Nursing Elites

1. A client with a history of bipolar disorder is stabilized on a mood stabilizer and has been prescribed lamotrigine (Lamictal). Which outcome indicates that the medication is effective?

• A. Decrease in manic episodes.
• B. Improvement in depressive symptoms.
• C. Reduction in anxiety symptoms.
• D. Increased sleep duration.

Correct answer: B

Rationale: The correct answer is B: Improvement in depressive symptoms. Lamotrigine is commonly used as a mood stabilizer and is particularly effective in managing depressive symptoms in bipolar disorder. While it may also help with preventing manic episodes, its primary indication is for treating depressive symptoms. Choices A, C, and D are incorrect because lamotrigine is not specifically indicated for reducing manic episodes, anxiety symptoms, or increasing sleep duration in bipolar disorder.

2. An antidepressant medication is prescribed for a client who reports sleeping only 4 hours in the past 2 days and weight loss of 9 lbs within the last month. Which client goal is most important to achieve within the first three days of treatment?

• A. Meet scheduled appointments with a dietitian.
• B. Sleep at least 6 hours a night.
• C. Understand the purpose of the medication regimen.
• D. Describe the reasons for hospitalization.

Correct answer: B

Rationale: The most important goal to achieve within the first three days of treatment is to ensure the client can sleep at least 6 hours a night. Adequate sleep is essential for stabilizing mood and improving overall functioning. Improving sleep patterns is crucial to address the reported sleep deficit and weight loss associated with depression. Choice A is not as urgent as improving sleep patterns. Choice C is important but not as immediate as addressing the sleep deficit. Choice D is unrelated to the immediate treatment goal of improving sleep and managing symptoms of depression.

3. What is the most appropriate intervention by the RN to address a client with obsessive-compulsive disorder (OCD) who repeatedly checks to see if the door is locked and asks for reassurance?

• A. Set a specific limit on the number of times the client can check the door.
• B. Help the client find an alternative activity to perform.
• C. Provide consistent reassurance that the door is locked.
• D. Ignore the checking behavior and focus on other behaviors.

Correct answer: A

Rationale: Setting a specific limit on the checking behavior is the most appropriate intervention for a client with OCD who repeatedly checks the door and seeks reassurance. This approach helps the client gradually reduce the compulsive behavior, promotes independence, and supports progress in treatment. Choice B is not the most suitable intervention as it does not directly address the compulsive checking behavior. Choice C, providing consistent reassurance, may reinforce the compulsive behavior and hinder treatment progress. Choice D of ignoring the behavior does not actively assist the client in managing their symptoms and addressing the underlying disorder.

4. The RN is admitting a male client who takes lithium carbonate (Eskalith) twice a day. Which information should the RN report to the HCP immediately?

• A. Short-term memory loss.
• B. Five-pound weight gain.
• C. Decreased affect.
• D. Nausea and vomiting.

Correct answer: D

Rationale: Nausea and vomiting are signs of potential lithium toxicity, which is a serious condition requiring immediate attention. These symptoms can indicate a dangerous level of lithium in the body that can lead to severe complications. Short-term memory loss (A), five-pound weight gain (B), and decreased affect (C) are important to monitor but are not as immediately concerning as symptoms of potential toxicity like nausea and vomiting.

5. When preparing to administer a prescribed medication to a homeless male at a community psychiatric clinic, the client tells the nurse that he usually takes a different dosage. What action should the nurse take?

• A. Tell him to take the medication then verify the dosage at the next healthcare team meeting.
• B. Withhold the medication until the dosage can be confirmed.
• C. Inform him that he may refuse the medication and document whether or not he takes it.
• D. Explain to the client that the dosage has been changed.

Correct answer: B

Rationale: Withholding the medication until the dosage can be confirmed ensures patient safety and accuracy in treatment.

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