Nursing Elites

1. In a mental health unit of a hospital, a LPN/LVN is leading a group psychotherapy session. What is the nurse's role in the termination stage of group development?

• A. Encourage problem solving
• B. Encourage accomplishment of the group's work
• C. Acknowledge the contributions of each group member
• D. Encourage members to become acquainted with one another

Correct answer: C

Rationale: During the termination stage of group development in psychotherapy, the nurse's role is to acknowledge the contributions of each group member. This action helps to close the group on a positive note, reinforcing the therapeutic experience. Choice A, encouraging problem-solving, is more relevant in the earlier stages of group development. Choice B, encouraging the accomplishment of the group's work, is important throughout the group process but is not specific to the termination stage. Choice D, encouraging members to become acquainted with one another, is more aligned with the initial stages of group formation rather than the termination stage.

2. A client is diagnosed with schizophrenia and exhibits apathy, lack of energy, and lack of interest in daily activities. The nurse should recognize that these symptoms are most likely due to which of the following?

• A. Negative symptoms of schizophrenia.
• B. Positive symptoms of schizophrenia.
• C. Side effects of antipsychotic medication.
• D. Symptoms of depression.

Correct answer: A

Rationale: Apathy, lack of energy, and lack of interest in daily activities are negative symptoms of schizophrenia (A). Positive symptoms of schizophrenia include hallucinations and delusions (B). While antipsychotic medication side effects can sometimes cause lethargy or sedation (C), the scenario specifically describes negative symptoms. Depression can also cause similar symptoms (D), but in the context of schizophrenia, these are recognized as negative symptoms.

3. When a client with schizophrenia is being discharged on antipsychotic medication, what is the most important instruction the nurse should provide?

• A. Stop the medication if you start feeling better.
• B. Be aware of the potential for weight gain with this medication.
• C. Report any unusual muscle movements immediately.
• D. You can drive as soon as you feel ready.

Correct answer: C

Rationale: The correct answer is to instruct the client to report any unusual muscle movements immediately. These movements may indicate extrapyramidal symptoms (EPS) or tardive dyskinesia, which are serious side effects of antipsychotic medications that require immediate attention. Choice A is incorrect because stopping the medication without medical advice can lead to a relapse of symptoms. Choice B is important but not as critical as monitoring for EPS. Choice D is incorrect because driving readiness is not directly related to antipsychotic medication instructions.

4. The nurse documents that a male client with paranoid schizophrenia is delusional. Which statement by the client confirms this assessment?

• A. The voices are telling me to kill the next person I see.
• B. The fire is burning my skin away right now.
• C. The snakes on the wall are going to eat me.
• D. The nurse at night is trying to poison me with pills.

Correct answer: D

Rationale: The correct answer is D. Believing that the nurse is trying to poison him with pills is a clear indication of delusional paranoia, a common symptom in paranoid schizophrenia. Choices A, B, and C do not directly relate to paranoid delusions and are more indicative of hallucinations or other forms of delusions not specific to paranoia.

5. A male employee who is assessed weekly in the employee clinic for blood pressure because of a history of hypertension tells the nurse that he is so upset with one of his co-workers that he would like to shoot him. What action should the nurse take first?

• A. Determine if the client has a weapon available for use.
• B. Inform the health care provider of the threat to harm a co-worker.
• C. Notify security of the client's intention to harm a co-worker.
• D. Have the employee escorted to a mental health facility.

Correct answer: A

Rationale: Determining if the client has access to a weapon is critical for immediate safety and to prevent potential harm.

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