Nursing Elites

1. A client is experiencing severe anxiety. Which of the following is an appropriate intervention?

• A. Encourage the client to participate in group therapy sessions.
• B. Encourage the client to verbalize feelings of anxiety.
• C. Encourage the client to limit caffeine intake.
• D. Encourage the client to avoid stressful situations.

Correct answer: B

Rationale: Encouraging the client to verbalize feelings of anxiety is an appropriate intervention for severe anxiety. Verbalizing emotions can help the client process their feelings and reduce the intensity of anxiety. It promotes emotional expression and may lead to a better understanding of the underlying causes of anxiety, paving the way for effective coping strategies. Choices A, C, and D are not the most appropriate interventions for severe anxiety. While group therapy can be beneficial, it may not be suitable for someone experiencing severe anxiety. Limiting caffeine intake and avoiding stressful situations are helpful strategies but may not address the root of the severe anxiety or provide immediate relief.

2. 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.

3. A male patient calls to tell the nurse that his monthly lithium level is 1.7 mEq/L. Which nursing intervention will the nurse implement initially?

• A. Reinforce that the level is above the therapeutic range.
• B. Instruct the patient to hold the next dose of medication and contact the prescriber.
• C. Advise the patient to go to the hospital emergency room immediately.
• D. Inform the patient about the possibility of seizures and appropriate precautions.

Correct answer: B

Rationale: A lithium level of 1.7 mEq/L is above the therapeutic range, indicating a potential risk of toxicity. The initial nursing intervention should be to instruct the patient to hold the next dose of medication and promptly contact the prescriber for further guidance and management. This action aims to prevent adverse effects and ensure the patient's safety by addressing the elevated lithium level appropriately.

4. When patients diagnosed with schizophrenia suffer from anosognosia, they often refuse medication, believing that:

• A. Medications provided are ineffective.
• B. Nurses are trying to control their minds.
• C. The medications will make them sick.
• D. They are not actually ill.

Correct answer: D

Rationale: Anosognosia is a lack of insight that affects patients with schizophrenia, leading them to deny or lack awareness of their illness. This lack of awareness often results in patients refusing medication because they genuinely believe they are not ill and do not need treatment. It is crucial for healthcare providers to approach such situations with understanding and empathy, recognizing the impact of anosognosia on treatment adherence.

5. A nursing instructor is discussing diseases of adaptation with students and when they are likely to occur. Which student response indicates that learning has occurred?

• A. When an individual has limited experience managing stress
• B. When an individual inherits adaptive genes
• C. When an individual faces pre-existing conditions that worsen stress
• D. When an individual's physiological and psychological resources are depleted

Correct answer: D

Rationale: The correct answer is D. During the stage of exhaustion in the general adaptation syndrome, an individual's physiological and psychological resources become depleted, leading to a reduced capacity to adapt effectively. This depletion of resources is when diseases of adaptation, such as stress-related disorders, are more likely to occur. Choices A, B, and C do not reflect an accurate understanding of diseases of adaptation. Limited experience managing stress, inheriting adaptive genes, and facing pre-existing conditions that worsen stress do not directly relate to the concept of physiological and psychological resource depletion leading to diseases of adaptation.

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