Nursing Elites

1. A patient with bipolar disorder is prescribed lithium. Which dietary advice should the nurse include?

• A. Avoid foods high in tyramine.
• B. Maintain a consistent salt intake.
• C. Increase protein intake.
• D. Avoid foods high in fat.

Correct answer: B

Rationale: Patients prescribed lithium should maintain a consistent salt intake. Fluctuations in salt intake can impact lithium levels, potentially leading to toxicity or reduced effectiveness of the medication. It is crucial for patients to adhere to a stable salt intake while taking lithium to ensure optimal treatment outcomes. Choices A, C, and D are incorrect. Avoiding foods high in tyramine is more relevant for patients on MAOIs, not lithium. Increasing protein intake or avoiding foods high in fat are not specific dietary recommendations for patients taking lithium.

2. Research conducted by Miller and Rahe in 1997 demonstrated a correlation between the effects of life changes and illness, leading to the development of the Recent Life Changes Questionnaire (RLCQ). Which principle most limits the effectiveness of this tool?

• A. Specific illnesses are not identified.
• B. The numerical values associated with specific life events are randomly assigned.
• C. Stress is viewed as only a physiological response.
• D. Personal perception of the event is excluded.

Correct answer: D

Rationale: The main limitation of the Recent Life Changes Questionnaire (RLCQ) is that it does not consider an individual's personal perception of a life event. As people may interpret events differently, their subjective perspective plays a crucial role in how they experience stress and its potential impact on their health. Ignoring personal perception limits the effectiveness of the tool as it fails to capture the variations in how people respond to life changes. Choices A, B, and C are not the main limitations of the RLCQ. Specific illnesses not being identified or numerical values being randomly assigned do not directly impact the personal perception of life events. Additionally, viewing stress as only a physiological response is not the primary limitation, as stress encompasses psychological and emotional components as well.

3. Why is it important to establish a contract with a client with an eating disorder at the beginning of treatment?

• A. The client and healthcare provider form a partnership that is challenging for the family to disrupt.
• B. A collaborative approach to treatment planning ensures that both physical and emotional needs will be addressed.
• C. Involving the client in decision-making enhances the feeling of control and fosters cooperation.
• D. Permission for refeeding is crucial as it can have adverse effects.

Correct answer: C

Rationale: Establishing a contract with a client with an eating disorder at the start of treatment is crucial to involve the client in decision-making processes. By engaging the client in decision-making, it enhances their sense of control over their treatment, which can lead to increased cooperation and better treatment outcomes. This collaborative approach empowers the client and fosters a therapeutic alliance between the client and the healthcare provider, rather than excluding the family or causing disruptions. It focuses on addressing both the physical and emotional needs of the client, ensuring a comprehensive treatment plan.

4. A client has generalized anxiety disorder (GAD), and a nurse is providing care. Which of the following interventions should the nurse avoid implementing?

• A. Encourage the client to express their feelings
• B. Monitor daily caloric intake and weight
• C. Promote regular physical activity
• D. Discourage the use of caffeine

Correct answer: B

Rationale: In caring for a client with generalized anxiety disorder (GAD), it is important to encourage the client to express their feelings, promote regular physical activity, and discourage the use of caffeine. Addressing weight and caloric intake monitoring may exacerbate anxiety related to body image, and focusing on these aspects can be distressing for the client. Therefore, monitoring daily caloric intake and weight should be avoided in this scenario.

5. A client displays signs and symptoms indicative of hypochondriasis. The nurse would initially expect to see:

• A. Self-preoccupation
• B. La belle indifference
• C. Fear of physicians
• D. Insight into the source of their fears

Correct answer: A

Rationale: In hypochondriasis, individuals are excessively preoccupied with and worried about having a serious illness, despite reassurance from medical professionals. This self-preoccupation is a key characteristic of hypochondriasis. 'La belle indifference' refers to a lack of concern or distress about symptoms, which is not typically seen in hypochondriasis. Fear of physicians may be present due to the individual's persistent belief in their illness despite medical reassurance. Insight into the source of their fears is usually lacking in hypochondriasis, as individuals often believe their physical symptoms are evidence of a serious illness.

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