Nursing Elites

1. A client diagnosed with bipolar disorder is experiencing a manic episode. Which of the following actions should the nurse take first?

• A. Encourage the client to participate in group therapy.
• B. Place the client in a private room to decrease stimulation.
• C. Encourage the client to participate in physical activity.
• D. Administer a prescribed sedative.

Correct answer: B

Rationale: During a manic episode, individuals with bipolar disorder may be easily overstimulated. Placing the client in a private room to decrease environmental stimuli is the priority intervention. This action can help reduce the risk of exacerbating manic symptoms and promote a calmer environment for the client. Choice A is not the priority as group therapy may be overwhelming during a manic episode. Choice C could potentially increase stimulation rather than decrease it. Choice D should not be the first action as sedatives are generally not the initial intervention for managing manic episodes.

2. During an assessment of a client with suspected substance use disorder, which of the following findings should the nurse expect? Select one that doesn't apply.

• A. Feelings of hopelessness
• B. Increased tolerance to the substance
• C. Withdrawal symptoms when not using the substance
• D. Unsuccessful attempts to cut down or control use

Correct answer: A

Rationale: In clients with substance use disorder, common findings include increased tolerance to the substance, withdrawal symptoms when not using it, and unsuccessful attempts to cut down or control use. Feelings of hopelessness are not typically a direct manifestation of substance use disorder. Instead, feelings of hopelessness may be associated with other mental health conditions or situational factors. Therefore, the correct answer is A. Choices B, C, and D are all expected findings in clients with substance use disorder.

3. The school nurse has been alerted to the fact that an 8-year-old boy routinely playacts as a police officer, 'locking up' other children on the playground to the point where the children get scared. The nurse recognizes that this behavior is most likely an indication of:

• A. The need to dominate others
• B. Inventing traumatic events
• C. A need to develop close relationships
• D. A potential symptom of traumatization

Correct answer: D

Rationale: The behavior of an 8-year-old boy playacting as a police officer and 'locking up' other children to the point of scaring them is likely a symptom of traumatization. Children may reenact traumatic experiences through play, and acting out aggressive or controlling roles can be a sign of underlying trauma. This behavior should be further assessed and addressed with appropriate support and intervention to help the child process and cope with any potential trauma.

4. Which client action is an example of the defense mechanism of displacement?

• A. A man kicks his dog after an argument with his boss.
• B. A woman yells at her children after a stressful day at work.
• C. A student immerses herself in studying to avoid thinking about a recent breakup.
• D. A person channels aggressive impulses into playing a sport.

Correct answer: B

Rationale: Displacement involves redirecting emotions, often anger or aggression, from their original source to a less threatening target. In this scenario, the woman redirects her frustration from work towards her children, who are perceived as less threatening and safer to express anger towards.

5. During an admission assessment and interview, which channels of information communication should the nurse be monitoring? Select one that doesn't apply.

• A. Auditory
• B. Visual
• C. Written
• D. Tactile

Correct answer: C

Rationale: During an admission assessment and interview, nurses should monitor auditory, visual, and tactile channels of communication. Written communication is not typically monitored during a face-to-face interview or assessment, making it the correct choice that doesn't apply in this scenario.

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