Nursing Elites

1. In managing a patient with anorexia nervosa, which initial treatment goal is most important?

• A. Addressing distorted body image
• B. Restoring nutritional status
• C. Resolving family conflicts
• D. Increasing social interactions

Correct answer: B

Rationale: The most crucial initial treatment goal for anorexia nervosa is restoring nutritional status. This is essential to prevent life-threatening complications associated with severe malnutrition, such as organ damage and cardiac issues. Addressing distorted body image, resolving family conflicts, and increasing social interactions are important aspects of treatment, but they are secondary to the critical need of restoring the patient's nutritional status to ensure their physical well-being and recovery.

2. A client diagnosed with schizophrenia is receiving discharge teaching. Which of the following instructions should the healthcare provider include? Select one that does not apply.

• A. Continue taking medications as prescribed
• B. Avoid all social interactions
• C. Report any side effects of medications to the healthcare provider
• D. Develop a daily routine

Correct answer: B

Rationale: Discharge instructions for a client diagnosed with schizophrenia should focus on promoting medication adherence, monitoring and reporting any medication side effects, and establishing a structured daily routine to support stability and well-being. Encouraging the client to avoid all social interactions is not appropriate as social support can be beneficial for individuals with schizophrenia. Social interactions can help reduce feelings of isolation, improve overall well-being, and provide emotional support. Therefore, advising the client to avoid all social interactions would not be in the best interest of their recovery and management of the condition.

3. A teenage boy is attracted to a female teacher. Without objective evidence, a school nurse overhears the boy state, 'I know she wants me.' This statement reflects which defense mechanism?

• A. Displacement
• B. Projection
• C. Rationalization
• D. Sublimation

Correct answer: B

Rationale: The correct answer is B: Projection. The nurse should determine that the client's statement reflects the defense mechanism of projection. Projection refers to the attribution of one's unacceptable feelings or impulses to another person. In this case, the boy is projecting his own desires onto the female teacher, believing that she wants him. By externalizing his feelings, the boy reduces his anxiety and discomfort about his own attraction. Displacement involves transferring emotions from one target to another, not attributing one's own feelings to others. Rationalization involves creating logical explanations for unacceptable behaviors, not projecting feelings onto others. Sublimation is the channeling of unacceptable impulses into socially acceptable actions, which is not demonstrated in this scenario.

4. What information should the nurse include in patient education for a patient prescribed valproic acid for bipolar disorder?

• A. Avoid consuming dairy products while taking this medication.
• B. Regular blood tests are necessary to monitor medication levels.
• C. Take the medication on an empty stomach for better absorption.
• D. It is safe to stop the medication abruptly if side effects occur.

Correct answer: B

Rationale: The correct answer is B: Regular blood tests are crucial when taking valproic acid to monitor the medication levels in the bloodstream. This monitoring helps ensure that the patient is receiving the correct dosage for effective treatment and to prevent adverse effects associated with either subtherapeutic or toxic levels of the medication. Choice A is incorrect because there is no specific interaction between valproic acid and dairy products. Choice C is incorrect as valproic acid can generally be taken with food to reduce gastrointestinal side effects. Choice D is incorrect as abruptly stopping valproic acid can lead to withdrawal symptoms and worsening of the condition.

5. A client is experiencing occasional feelings of sadness due to the recent death of a beloved pet. The client's appetite, sleep patterns, and daily routine have not changed. How should the nurse interpret the client's behaviors?

• A. The client's behaviors demonstrate mental illness in the form of depression.
• B. The client's behaviors are extensive, indicating the presence of mental illness.
• C. The client's behaviors are not congruent with cultural norms.
• D. The client's behaviors demonstrate no functional impairment, indicating no mental illness.

Correct answer: D

Rationale: In this scenario, the nurse should interpret the client's behaviors as not indicative of mental illness. The client is experiencing normal feelings of sadness following the loss of a pet, and the fact that the client's appetite, sleep patterns, and daily routine remain unchanged suggests no functional impairment. It is essential to recognize that experiencing occasional feelings of sadness in response to a significant life event, such as the death of a pet, does not necessarily signify mental illness, especially when there is no significant impairment in daily functioning. Choices A, B, and C are incorrect because they incorrectly suggest that the client's behaviors indicate mental illness, which is not the case in this context.

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