefore, this choice does not need to be questioned, as it reflects a standard practice.
D. Prazosin for nightmares in patients with PTSD.
Prazosin is an alpha-1 adrenergic antagonist commonly used to treat nightmares associated with post-traumatic stress disorder (PTSD). It helps alleviate symptoms by reducing the effects of norepinephrine. This choice does not need to be questioned as it is a recognized treatment option for this specific condition.
This question is an excerpt from Nurse Dive's nursing test bank - ATI Custom Psych Nursing Spring 2023 Proctored Exam 3. Take the full exam now
Similar Questions
A nurse on an inpatient mental health unit is caring for a client who has major depressive disorder and malnutrition. Which of the following actions should the nurse take to improve the client's nutritional status?
A. Ask the provider to arrange a consultation with the facility chaplain.
This option is not directly related to improving the client's nutritional status. While spiritual support and counseling can be beneficial for overall well-being, it may not address the specific nutritional needs of the client.
B. Enroll the client in a nutritional class on the unit.
While education about nutrition can be helpful, enrolling the client in a nutritional class may not be the most immediate or effective intervention. Clients with major depressive disorder and malnutrition may benefit more from personalized support and encouragement during meals.
C. Weigh the client at the same time every morning.
Regular weight monitoring is important in assessing changes in nutritional status. Weighing the client at the same time every morning can provide consistent and valuable data to track progress or identify any concerns related to malnutrition.
D. Sit with the client during meals and snacks.
This is the most appropriate intervention among the options provided. Sitting with the client during meals and snacks can offer emotional support, encourage the client to eat, and provide an opportunity for the nurse to monitor the client's food intake. It also creates a positive social interaction during meals, which can be particularly beneficial for clients with major depressive disorder who may experience appetite changes or difficulty eating alone.
A nurse is providing discharge teaching to a client with a new prescription for phenelzine. The nurse should instruct the client to avoid which of the following foods when taking this medication?
A. Frozen peas.
Frozen peas are low in tyramine and are generally safe to consume while taking MAOIs like phenelzine.
B. Cottage cheese.
Cottage cheese is low in tyramine compared to aged cheeses and is typically safe to eat while on phenelzine.
C. Shellfish.
Fresh shellfish are not high in tyramine and can generally be eaten without issue when taking phenelzine.
D. Salami.
Salami is a type of aged, fermented, and cured meat, which is high in tyramine. Consuming salami while taking phenelzine can lead to a dangerous hypertensive crisis due to the interaction with tyramine.
Full Explanation
a. Frozen peas are low in tyramine and are generally safe to consume while taking MAOIs like phenelzine.
b. Cottage cheese is low in tyramine compared to aged cheeses and is typically safe to eat while on phenelzine.
c. Fresh Shellfish are not high in tyramine and can generally be eaten without issue when taking phenelzine.
d. Salami is a type of aged, fermented, and cured meat, which is high in tyramine. Consuming salami while taking phenelzine can lead to a dangerous hypertensive crisis due to the interaction with tyramine.
A nurse is caring for a client who has bipolar disorder and a new prescription for valproate. Which of the following instructions should the nurse give the client about the use of this medication?
A. Thyroid function tests should be performed every 6 months.
Thyroid function tests should be performed every 6 months. Rationale: This choice is incorrect because valproate medication does not typically impact thyroid function. Instead, valproate is known to affect liver function, which is why monitoring liver function tests is necessary. Thyroid function tests are not directly related to the use of valproate.
B. High serum sodium levels can cause toxic levels of valproate.
High serum sodium levels can cause toxic levels of valproate. Rationale: This choice is incorrect. While electrolyte imbalances can affect various medications, there is no direct relationship between high serum sodium levels and toxic levels of valproate. Valproate toxicity is primarily associated with its effect on the liver, not sodium levels.
C. A pretreatment electroencephalogram (EEG) will be done.
A pretreatment electroencephalogram (EEG) will be done. Rationale: This choice is incorrect. Valproate is commonly used to treat bipolar disorder, and an EEG is not a routine requirement for its use. EEGs are used to evaluate brain activity and are not directly linked to valproate treatment.
D. Liver function tests must be monitored.
Liver function tests must be monitored. Rationale: This choice is the correct answer. Valproate is metabolized by the liver, and its use can potentially lead to liver damage or dysfunction. Monitoring liver function tests, including measures such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST), is essential to detect any signs of liver impairment early and ensure the safety of the client.