Nursing Elites

1. When evaluating a client's progress in psychotherapy, which outcome is appropriate for the client?

• A. The client will identify triggers for anxiety.
• B. The client will develop coping strategies.
• C. The client will decrease avoidance behaviors.
• D. The client will express feelings of anger.

Correct answer: A

Rationale: In psychotherapy, identifying triggers for anxiety is a crucial step towards understanding and managing one's anxiety symptoms. By recognizing these triggers, clients can work on developing coping strategies and addressing the root cause of their anxiety, leading to improved mental health outcomes. Decreasing avoidance behaviors and expressing feelings of anger are also important aspects of therapy. However, identifying triggers for anxiety is a more specific and foundational goal in addressing anxiety disorders, making it the most appropriate outcome to evaluate a client's progress in psychotherapy.

2. A client with bipolar disorder is prescribed lithium. Which dietary instruction should the nurse provide?

• A. Avoid foods high in potassium.
• B. Increase intake of caffeinated beverages.
• C. Maintain consistent sodium intake.
• D. Follow a low-protein diet.

Correct answer: C

Rationale: The correct instruction for a client with bipolar disorder prescribed lithium is to maintain consistent sodium intake. Fluctuations in sodium levels can impact lithium levels, potentially leading to toxicity. Therefore, it is crucial to advise the client to keep their sodium intake consistent to ensure the effectiveness and safety of the lithium therapy. Choices A, B, and D are incorrect. Avoiding foods high in potassium is not directly related to lithium therapy. Increasing intake of caffeinated beverages can interfere with the action of lithium. Following a low-protein diet is not a standard recommendation for clients prescribed lithium.

3. Which of the following interventions should be implemented for a client with anorexia nervosa? Select one that does not apply.

• A. Monitor daily caloric intake and weight
• B. Establish a structured eating plan
• C. Encourage the client to exercise
• D. Provide liquid supplements as prescribed

Correct answer: C

Rationale: Interventions for a client with anorexia nervosa include monitoring daily caloric intake and weight, establishing a structured eating plan, providing liquid supplements as prescribed, and offering rewards for weight gain. However, encouraging the client to exercise is not appropriate as it may exacerbate the condition by increasing caloric expenditure and reinforcing unhealthy behaviors associated with the disorder. Exercise may further contribute to excessive weight loss and worsen the client's physical health in the context of anorexia nervosa.

4. Which of the following are characteristics of borderline personality disorder? Select one that does not apply.

• A. Intense fear of abandonment
• B. Unstable relationships
• C. Impulsivity
• D. Grandiosity

Correct answer: D

Rationale: Borderline personality disorder is characterized by an intense fear of abandonment, unstable relationships, impulsivity, and chronic feelings of emptiness. Grandiosity, which involves an exaggerated sense of self-importance and superiority, is more commonly associated with narcissistic personality disorder rather than borderline personality disorder. Therefore, the correct answer is D.

5. A client has a history of excessive drinking, which has led to multiple arrests for driving under the influence (DUI). The client states, 'I work hard to provide for my family. I don't see why I can't drink to relax.' The nurse recognizes the use of which defense mechanism?

• A. Projection
• B. Rationalization
• C. Regression
• D. Sublimation

Correct answer: B

Rationale: The correct answer is Rationalization. The client is using rationalization as a defense mechanism by justifying their excessive drinking as a way to relax due to working hard to provide for their family. Rationalization involves creating logical excuses to justify unacceptable feelings or behaviors. Projection involves attributing one's unacceptable feelings or thoughts to others. Regression is reverting to an earlier stage of development in the face of unacceptable thoughts or impulses. Sublimation is the channeling of unacceptable impulses into socially acceptable activities.

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