Nursing Elites

1. A client with generalized anxiety disorder (GAD) is prescribed buspirone (BuSpar). The nurse should include which information in the client's discharge teaching?

• A. This medication can cause physical dependence.
• B. It may take 2 to 4 weeks before you notice improvement.
• C. Avoid alcohol while taking this medication.
• D. You may experience sedation as a side effect.

Correct answer: B

Rationale: Corrected Rationale: Buspirone takes time to become fully effective, so the client should be informed to expect a gradual improvement in anxiety symptoms. Choice A is incorrect because buspirone is not associated with physical dependence. Choice C is not directly related to buspirone but is generally a good practice when taking any medication. Choice D is less common with buspirone compared to other anxiety medications.

2. A client with bipolar disorder is being discharged with a prescription for lithium. What is the most important instruction the nurse should provide?

• A. Avoid foods high in sodium.
• B. Drink plenty of fluids, especially during hot weather.
• C. Take your medication with food.
• D. Monitor your blood pressure regularly.

Correct answer: B

Rationale: The correct answer is to instruct the client to drink plenty of fluids, especially during hot weather. Maintaining adequate hydration is crucial for clients taking lithium as dehydration can lead to lithium toxicity. Choice A is incorrect because while it is important to monitor sodium intake, staying hydrated is more critical. Choice C is incorrect as lithium is usually recommended to be taken with food to reduce stomach upset. Choice D is also important but not the most crucial instruction compared to ensuring proper hydration.

3. A 40-year-old male client diagnosed with schizophrenia and alcohol dependence has not had any visitors or phone calls since admission. He reports he has no family that cares about him and was living on the streets prior to this admission. According to Erikson's theory of psychosocial development, which stage is the client in at this time?

• A. Isolation.
• B. Stagnation.
• C. Despair.
• D. Role confusion.

Correct answer: B

Rationale: The client is in Erikson's 'Generativity vs. Stagnation' stage (age 24 to 45). This stage involves maintaining intimate relationships and moving toward developing a family, which the client seems to be struggling with due to lack of visitors and family support. Choices (A), (C), and (D) are incorrect. Isolation typically occurs in young adulthood (age 18 to 25), Despair in maturity (age 45 to death), and Role confusion in adolescence (age 12 to 20). These stages reflect challenges individuals face if they do not successfully navigate their psychosocial developmental tasks.

4. A client with obsessive-compulsive disorder (OCD) spends several hours a day washing his hands. What is the best nursing intervention?

• A. Restrict the client's access to soap and water.
• B. Encourage the client to discuss their compulsions.
• C. Allow the client to continue the behavior until ready to stop.
• D. Schedule activities that distract the client from hand-washing.

Correct answer: B

Rationale: Encouraging the client to discuss their compulsions is the best nursing intervention when caring for a client with OCD who spends excessive time on hand-washing. This approach can help the client identify underlying anxieties and triggers associated with the compulsive behavior. Restricting access to soap and water (Choice A) can lead to increased anxiety and worsen the obsession. Allowing the client to continue the behavior (Choice C) can perpetuate the compulsive cycle. Scheduling distracting activities (Choice D) may provide temporary relief but does not address the root cause of the behavior.

5. The wife of a male client recently diagnosed with schizophrenia asks the nurse, 'What exactly is schizophrenia? Is my husband all right?' Which response is best for the nurse to provide to this family member?

• A. It sounds like you're worried about your husband. Let's sit down and talk.
• B. It is a chemical imbalance in the brain that causes disorganized thinking.
• C. Your husband will be just fine if he takes his medications regularly.
• D. I think you should talk to your husband's psychologist about this question.

Correct answer: B

Rationale: The best response for the nurse to provide to the wife of the client diagnosed with schizophrenia is to offer factual information. Choice B is the correct answer as it explains that schizophrenia is a mental disorder characterized by a chemical imbalance in the brain that causes disorganized thinking. This response provides a simple and accurate explanation of the condition. Choices A, C, and D are incorrect because they do not directly address the wife's question about what schizophrenia is. Choice A focuses on emotional support rather than providing information about the disorder. Choice C gives false reassurance without addressing the nature of schizophrenia. Choice D deflects the question by suggesting the wife speak to the psychologist, missing an opportunity to educate and support the family member.

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