Nursing Elites

1. A client who is known to abuse drugs is admitted to the psychiatric unit. Which medication should the nurse anticipate administering to a client who is exhibiting benzodiazepine withdrawal symptoms?

• A. Diphenhydramine (Benadryl)
• B. Perphenazine (Trilafon)
• C. Isocarboxazid (Marplan)
• D. Chlordiazepoxide (Librium)

Correct answer: D

Rationale: Chlordiazepoxide (Librium) is the correct choice for managing benzodiazepine withdrawal symptoms. Benzodiazepines are drugs that can lead to physical dependence, and abrupt discontinuation can result in withdrawal symptoms. Chlordiazepoxide, a benzodiazepine itself, is often used in a controlled manner to taper off the drug gradually and manage withdrawal symptoms effectively. Choices A, Diphenhydramine, and B, Perphenazine, are not typically used to manage benzodiazepine withdrawal. Choice C, Isocarboxazid, is a monoamine oxidase inhibitor (MAOI) used in the treatment of depression and not indicated for benzodiazepine withdrawal.

2. To evaluate the effectiveness of cognitive-behavioral techniques, which client outcomes should the nurse include in the plan of care?

• A. Relates insights into problematic relationships
• B. Demonstrates a healthy relationship with her husband
• C. Describes how the family can resolve problems
• D. Changes thought patterns related to problem-solving

Correct answer: D

Rationale: The correct answer is D. Cognitive-behavioral therapy focuses on changing thought patterns by guiding the client to engage in problem-solving strategies to address the current situation. This approach helps individuals modify negative thinking patterns and develop more adaptive ways to cope with challenges. Choices A, B, and C are incorrect because while they may be important aspects to consider in therapy, the primary focus in cognitive-behavioral therapy is on identifying and changing negative thought patterns rather than exploring relationships or family problem-solving skills.

3. A female client requests that her husband be allowed to stay in the room during the admission assessment. While interviewing the client, the nurse notes a discrepancy between the client’s verbal and nonverbal communication. What action should the nurse take?

• A. Pay close attention and document the nonverbal messages.
• B. Ask the client’s husband to interpret the discrepancy.
• C. Ignore the nonverbal behavior and focus on the client’s verbal messages.
• D. Integrate the verbal and nonverbal messages and interpret them as one.

Correct answer: A

Rationale: When a nurse observes a discrepancy between a client's verbal and nonverbal communication, it is essential to pay close attention and document the nonverbal messages. Nonverbal cues, such as body language and facial expressions, can provide valuable insights into the client's emotional state, feelings, and concerns that may not be expressed verbally. By documenting these nonverbal messages, the nurse can gain a more comprehensive understanding of the client's communication and address any potential underlying issues. Asking the client's husband to interpret the discrepancy (Choice B) may not always provide an accurate understanding of the client's nonverbal cues. Ignoring the nonverbal behavior (Choice C) could lead to missing important cues affecting the client's care. Integrating verbal and nonverbal messages (Choice D) is important, but initially focusing on documenting and understanding the nonverbal cues can enhance the nurse's assessment and communication with the client.

4. A female client with obsessive-compulsive personality disorder is admitted to the hospital for a cardiac catheterization. The afternoon before the procedure, the client begins to keep detailed notes of the nursing care she is receiving and reports her findings to the RN at bedtime. What action should the nurse implement?

• A. Explain to the client that her behavior invades the rights of the nursing staff.
• B. Ask the client to explain why she is keeping a detailed record of her nursing care.
• C. Teach the client strategies to control her obsessive-compulsive behavior.
• D. Encourage the client to express her feelings regarding the upcoming procedure.

Correct answer: B

Rationale: Asking the client to explain why she is keeping a detailed record of her nursing care is the most appropriate action for the nurse to take in this situation. Understanding the client’s motivations for keeping detailed records can provide insight into her obsessive-compulsive behaviors and help manage them effectively. This approach allows for a non-confrontational exploration of the behavior. Choice A is incorrect because it may be perceived as confrontational and does not address the underlying reasons for the behavior. Choice C is incorrect because teaching strategies to control behavior should come after understanding the client's motives. Choice D is incorrect as it does not directly address the behavior of keeping detailed records, which is the immediate concern that needs to be addressed.

5. What assessment questions should the nurse ask when attempting to determine a teenager’s mental health resilience? Select all that apply.

• A. How did you cope when your father deployed with the Army for a year in Iraq?
• B. Who did you go to for advice while your father was away for a year in Iraq?
• C. How do you feel about talking to a mental health counselor?
• D. Where do you see yourself in 10 years?

Correct answer: C

Rationale: The question 'How do you feel about talking to a mental health counselor?' is the most appropriate to assess the teenager's mental health resilience as it directly addresses their willingness to seek help and cope effectively. Choices A and B focus on coping mechanisms during a specific event, which may not reflect the teenager's overall resilience. Choice D is more related to future aspirations rather than assessing current mental health resilience.

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