Nursing Elites

1. When caring for a client experiencing alcohol withdrawal, which intervention should the nurse implement to prevent complications?

• A. Provide a well-lit environment.
• B. Administer antipsychotic medication as prescribed.
• C. Monitor the client's vital signs closely.
• D. Encourage the client to express their feelings.

Correct answer: D

Rationale: Encouraging the client to express their feelings is essential during alcohol withdrawal as it can help them cope with the emotional and psychological stress associated with the process. This intervention promotes open communication, allows the client to verbalize their emotions, and may prevent escalating anxiety or agitation, ultimately reducing the risk of complications. Providing a well-lit environment (Choice A) is not directly related to preventing complications of alcohol withdrawal. Administering antipsychotic medication (Choice B) is not the standard treatment for alcohol withdrawal; medications such as benzodiazepines are more commonly used. While monitoring vital signs (Choice C) is important, encouraging the client to express their feelings (Choice D) directly addresses emotional well-being, which is crucial during this vulnerable time.

2. Ted, a former executive, is now unemployed due to manic episodes at work. He was diagnosed with bipolar I 8 years ago. Ted has a history of IV drug abuse, which resulted in hepatitis C. He is taking his lithium exactly as scheduled, a fact that both Ted's wife and his blood tests confirm. To reduce Ted's mania, the psychiatric nurse practitioner recommends:

• A. Clonazepam (Klonopin)
• B. Fluoxetine (Prozac)
• C. Electroconvulsive therapy (ECT)
• D. Lurasidone (Latuda)

Correct answer: C

Rationale: Electroconvulsive therapy (ECT) can be an effective treatment for reducing mania in patients with bipolar disorder who have not responded to medication. In Ted's case, where he has a history of bipolar I disorder, lithium treatment, and manic episodes, ECT may be recommended by the psychiatric nurse practitioner to help manage his symptoms.

3. A nurse is assessing a client with suspected post-traumatic stress disorder (PTSD). Which of the following findings shouldn't the nurse expect?

• A. Flashbacks
• B. Avoidance of reminders of the trauma
• C. Increased arousal and hypervigilance
• D. Manic episodes

Correct answer: D

Rationale: Findings in a client with PTSD include flashbacks, avoidance of reminders of the trauma, increased arousal and hypervigilance, and negative changes in thoughts and mood. Manic episodes are not typically associated with PTSD.

4. A distraught, single, first-time mother cries and asks a nurse, 'How can I go to work if I can't afford childcare?' What is the nurse's initial action in assisting the client with the problem-solving process?

• A. Determine the risks and benefits of each alternative.
• B. Formulate goals for resolving the problem.
• C. Evaluate the outcome of the implemented solution.
• D. Assess the facts of the situation.

Correct answer: D

Rationale: In this scenario, the nurse's first step should be to assess the facts of the situation. By gathering accurate information about the client's circumstances related to childcare and work, the nurse can better understand the client's needs and concerns, which is essential before proceeding with any problem-solving process. Choice A is incorrect because assessing risks and benefits comes later in the problem-solving process. Choice B is incorrect as formulating goals should follow a thorough assessment. Choice C is incorrect since evaluating outcomes happens after implementing a solution, which is premature at this stage.

5. A patient with obsessive-compulsive disorder (OCD) is performing a ritualistic handwashing routine. What is the nurse's best initial response?

• A. Interrupt the ritual to help the patient gain control.
• B. Allow the ritual but set limits on the duration.
• C. Ignore the behavior to avoid reinforcing it.
• D. Encourage the patient to stop the ritual and discuss their feelings.

Correct answer: B

Rationale: In managing a patient with OCD engaging in ritualistic behaviors like handwashing, the nurse's best initial response is to allow the ritual but set limits on the duration. This approach helps in managing the behavior while gradually working towards reducing its frequency. Interrupting the ritual abruptly may cause distress to the patient, ignoring the behavior may reinforce it, and encouraging the patient to stop the ritual without setting limits may not be as effective in the initial stage of intervention.

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