Nursing Elites

1. A male client who has been on lithium therapy for 5 years is experiencing frequent urination and increased thirst. What should the nurse's next action be?

• A. Instruct the client to increase fluid intake.
• B. Assess for signs of lithium toxicity.
• C. Suggest the client reduce salt intake.
• D. Notify the healthcare provider immediately.

Correct answer: B

Rationale: Frequent urination and increased thirst can be signs of lithium toxicity, which can lead to serious complications if not addressed promptly. Assessing for signs of lithium toxicity is crucial to determine the client's condition and prevent further harm. Instructing the client to increase fluid intake (Choice A) may worsen the situation by exacerbating lithium toxicity. Suggesting the client reduce salt intake (Choice C) is not the priority when signs of toxicity are present. Notifying the healthcare provider immediately (Choice D) is important, but the initial action should be to assess the client for signs of lithium toxicity to provide immediate care.

2. A client with generalized anxiety disorder is being treated with lorazepam (Ativan). What is the most important teaching point for the LPN/LVN to reinforce?

• A. Take the medication on an empty stomach.
• B. Avoid drinking alcohol while taking this medication.
• C. This medication may cause drowsiness, so avoid driving.
• D. You can stop taking the medication once you feel better.

Correct answer: B

Rationale: The most important teaching point for the LPN/LVN to reinforce is to avoid drinking alcohol while taking lorazepam (Ativan). Alcohol can enhance the sedative effects of lorazepam, increasing the risk of severe side effects and complications. Choice A is incorrect because lorazepam can be taken with or without food. Choice C is not the most critical teaching point, although it is essential to avoid activities that require mental alertness until the effects of the medication are known. Choice D is incorrect because abruptly stopping lorazepam can lead to withdrawal symptoms and should only be done under medical supervision.

3. On admission to a residential care facility, an elderly female client tells the nurse that she enjoys cooking, quilting, and watching television. Twenty-four hours after admission, the nurse notes that the client is withdrawn and isolated. It is best for the nurse to encourage this client to become involved in which activity?

• A. Clean the unit kitchen cabinets.
• B. Participate in a group quilting project.
• C. Watch television in the activity room.
• D. Bake a cake for a resident's birthday.

Correct answer: B

Rationale: Peer interaction in a group activity (B) such as participating in a group quilting project will help to prevent social isolation and withdrawal. This will provide the elderly client with an opportunity to engage with others, share experiences, and feel a sense of belonging. Choices (A, C, and D) are activities that can be accomplished alone, without peer interaction, which may not effectively address the client's feelings of withdrawal and isolation.

4. A male client with bipolar disorder has not slept or eaten in four days. He paces and becomes increasingly agitated and loud while the nurse talks to his spouse. What intervention is the best for the nurse to implement at this time?

• A. Move to a quiet area and provide peanut butter with crackers.
• B. Walk with the client to the cafeteria and star as he eats lunch.
• C. Request a full lunch tray from the dietary department.
• D. Encourage the spouse to eat lunch with the client.

Correct answer: A

Rationale: In this situation, the best intervention for the nurse to implement is to move the client to a quiet area and provide peanut butter with crackers. The client's behavior indicates increasing agitation and loudness, which could be exacerbated by a noisy environment. Providing a quiet space can help reduce stimuli and promote a sense of calm. Additionally, offering a small, manageable snack like peanut butter with crackers can address the client's immediate needs for sustenance without overwhelming him. Choices B, C, and D do not address the client's current agitation and lack of sleep or food effectively, making them less appropriate interventions in this scenario.

5. The LPN/LVN is caring for a client who was recently diagnosed with a mental illness. The client asks, 'Will I be able to live a normal life?' What is the best response for the nurse to provide?

• A. Yes, you will be able to live a normal life.
• B. Many people with mental illness lead full and productive lives.
• C. It will depend on your treatment and the choices you make.
• D. There is no normal; everyone is unique in their own way.

Correct answer: C

Rationale: The best response for the nurse is to provide the client with hope while acknowledging the importance of their treatment and choices. Choice C addresses the client's concern by highlighting the impact of their treatment and personal choices on their future. It encourages personal responsibility and active participation in their recovery. Choices A and B may sound reassuring, but they do not empower the client to take an active role in their well-being. Choice D, while promoting individuality, does not directly address the client's question about living a normal life after a mental illness diagnosis.

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