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. When caring for a client with anorexia nervosa in a psychiatric unit, which intervention should the nurse implement to address the client's nutritional needs?

• A. Provide small, frequent meals throughout the day.
• B. Monitor the client's weight daily.
• C. Offer a liquid supplement if the client refuses solid food.
• D. Encourage the client to choose from a variety of food options.

Correct answer: A

Rationale: Providing small, frequent meals throughout the day is a crucial intervention when caring for a client with anorexia nervosa. This approach helps in gradually increasing caloric intake and meeting the client's nutritional needs. Offering large meals can be overwhelming and may contribute to anxiety in these clients. By providing small, frequent meals, the nurse supports the client in establishing a healthier eating pattern and aids in the restoration of adequate nutrition levels. Monitoring the client's weight daily (Choice B) may exacerbate anxiety related to body image and weight, which are common concerns in anorexia nervosa. Offering a liquid supplement if the client refuses solid food (Choice C) may not address the underlying issues related to food aversion and may not provide the necessary nutrients in a balanced way. Encouraging the client to choose from a variety of food options (Choice D) may be overwhelming for someone with anorexia nervosa and could lead to increased anxiety around food choices.

3. A healthcare provider is providing care for a patient with major depressive disorder who is prescribed a tricyclic antidepressant (TCA). Which common side effect should the healthcare provider educate the patient about?

• A. Hypertension
• B. Diarrhea
• C. Dry mouth
• D. Weight loss

Correct answer: C

Rationale: Dry mouth is a common side effect associated with tricyclic antidepressants (TCAs). TCAs can cause anticholinergic side effects, such as dry mouth, due to their mechanism of action. Educating the patient about dry mouth can help them stay informed and manage this common side effect effectively during treatment. Hypertension (Choice A) is not a common side effect of TCAs. Diarrhea (Choice B) is more commonly associated with selective serotonin reuptake inhibitors (SSRIs) than with TCAs. Weight loss (Choice D) is not a common side effect of TCAs; in fact, TCAs are more likely to cause weight gain.

4. When educating a client prescribed diazepam for anxiety, which statement indicates an accurate understanding of the medication?

• A. I should take this medication only when I feel anxious.
• B. I should avoid drinking alcohol while taking this medication.
• C. I should avoid driving until I know how this medication affects me.
• D. I can stop taking this medication abruptly if I feel better.

Correct answer: B

Rationale: The correct answer is B. Clients prescribed diazepam for anxiety should avoid drinking alcohol while taking this medication. Alcohol can potentiate the side effects of diazepam, such as drowsiness and dizziness, increasing the risk of harm. Choice A is incorrect because diazepam is typically taken regularly as prescribed, not just when feeling anxious. Choice C is also important but not directly related to the medication itself. Choice D is dangerous advice; stopping diazepam abruptly can lead to withdrawal symptoms and should only be done under medical supervision.

5. When providing care for 10-year-old Harper diagnosed with posttraumatic stress disorder (PTSD), which goal should be addressed initially?

• A. Harper will be able to identify feelings through the use of play therapy.
• B. Harper and her parents will have access to protective resources available through social services.
• C. Harper will demonstrate the effective use of relaxation techniques to restore a sense of control over disturbing thoughts.
• D. Harper and her parents will demonstrate an understanding of the personal human response to traumatic events.

Correct answer: C

Rationale: The initial goal when caring for a child with PTSD like Harper is to address restoring a sense of control over disturbing thoughts by teaching relaxation techniques. This approach helps the child manage their distressing emotions and promotes a feeling of empowerment in dealing with their condition.

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