Nursing Elites

1. When planning care for a client with schizophrenia, which of the following interventions should be included in the plan of care?

• A. Encourage reality testing
• B. Provide opportunities for socialization
• C. Monitor for command hallucinations
• D. Promote adherence to medication regimen

Correct answer: A

Rationale: When caring for a client with schizophrenia, encouraging reality testing is essential. This intervention assists the client in distinguishing between delusions and reality, aiding in their treatment. While providing opportunities for socialization can help reduce isolation, monitoring for command hallucinations is crucial for the client's safety. Promoting adherence to the medication regimen is vital for symptom management. Addressing delusional thoughts in a therapeutic manner is preferable to outright discouragement, fostering a supportive environment for the client.

2. A healthcare professional is assessing a client who has been diagnosed with major depressive disorder. Which symptom should the healthcare professional expect to observe?

• A. Increased energy
• B. Weight gain
• C. Increased appetite
• D. Restlessness

Correct answer: B

Rationale: Weight gain is a common symptom of major depressive disorder. Individuals with major depressive disorder often experience changes in appetite, leading to weight gain or loss. This symptom is related to disruptions in the individual's eating habits and metabolism, which are commonly associated with depression. Choices A, C, and D are incorrect because increased energy, increased appetite, and restlessness are not typical symptoms of major depressive disorder. In fact, individuals with depression often experience fatigue, changes in appetite, and feelings of restlessness or agitation.

3. Which of the following interventions is most appropriate for a client experiencing severe anxiety?

• A. Encourage the client to talk about their feelings.
• B. Provide a quiet and calm environment.
• C. Encourage the client to exercise vigorously.
• D. Encourage the client to participate in group activities.

Correct answer: B

Rationale: In cases of severe anxiety, creating a quiet and calm environment is crucial as it can help reduce stimulation and promote relaxation. This environment can provide a sense of safety and security, which are essential for individuals experiencing heightened anxiety levels. Encouraging the client to talk about their feelings may not be suitable during severe anxiety as it can further escalate distress by focusing on the source of anxiety. Vigorous exercise and group activities may not be appropriate initially, as they can increase arousal levels rather than promoting a sense of calm needed to manage severe anxiety.

4. Cognitive-behavioral therapy (CBT) is often used to treat which of the following conditions?

• A. Schizophrenia
• B. Bipolar disorder
• C. Posttraumatic stress disorder
• D. Generalized anxiety disorder

Correct answer: D

Rationale: Cognitive-behavioral therapy (CBT) is a widely used therapeutic approach effective in treating various mental health conditions. While CBT can be beneficial for different disorders, it is particularly well-suited for anxiety-related conditions like generalized anxiety disorder. CBT focuses on identifying and modifying negative thought patterns and behaviors contributing to anxiety, making it a suitable choice for treating generalized anxiety disorder. Therefore, the correct answer is D. Choices A, B, and C are incorrect because CBT is not typically the first-line treatment for schizophrenia, bipolar disorder, or posttraumatic stress disorder, although it may be used as a part of a comprehensive treatment plan.

5. 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.

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