In the treatment of generalized anxiety disorder (GAD), what medication is frequently prescribed as a first-line treatment?
- A. Clonazepam
- B. Buspirone
- C. Propranolol
- D. Hydroxyzine
Correct Answer: B
Rationale: Buspirone is often chosen as a first-line treatment for generalized anxiety disorder (GAD) due to its efficacy and favorable side effect profile. Unlike benzodiazepines such as clonazepam (A), buspirone does not carry the risk of tolerance, dependence, or withdrawal symptoms, making it a preferred choice. While propranolol (C) and hydroxyzine (D) are sometimes used for anxiety, they are not typically considered first-line treatments for GAD.
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A patient with bipolar disorder is prescribed lithium. Which dietary advice should the nurse include?
- A. Avoid foods high in tyramine.
- B. Maintain a consistent salt intake.
- C. Increase protein intake.
- D. Avoid foods high in fat.
Correct Answer: B
Rationale: Patients prescribed lithium should maintain a consistent salt intake. Fluctuations in salt intake can impact lithium levels, potentially leading to toxicity or reduced effectiveness of the medication. It is crucial for patients to adhere to a stable salt intake while taking lithium to ensure optimal treatment outcomes. Choices A, C, and D are incorrect. Avoiding foods high in tyramine is more relevant for patients on MAOIs, not lithium. Increasing protein intake or avoiding foods high in fat are not specific dietary recommendations for patients taking lithium.
When assessing a patient with schizophrenia who exhibits flat affect and social withdrawal, these symptoms are classified as:
- A. Positive symptoms
- B. Negative symptoms
- C. Cognitive symptoms
- D. Mood symptoms
Correct Answer: B
Rationale: Flat affect and social withdrawal are characteristic of negative symptoms in schizophrenia. Negative symptoms involve disruptions to normal emotions and behaviors, such as reduced emotional expression (flat affect) and social withdrawal. These symptoms reflect a decrease or absence of normal functions. Positive symptoms, on the other hand, involve the presence of abnormal behaviors or experiences, such as hallucinations and delusions, which are added to a person's experiences. Cognitive symptoms relate to difficulties with thinking, memory, and processing information, impacting cognition. Mood symptoms involve disturbances in mood regulation, which is distinct from the flat affect seen in negative symptoms.
When a patient with major depressive disorder is started on fluoxetine, what is the most important side effect for the nurse to monitor?
- A. Weight gain
- B. Suicidal ideation
- C. Hypertension
- D. Hyperglycemia
Correct Answer: B
Rationale: When initiating fluoxetine therapy in a patient with major depressive disorder, monitoring for suicidal ideation is crucial due to the increased risk of suicidal thoughts or behaviors that can occur, especially in the initial phase of treatment. This close monitoring is essential to ensure patient safety and intervene promptly if such symptoms arise. Weight gain, hypertension, and hyperglycemia are potential side effects of some medications used to treat depression, but suicidal ideation is the most critical and immediate side effect to monitor for when starting fluoxetine.
During a panic attack, what is the nurse's priority intervention for a patient with panic disorder?
- A. Encourage the patient to verbalize their feelings.
- B. Provide reassurance and stay with the patient.
- C. Leave the patient alone to calm down.
- D. Distract the patient with a task.
Correct Answer: B
Rationale: During a panic attack, the priority intervention for the nurse is to provide reassurance and stay with the patient. This action helps reduce fear and provides a sense of safety, which can aid in calming the patient and preventing further escalation of the panic attack. Encouraging the patient to verbalize their feelings (Choice A) may be beneficial after the acute phase of the panic attack. Leaving the patient alone (Choice C) may increase feelings of abandonment and escalate the panic attack. Distracting the patient with a task (Choice D) is not recommended during a panic attack as it may divert attention but not address the underlying anxiety and fear.
A patient with generalized anxiety disorder (GAD) is prescribed escitalopram. The nurse should educate the patient that the full therapeutic effect of this medication may take:
- A. 1-2 days
- B. 1-2 weeks
- C. 2-4 weeks
- D. 6-8 weeks
Correct Answer: D
Rationale: Escitalopram, an SSRI used in treating generalized anxiety disorder, typically takes 6-8 weeks to achieve its full therapeutic effect. While some improvement may be noticed earlier, the maximum benefit is usually experienced after this timeframe. Options A, B, and C are incorrect because they underestimate the time required for escitalopram to reach its full effectiveness. Educating patients about the realistic timeline for medication effectiveness is crucial in managing expectations and ensuring adherence to the prescribed treatment.