Nursing Elites

1. A client with a leg amputation is upset about his appearance. The LPN/LVN intends to address which most closely associated psychosocial problem?

• A. Inability to be mobile
• B. Isolating self from others
• C. Inability to tolerate activity
• D. Concern about body persona

Correct answer: D

Rationale: The correct answer is D. A client with a leg amputation being upset about his appearance is most closely associated with concerns about body image and self-perception. This individual may be worried about how others perceive them, impacting their self-esteem and overall well-being. Choices A, B, and C are incorrect because the primary psychosocial issue in this scenario is related to body image and self-perception, not mobility, social isolation, or activity tolerance.

2. The nurse is performing intake interviews at a psychiatric clinic. A female client with a known history of drug abuse reports that she had a heart attack four years ago. Use of which substance abuse places the client at the highest risk for myocardial infarction?

• A. Benzodiazepines
• B. Marijuana
• C. Methamphetamine
• D. Alcohol

Correct answer: C

Rationale: Methamphetamine use is strongly associated with cardiovascular risks, including myocardial infarction, due to its stimulant effects on the heart. Benzodiazepines (Choice A) are not typically associated with an increased risk of myocardial infarction. Marijuana (Choice B) is not commonly linked to heart attacks, though it can have other health effects. Alcohol (Choice D) abuse can lead to cardiovascular issues, but methamphetamine has a more direct and potent impact on the heart, making it the highest risk factor in this scenario.

3. A client with obsessive-compulsive disorder (OCD) spends several hours a day arranging and rearranging items in their room. What is the most therapeutic nursing intervention?

• A. Distract the client with another activity.
• B. Allow the client to continue the behavior.
• C. Set a time limit for the behavior.
• D. Encourage the client to verbalize their feelings.

Correct answer: D

Rationale: Encouraging the client to verbalize their feelings is the most therapeutic intervention for a client with OCD spending excessive time on compulsive behaviors. By expressing their feelings, the client can explore the underlying anxiety that drives the compulsion. This intervention also provides an opportunity for the nurse to offer support and help the client develop coping strategies.\n Choice A, distracting the client with another activity, may provide temporary relief but does not address the root cause of the behavior.\n Choice B, allowing the client to continue the behavior, does not promote therapeutic progress and may perpetuate the compulsion.\n Choice C, setting a time limit for the behavior, may create additional stress for the client and does not address the underlying emotional issues associated with OCD.

4. A nurse is caring for a client who is experiencing severe anxiety. Which intervention is most appropriate for the nurse to implement?

• A. Instruct the client to take deep breaths and focus on the present.
• B. Encourage the client to discuss their fears in detail.
• C. Distract the client with a humorous story or anecdote.
• D. Leave the client alone to process their emotions.

Correct answer: A

Rationale: The correct intervention for a client experiencing severe anxiety is to instruct the client to take deep breaths and focus on the present. Deep breathing can help reduce the physiological symptoms of anxiety and provide the client with a way to regain control over their emotions. Choice B is incorrect as discussing fears in detail may escalate anxiety levels. Choice C is inappropriate as distracting the client may not address the root cause of anxiety. Choice D is not recommended as leaving the client alone can increase feelings of isolation and distress.

5. The nurse is admitting a male client who takes lithium carbonate (Eskalith) twice a day. Which information should the nurse report to the healthcare provider immediately?

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

Correct answer: D

Rationale: Nausea and vomiting should be reported immediately because they could indicate lithium toxicity, which requires urgent medical attention to prevent more severe effects. Short-term memory loss, depressed affect, and weight gain are common side effects of lithium but do not require immediate medical attention compared to symptoms of toxicity like nausea and vomiting.

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