Nursing Elites

1. A client is scheduled to complete a positron emission tomography (PET) scan. The client asks the nurse to explain the reason the test was prescribed. How should the nurse respond?

• A. Images indicate the presence of tumors and scars.
• B. The scan clearly outlines structures of the brain.
• C. Results show activity in various portions of the brain.
• D. PET shows biochemical levels of neurotransmitters.

Correct answer: C

Rationale: The correct answer is C. PET scans are primarily used to detect and observe the metabolic activity in various parts of the brain. This helps in diagnosing conditions related to brain function, such as tumors, brain disorders, and overall brain activity. Choices A, B, and D are incorrect because PET scans focus on metabolic activity and functions in the brain rather than solely indicating the presence of tumors, outlining brain structures, or showing biochemical levels of neurotransmitters.

2. A male hospital employee is pushed out of the way by a female employee because of an oncoming gurney. The pushed employee becomes very angry and swings at the female employee. Both employees are referred for counseling with the staff psychiatric nurse. Which factor in the pushed employee's history is most related to the reaction that occurred?

• A. Is worried about losing his job to a woman
• B. Tortured animals as a child
• C. Was physically abused by his mother
• D. Hates to be touched by anyone

Correct answer: C

Rationale: The correct answer is C: 'Was physically abused by his mother.' A history of physical abuse can lead to heightened responses to physical contact. In this scenario, the employee's reaction of becoming very angry and swinging at the female employee after being pushed may be influenced by past experiences of physical abuse. This history can contribute to increased sensitivity to physical interactions and may trigger defensive or aggressive responses. Choices A, B, and D are less directly related to the employee's reaction in this specific context. While worrying about losing his job to a woman could contribute to underlying stress or insecurity, torturing animals as a child reflects a different type of behavioral issue, and hating to be touched by anyone suggests personal boundaries unrelated to the observed behavior in this scenario.

3. A client with a history of substance abuse is admitted to the hospital for detoxification. What is the most important intervention for the LPN/LVN to implement?

• A. Monitor the client for signs of withdrawal.
• B. Encourage the client to express feelings about substance use.
• C. Provide the client with information about support groups.
• D. Administer prescribed medications to manage withdrawal symptoms.

Correct answer: D

Rationale: Administering prescribed medications to manage withdrawal symptoms is the priority intervention for a client undergoing detoxification. This intervention aims to prevent severe complications that may arise during the detox process. Monitoring for signs of withdrawal (choice A) is important but providing immediate medical management through medications takes precedence to ensure the client's safety. Encouraging the client to express feelings (choice B) and providing information about support groups (choice C) are essential aspects of care but are not as urgent as administering medications to manage withdrawal symptoms.

4. Which client outcome indicates improvement for a client who is admitted with auditory hallucinations?

• A. Argues with the voices.
• B. Tells when voices decrease.
• C. Follows what the voices say.
• D. Tells the nurse what the voices say.

Correct answer: B

Rationale: The correct answer is B: 'Tells when voices decrease.' This outcome indicates improvement because it shows that the client is experiencing a reduction in auditory hallucinations. By communicating that the voices are decreasing, it suggests that the client's symptoms are improving and the treatment is effective. Choices A, C, and D are incorrect. Arguing with the voices (A) indicates ongoing engagement with the hallucinations, which is not a positive outcome. Following what the voices say (C) suggests compliance with the hallucinations, which is not indicative of improvement. Lastly, telling the nurse what the voices say (D) does not necessarily demonstrate a reduction in hallucinations or improvement in the client's condition.

5. The nurse is leading a 'current events group' with chronic psychiatric clients. One group member states, 'Clara Barton was my nurse during my last hospitalization. She was a very mean nurse and wasn't nice to me.' Which response would be best for the nurse to make?

• A. 'Clara Barton was not your nurse.'
• B. 'What did she do to you that was so mean?'
• C. 'I didn't know that Clara Barton was a nurse.'
• D. 'Clara Barton started the American Red Cross.'

Correct answer: D

Rationale: (D) presents the reality of the situation in relation to American culture. The fact that Clara Barton was a nurse during the Civil War should be addressed on an individual basis. Since this is group therapy, the nurse would be illustrating the concept of universality. (A) is likely to promote defensiveness. (B and C) would support the delusion. Therefore, the most appropriate response is (D) as it provides factual information that can redirect the conversation in a constructive manner.

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