Nursing Elites

1. A female client with obsessive-compulsive disorder (OCD) is describing her obsessions and compulsions and asks the nurse why these make her feel safer. What information should the nurse include in this client's teaching plan? (select one that does not apply.)

• A. Compulsions relieve anxiety
• B. Anxiety is the key reason for OCD
• C. Obsessions cause compulsions
• D. Obsessive thoughts are linked to levels of neurochemicals

Correct answer: C

Rationale: The correct answer is C. Obsessions do not cause compulsions; rather, obsessions are intrusive, unwanted thoughts, images, or urges that trigger intensely distressing feelings, while compulsions are repetitive behaviors or mental acts that a person feels driven to perform in response to an obsession or according to rules that must be applied rigidly. Choices A, B, and D are incorrect. Choice A is incorrect because compulsions are behaviors or mental acts aimed at reducing distress or preventing a dreaded event or situation. Choice B is incorrect because while anxiety is often a significant component of OCD, it is not the only reason for the disorder. Choice D is incorrect because obsessive thoughts are not solely linked to levels of neurochemicals but are more complex and multifactorial.

2. A client is being successfully treated with clozapine (Clozaril). Which of the following statements by the client reflects a need for further teaching about managing the drug's adverse effects?

• A. If I eat too many fruits, I'll get constipated.
• B. I need to take the medicine with food to avoid nausea.
• C. I have to get up slowly so I don't get dizzy.
• D. Sometimes I have to push myself because I'm sleepy.

Correct answer: A

Rationale: Choice A reflects a need for further teaching as the client mistakenly believes that eating too many fruits causes constipation, showing a misunderstanding about dietary fiber's role in preventing constipation. Choices B, C, and D demonstrate accurate understanding of managing clozapine's adverse effects, such as taking it with food to avoid nausea, getting up slowly to prevent dizziness, and pushing oneself when feeling sleepy.

3. A female client with anorexia nervosa is admitted to the hospital. What is the priority assessment for the nurse to perform?

• A. Assess the client's body image perception.
• B. Monitor the client's electrolyte levels.
• C. Evaluate the client's exercise habits.
• D. Assess the client's relationship with her family.

Correct answer: B

Rationale: The correct answer is to monitor the client's electrolyte levels. In clients with anorexia nervosa, electrolyte imbalances can lead to serious, potentially life-threatening complications such as cardiac arrhythmias. Assessing body image perception (choice A) is important but not the priority when compared to monitoring electrolyte levels. Evaluating exercise habits (choice C) and assessing the client's relationship with her family (choice D) are also important aspects of care but do not take precedence over monitoring electrolyte levels in a client with anorexia nervosa.

4. A male client with alcohol dependence is admitted for detoxification. The nurse knows that which assessment finding is indicative of alcohol withdrawal?

• A. Bradycardia
• B. Hypotension
• C. Tremors
• D. Hyperglycemia

Correct answer: C

Rationale: Tremors are a common sign of alcohol withdrawal. The central nervous system becomes hyperexcitable due to the suppression caused by chronic alcohol intake. Tremors are a manifestation of this hyperexcitability and are a key indicator of alcohol withdrawal. Bradycardia and hypotension are more commonly associated with conditions like shock or severe dehydration rather than alcohol withdrawal. Hyperglycemia is not a typical finding in alcohol withdrawal; instead, hypoglycemia is more commonly seen due to the effects of alcohol on glucose metabolism.

5. A client with obsessive-compulsive disorder (OCD) spends hours each day washing their hands. Which nursing intervention is most appropriate initially?

• A. Allow the client to continue the behavior to reduce anxiety.
• B. Set strict limits on the time allowed for handwashing.
• C. Distract the client with other activities.
• D. Encourage the client to participate in a support group.

Correct answer: A

Rationale: Initially, it is most appropriate to allow the client to continue the behavior to reduce anxiety (A). For clients with OCD, abruptly stopping compulsive behaviors can lead to increased anxiety and distress. Setting strict limits (B) may exacerbate anxiety at first. Distraction with other activities (C) may not address the underlying issue effectively. While support groups (D) can be beneficial, they are typically introduced after establishing trust and gradually working on reducing compulsive behaviors.

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