Nursing Elites

1. A client with an eating disorder is being treated in a behavioral health unit. Which behavior would the nurse expect to see if the client is responding positively to the treatment?

• A. Adherence to the treatment plan and increased self-care activities.
• B. Increased isolation from others.
• C. Frequent complaining about treatment procedures.
• D. Refusal to eat meals provided by the unit.

Correct answer: A

Rationale: A positive response to treatment for a client with an eating disorder is indicated by adherence to the treatment plan and an increase in self-care activities. These behaviors show that the client is actively engaging in their treatment and taking steps towards recovery. Option B, increased isolation from others, is not indicative of a positive response to treatment as it may suggest withdrawal or avoidance. Option C, frequent complaining about treatment procedures, is not a behavior that signifies a positive response; it may indicate dissatisfaction or discomfort with the treatment. Option D, refusal to eat meals provided by the unit, is also not a positive response as it could suggest continued resistance to treatment and potential worsening of symptoms.

2. The nurse is planning client teaching for a 35-year-old client with early alcoholic cirrhosis. Which self-care measure should the nurse emphasize for the client’s recovery?

• A. Support group meetings.
• B. Vitamin B and multivitamin supplements.
• C. Diet with adequate calories and protein.
• D. Alcohol abstinence.

Correct answer: D

Rationale: Alcohol abstinence is the most critical self-care measure for a client with early alcoholic cirrhosis. Continued alcohol consumption can lead to further liver damage and worsen the condition. Support group meetings may offer emotional support but do not address the root cause of the issue. While vitamin supplements and a nutritious diet are important for overall health, alcohol abstinence takes precedence in managing cirrhosis caused by alcohol consumption.

3. Following involvement in a motor vehicle collision, a middle-aged adult client is admitted to the hospital with multiple facial fractures. The client’s blood alcohol level is high on admission. Which PRN prescription should be administered if the client begins to exhibit signs and symptoms of delirium tremens (DT)?

• A. Hydromorphone (Dilaudid) 2 mg IM
• B. Prochlorperazine (Compazine) 5 mg IM
• C. Chlorpromazine (Thorazine) 50 mg IM
• D. Lorazepam (Ativan) 2 mg IM

Correct answer: D

Rationale: Delirium tremens (DT) is a severe form of alcohol withdrawal that can occur in individuals with high blood alcohol levels. Lorazepam (Ativan) is the preferred medication for managing DT due to its efficacy in reducing symptoms such as agitation, hallucinations, and autonomic instability. Hydromorphone, Prochlorperazine, and Chlorpromazine are not indicated for the treatment of delirium tremens. Hydromorphone is an opioid analgesic, Prochlorperazine is an antiemetic, and Chlorpromazine is an antipsychotic. Therefore, the correct choice is Lorazepam (Ativan) to address the symptoms associated with delirium tremens effectively.

4. A teenager who has lost 20 pounds in the last three months is admitted to the hospital with hypotension and tachycardia. The client reports irregular menses and hair loss. Which intervention is most important for the nurse to include in the client’s plan of care?

• A. Initiate caloric and nutritional therapy.
• B. Implement behavioral modification therapy.
• C. Evaluate the client for low self-esteem.
• D. Record daily weights and graph trends.

Correct answer: A

Rationale: The client presents with evidence of anorexia nervosa resulting from self-starvation, which is a life-threatening condition. Providing nutrition and calories is the priority intervention so that the risk of electrolyte imbalance and severe dehydration can be reduced. Behavioral modification therapy (Choice B) may be beneficial in the long term but is not the priority in this acute situation. Evaluating for low self-esteem (Choice C) may be part of the nursing assessment but does not address the immediate life-threatening issues. Recording daily weights and graphing trends (Choice D) is important for monitoring progress but does not address the critical need for nutritional therapy in this case.

5. A male adolescent was admitted to the unit two days ago for depression. When the mental health nurse tries to interview the client to establish rapport, he becomes very irritated and sarcastic. Which action is best for the nurse to take?

• A. Offer to play a game of cards with the client.
• B. Report the behavior to the next shift.
• C. Document the behavior in the chart.
• D. Plan to talk with the client the next day.

Correct answer: A

Rationale: Offering to play a game of cards with the adolescent is the best action for the nurse to take in this situation. Engaging in an activity like playing a game can help establish rapport with the adolescent as it provides a more relaxed and non-threatening environment for communication. This approach can help the adolescent feel more comfortable and open up, as adolescents often find it easier to communicate when involved in an activity. Reporting the behavior to the next shift, documenting the behavior, or planning to talk with the client the next day do not directly address the immediate need to establish rapport and improve communication with the adolescent.

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