Nursing Elites

1. During a manic episode, which nursing intervention is most appropriate?

• A. Encourage group activities to increase socialization.
• B. Provide a structured environment with limited stimuli.
• C. Allow the patient to engage in physical activities freely.
• D. Give the patient detailed and complex tasks to complete.

Correct answer: B

Rationale: During a manic episode, individuals may experience heightened energy levels and reduced impulse control. Providing a structured environment with limited stimuli is the most appropriate nursing intervention. This approach helps reduce excessive stimulation and potential triggers for further escalation of manic behavior. It promotes a calming and controlled setting, assisting in managing symptoms and promoting the patient's well-being. Encouraging group activities (Choice A) may lead to overstimulation, allowing the patient to engage in physical activities freely (Choice C) could be risky due to impulsivity, and giving detailed tasks (Choice D) might overwhelm the individual.

2. A client has been diagnosed with major depressive disorder. Which is an appropriate short-term goal for the client?

• A. The client will report a decrease in depressive symptoms.
• B. The client will establish a sleep routine.
• C. The client will improve social interactions.
• D. The client will set realistic goals for the future.

Correct answer: A

Rationale: Setting a goal for the client to report a decrease in depressive symptoms is appropriate as it is specific, measurable, and achievable in the short term. Monitoring changes in depressive symptoms provides valuable feedback on the effectiveness of the treatment plan. While establishing a sleep routine, improving social interactions, and setting realistic goals for the future are important aspects of recovery, they are more suitable as intermediate or long-term goals. In the context of short-term goals, focusing on symptom reduction can provide immediate feedback on the client's progress and help adjust the treatment plan accordingly.

3. A client with a history of alcohol use disorder is admitted to the hospital for detoxification. Which of the following symptoms should the nurse expect to observe during withdrawal? Select one that doesn't apply.

• A. Tremors
• B. Hallucinations
• C. Diaphoresis
• D. Bradycardia

Correct answer: D

Rationale: During alcohol withdrawal, symptoms such as tremors, hallucinations, diaphoresis, and seizures are commonly observed. Bradycardia is not typically associated with alcohol withdrawal; instead, tachycardia, an increased heart rate, is more commonly seen. Therefore, bradycardia is the correct answer as it is not an expected symptom during alcohol withdrawal. Tremors, hallucinations, and diaphoresis are all common manifestations of alcohol withdrawal, while bradycardia is not typically seen in this context.

4. 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: C

Rationale: Monitoring the client's vital signs closely is crucial during alcohol withdrawal as it helps detect any physiological changes early, such as hypertension, tachycardia, or fever, which can indicate potential complications like delirium tremens. Early identification and prompt intervention can prevent severe outcomes in clients experiencing alcohol withdrawal.

5. When assessing a patient with generalized anxiety disorder (GAD), which symptom would the nurse most likely observe?

• A. Flashbacks
• B. Excessive worry
• C. Hallucinations
• D. Compulsive behaviors

Correct answer: B

Rationale: Excessive worry is a characteristic feature of generalized anxiety disorder (GAD). Patients with GAD experience persistent and excessive worry about various aspects of their life, such as work, health, or family, even when there is little or no reason for concern. This chronic worrying can significantly impact their daily functioning and quality of life. Flashbacks are more commonly associated with post-traumatic stress disorder (PTSD), hallucinations are more typical in conditions like schizophrenia, while compulsive behaviors are seen in obsessive-compulsive disorder (OCD). Therefore, in the context of GAD, excessive worry is the symptom that the nurse is most likely to observe.

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