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 client with bipolar disorder is experiencing a manic episode. Which intervention should the nurse implement to ensure the client's safety?

• A. Provide a structured environment with minimal stimuli.
• B. Monitor the client closely for signs of exhaustion.
• C. Encourage the client to rest and sleep as needed.
• D. Encourage the client to engage in regular physical activity.

Correct answer: A

Rationale: During a manic episode in bipolar disorder, individuals may exhibit increased energy levels, impulsivity, and reduced need for sleep, which can lead to risky behaviors and accidents. Providing a structured environment with minimal stimuli helps to reduce the risk of overstimulation and impulsive actions, thereby promoting the client's safety. This intervention aims to create a calm and controlled setting that can prevent potential harm to the client during this phase of the disorder.

3. 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.

4. When assessing a client diagnosed with major depressive disorder who states, 'I feel like I can't go on,' which of the following actions should the nurse take first?

• A. Administer a prescribed antidepressant medication.
• B. Ask the client if they have a plan to commit suicide.
• C. Encourage the client to attend a support group.
• D. Contact the client's family to provide support.

Correct answer: B

Rationale: The priority action for the nurse is to assess the client's risk for suicide. By asking if the client has a plan to commit suicide, the nurse can determine the immediate safety of the client and take appropriate interventions to prevent harm. Administering antidepressant medication is not the first action to take in this situation as assessing the client's safety is the priority. Encouraging the client to attend a support group or contacting the client's family, although beneficial, are not immediate actions to ensure the client's safety in a crisis situation.

5. Which intervention is particularly well chosen for addressing a population at high risk for developing schizophrenia?

• A. Screening a group of males aged 15 to 25 for early symptoms.
• B. Forming a support group for females aged 25 to 35 with substance use issues.
• C. Providing coping skills information to a group aged 45 to 55.
• D. Educating parents of developmentally delayed 5- to 6-year-olds on early intervention importance.

Correct answer: A

Rationale: Screening males aged 15 to 25 for early symptoms of schizophrenia is a well-chosen intervention as this age group is at a higher risk for developing the condition. Early identification can lead to timely treatment and better outcomes, making this intervention particularly effective in addressing the population at risk for schizophrenia.

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