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. 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.

3. A client states that she hears God's voice telling her that she has sinned and needs to punish herself. Which response by the LPN/LVN is most important?

• A. How do you think you will be punished?
• B. Please tell staff when you think you need to punish yourself.
• C. What exactly do you think you have done to be punished?
• D. Let's talk about your strengths

Correct answer: B

Rationale: The most important response by the LPN/LVN is to encourage the client to communicate with staff when they feel the need to punish themselves. This approach can help assess the risk of self-harm and enable appropriate intervention. Choice A focuses more on the method of punishment rather than encouraging help-seeking behavior. Choice C seeks specific details about the perceived wrongdoing rather than addressing the immediate concern of self-punishment. Choice D, discussing strengths, does not directly address the client's current distress and potential self-harm risk.

4. An adolescent with major depressive disorder has been taking duloxetine (Cymbalta) for the past 12 days. Which assessment finding requires immediate follow-up?

• A. Describes life as without purpose.
• B. Exhibits an increase in sweating.
• C. States is often fatigued and drowsy.
• D. Complains of nausea and loss of appetite.

Correct answer: A

Rationale: The correct answer is A. Expressing that life is without purpose can indicate deepening depression or suicidal ideation, which requires immediate attention. While sweating, fatigue, drowsiness, nausea, and loss of appetite can be side effects of duloxetine (Cymbalta), they do not indicate the same level of urgency as a statement suggesting deepening depression or suicidal ideation.

5. A client with schizophrenia who has been stabilized on medication is being discharged from the hospital. What discharge teaching is most important for the LPN/LVN to reinforce?

• A. The importance of adhering to the prescribed medication regimen.
• B. How to recognize early signs of relapse.
• C. The need to continue follow-up appointments with the healthcare provider.
• D. The importance of maintaining a healthy lifestyle, including proper diet and exercise.

Correct answer: A

Rationale: The correct answer is A. Reinforcing the importance of adhering to the prescribed medication regimen is crucial for preventing relapse in clients with schizophrenia. Compliance with medication is essential in managing the symptoms and preventing a worsening of the condition. Choice B, recognizing early signs of relapse, is important but secondary to ensuring medication adherence. Choice C, follow-up appointments, is also important but not as critical as medication compliance immediately post-discharge. Choice D, maintaining a healthy lifestyle, is beneficial for overall health but is not as directly linked to preventing relapse in schizophrenia as medication adherence.

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