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. When an individual uses the defense mechanism of displacement after the boss openly disagrees with suggestions, what behavior would be expected from this individual?

• A. The individual assertively confronts the boss
• B. The individual leaves the staff meeting to work out in the gym
• C. The individual criticizes a coworker
• D. The individual takes the boss out to lunch

Correct answer: C

Rationale: The correct answer is C. The individual using the defense mechanism of displacement would criticize a coworker after being confronted by the boss. Displacement involves transferring feelings from one target to a neutral or less-threatening target, hence the individual criticizing a coworker instead of directly confronting the boss. Choices A, B, and D are incorrect. Choice A is incorrect because the individual is not likely to assertively confront the boss when using displacement. Choice B is incorrect as leaving the meeting to work out in the gym is not a typical response when displacement is used. Choice D is incorrect as taking the boss out to lunch does not align with the concept of displacement, which involves redirecting emotions onto another target.

3. A client has been taking lithium for several years with good symptom control. The client presents in the emergency department with blurred vision, tinnitus, and severe diarrhea. Which lithium level should the nurse correlate with these symptoms?

• A. 3.7
• B. 1.7
• C. 2.6
• D. 1.3

Correct answer: B

Rationale: Symptoms such as blurred vision, tinnitus, and severe diarrhea are indicative of lithium toxicity. A lithium level of 1.7 is within the toxic range. When clients present with these symptoms, it is crucial for the nurse to correlate them with elevated lithium levels to ensure timely intervention and prevent further complications.

4. A client with major depressive disorder is prescribed an antidepressant. Which of the following instructions should the nurse exclude from the teaching?

• A. It may take several weeks for the medication to take effect
• B. Avoid alcohol while taking this medication
• C. Discourage the client from washing her hands
• D. You may experience an increase in energy before your mood improves

Correct answer: C

Rationale: The nurse should not include the instruction to discourage the client from washing her hands in the teaching for a client prescribed an antidepressant. This instruction is not relevant to the medication regimen. Instead, the nurse should educate the client that it may take several weeks for the medication to take effect, to avoid alcohol, not to discontinue the medication abruptly, and that there may be an increase in energy before mood improves. Regular blood tests are not typically required for most antidepressants.

5. A client has a history of excessive drinking, which has led to multiple arrests for driving under the influence (DUI). The client states, 'I work hard to provide for my family. I don't see why I can't drink to relax.' The nurse recognizes the use of which defense mechanism?

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

Correct answer: B

Rationale: The correct answer is Rationalization. The client is using rationalization as a defense mechanism by justifying their excessive drinking as a way to relax due to working hard to provide for their family. Rationalization involves creating logical excuses to justify unacceptable feelings or behaviors. Projection involves attributing one's unacceptable feelings or thoughts to others. Regression is reverting to an earlier stage of development in the face of unacceptable thoughts or impulses. Sublimation is the channeling of unacceptable impulses into socially acceptable activities.

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