Nursing Elites

1. A client with bipolar disorder is prescribed lithium. Which of the following statements by the client indicates a need for further teaching?

• A. I should maintain a consistent salt intake.
• B. I should drink 6-8 glasses of water daily.
• C. I need to have my lithium levels checked regularly.
• D. I can stop taking my medication once my mood stabilizes.

Correct answer: D

Rationale: The statement "I can stop taking my medication once my mood stabilizes" indicates a need for further teaching. Clients should continue taking their medication as prescribed and have regular monitoring of lithium levels.

2. A healthcare professional is assessing a client's use of defense mechanisms. Which statement would indicate to the healthcare professional that the client is using the defense mechanism of projection?

• A. The client accuses others of being angry when it is the client who is angry.
• B. The client refuses to acknowledge a problem despite evidence to the contrary.
• C. The client attributes his own feelings of hostility to others.
• D. The client avoids dealing with painful feelings by focusing on something else.

Correct answer: C

Rationale: Projection is a defense mechanism where individuals attribute their own unacceptable feelings, thoughts, or impulses onto others. In this case, the client is projecting his own feelings of hostility onto others by assuming they possess these feelings instead.

3. Which patient should be most carefully assessed for fluid and electrolyte imbalance among those receiving the following drugs?

• A. lithium (Eskalith)
• B. clozapine (Clozaril)
• C. diazepam (Valium)
• D. amitriptyline

Correct answer: A

Rationale: Lithium is known to cause polyuria (excessive urination) and polydipsia (excessive thirst), which can lead to fluid and electrolyte imbalances. Therefore, patients receiving lithium should be carefully monitored for signs of fluid and electrolyte disturbances to prevent any potential complications.

4. A client is under a great deal of stress. Which nursing recommendation would be least helpful in assisting the client in coping with stress? Select one that doesn't apply.

• A. Enjoy a pet.
• B. Spend time with a loved one.
• C. Listen to music.
• D. Focus on the stressors.

Correct answer: D

Rationale: Focusing on the stressors can exacerbate stress levels in the client's life rather than helping to cope with it. Engaging in activities such as enjoying a pet, spending time with loved ones, and listening to music are known to be stress-relieving and can aid in coping with stress. It is essential to encourage strategies that promote relaxation and positive emotions, rather than fixating on the stressors that may worsen the client's condition. Therefore, 'Focus on the stressors' is the least helpful recommendation as it does not contribute to stress management.

5. A client has been diagnosed with borderline personality disorder. Which behavior is characteristic of this disorder?

• A. Excessive need for attention
• B. Instability in relationships
• C. Fear of abandonment
• D. Lack of interest in activities

Correct answer: B

Rationale: The correct answer is B: Instability in relationships. Individuals with borderline personality disorder often exhibit instability in their relationships, characterized by intense and unstable interpersonal connections, oscillating between idealization and devaluation. This pattern can lead to frequent conflicts, dramatic emotional shifts, and difficulties maintaining stable relationships. Choices A, C, and D are incorrect. While individuals with borderline personality disorder may also have an excessive need for attention, fear of abandonment, or lack of interest in activities, the hallmark feature defining this disorder is the instability in relationships.

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