Nursing Elites

1. A client diagnosed with paranoid schizophrenia is still withdrawn, unkempt, and unmotivated to get out of bed. A mental health aide asks the nurse why the client is this way after being on fluphenazine (Prolix) 10 mg for 7 days. The LPN/LVN should tell the health aide:

• A. Prolixin is the most effective with positive symptoms of schizophrenia.
• B. The client will be less withdrawn and unmotivated when the Prolixin takes effect.
• C. The client's Prolixin dose probably needs to be increased again.
• D. Lack of motivation is a common side effect of the Prolixin.

Correct answer: A

Rationale: Prolixin is more effective with positive symptoms of schizophrenia, such as hallucinations and delusions, rather than negative symptoms like withdrawal and lack of motivation.

2. An LPN/LVN is conducting an initial assessment on a client in crisis. When assessing the client's perception of the precipitating event that led to the crisis, the appropriate question to ask is:

• A. With whom do you live?
• B. Who is available to help you?
• C. What leads you to seek help now?
• D. What do you usually do to feel better?

Correct answer: C

Rationale: The correct question to ask when assessing a client's perception of the precipitating event that led to a crisis is 'What leads you to seek help now?' This question directly addresses the client's current situation and triggers that brought them to seek assistance. Choices A and B are more focused on the client's social support system rather than the root cause of the crisis. Choice D addresses coping mechanisms rather than the actual trigger for seeking help.

3. A client is admitted to the hospital with a diagnosis of anorexia nervosa. What is the most important intervention for the LPN/LVN to implement during the first 24 hours of hospitalization?

• A. Encourage the client to eat small, frequent meals.
• B. Monitor the client's vital signs and weight.
• C. Establish a trusting relationship with the client.
• D. Provide emotional support to the client.

Correct answer: B

Rationale: The correct answer is to monitor the client's vital signs and weight. This intervention is crucial in assessing the severity of the client's condition and planning appropriate care. Vital signs and weight monitoring help in evaluating the client's physiological status and identifying any immediate concerns related to anorexia nervosa. Choices A, C, and D are important aspects of care for a client with anorexia nervosa; however, during the initial 24 hours of hospitalization, monitoring vital signs and weight takes precedence as it provides essential data for the client's ongoing management and treatment.

4. A young adult male with a history of substance abuse is admitted to the psychiatric unit for detoxification. He is agitated, sweating, and reports seeing bugs crawling on the walls. What is the priority nursing intervention?

• A. Reassure the client that the bugs are not real.
• B. Administer the prescribed benzodiazepine.
• C. Place the client in a quiet, dark room.
• D. Encourage the client to express his feelings.

Correct answer: B

Rationale: The correct answer is to administer the prescribed benzodiazepine. This intervention helps manage the client's agitation and hallucinations, which are common symptoms during detoxification from substances. Reassuring the client that the bugs are not real (Choice A) may not be effective in addressing the underlying causes of the hallucinations. Placing the client in a quiet, dark room (Choice C) may help reduce sensory stimulation but does not directly address the client's symptoms. Encouraging the client to express his feelings (Choice D) is important for therapeutic communication but may not be the priority when the client is experiencing severe agitation and hallucinations.

5. A client with an eating disorder is planning to attend group meetings with Overeaters Anonymous. The LPN/LVN describes this group to the client, knowing that which finding(s) are characteristic of this form of self-help group? Select one that does not apply.

• A. A common goal is shared by all members
• B. Members are required to remain anonymous
• C. The leader is a professional mental health care provider
• D. Attendance must be prescribed by the health care provider

Correct answer: A

Rationale: Overeaters Anonymous is a self-help group characterized by shared goals among members to address eating disorders. This provides a supportive environment for personal change and growth. Choice B is incorrect as members are not required to remain anonymous in Overeaters Anonymous. Choice C is incorrect as the leader in such self-help groups is usually a member who has experienced similar issues, not necessarily a professional mental health care provider. Choice D is incorrect as attendance at Overeaters Anonymous meetings is voluntary and not prescribed by a healthcare provider.

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