Nursing Elites

1. A patient is receiving education about taking clozapine. Which statement indicates the patient understands the side effects?

• A. I should report any signs of infection to my healthcare provider immediately.
• B. I can stop taking this medication once I feel better.
• C. I should take this medication on an empty stomach.
• D. I should avoid drinking alcohol while taking this medication.

Correct answer: A

Rationale: The correct answer is A because patients taking clozapine should report signs of infection immediately due to the risk of agranulocytosis. Agranulocytosis is a potentially life-threatening side effect of clozapine characterized by a significant decrease in white blood cell count, which can leave the patient vulnerable to infections. Reporting signs of infection promptly is crucial to prevent serious complications.

2. A nurse hears a newly licensed nurse discussing a client’s hallucinations in the hallway with another nurse. Which of the following actions should the nurse take first?

• A. Notify the nurse manager
• B. Tell the nurse to stop discussing the behavior
• C. Provide an in-service program about confidentiality
• D. Complete an incident report

Correct answer: B

Rationale: The correct action the nurse should take first in this situation is to tell the newly licensed nurse to stop discussing the client's hallucinations with another nurse. Maintaining client confidentiality is a critical aspect of nursing practice. By addressing the behavior immediately, the nurse helps prevent the inappropriate sharing of sensitive information about a client. Choice A is not the first action to take because addressing the behavior directly is more immediate and can prevent further breaches of confidentiality. Choice C is not the priority at this moment as immediate action is required to address the current situation. Choice D, completing an incident report, should come after addressing the immediate issue and ensuring that the inappropriate behavior ceases.

3. While being treated in an inpatient facility, what is the most appropriate intervention for a patient with anorexia nervosa?

• A. Allowing the patient to eat alone to reduce stress
• B. Monitoring the patient's weight daily
• C. Encouraging the patient to exercise daily
• D. Providing the patient with a high-calorie diet

Correct answer: B

Rationale: Monitoring the patient's weight daily is the most appropriate intervention for a patient with anorexia nervosa being treated in an inpatient facility. This approach helps healthcare providers track the patient's progress, assess nutritional status, and promptly identify any concerning changes or trends that may require intervention.

4. When developing a care plan for a patient with borderline personality disorder, which intervention should be included to address self-harm behaviors?

• A. Encouraging the patient to keep a journal of their thoughts and feelings.
• B. Setting clear and consistent boundaries with the patient.
• C. Providing the patient with coping skills to manage their emotions.
• D. Developing a safety plan with the patient.

Correct answer: D

Rationale: Developing a safety plan with the patient is crucial when addressing self-harm behaviors in individuals with borderline personality disorder. This intervention helps outline steps to take during a crisis, identifies triggers, and provides strategies to prevent self-harm incidents. It involves collaboratively creating a plan between the patient and the healthcare team to ensure a structured and supportive approach to managing potentially dangerous situations.

5. The nurse is providing medication education to a patient who has been prescribed lithium to stabilize mood. Which early signs and symptoms of toxicity should the nurse stress to the patient?

• A. Increased attentiveness
• B. Getting up at night to urinate
• C. Improved vision
• D. An upset stomach for no apparent reason

Correct answer: D

Rationale: The correct early sign of lithium toxicity that the nurse should stress to the patient is an upset stomach for no apparent reason. Early signs of lithium toxicity often manifest as gastrointestinal symptoms such as nausea, vomiting, and diarrhea. This can serve as an important indicator for the patient to seek medical attention promptly to prevent further complications. Choices A, B, and C are incorrect. Increased attentiveness, getting up at night to urinate, and improved vision are not early signs of lithium toxicity. It is crucial for the nurse to educate the patient on recognizing gastrointestinal symptoms as potential indicators of toxicity.

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