Nursing Elites

1. Substance abuse is often present in individuals diagnosed with bipolar disorder. Laura, a 28-year-old with a bipolar disorder diagnosis, chooses to drink alcohol instead of taking her prescribed medications. The nurse caring for this patient recognizes that:

• A. Anxiety may be present.
• B. Alcohol ingestion is a form of self-medication.
• C. The patient is lacking a sufficient number of neurotransmitters.
• D. The patient is using alcohol as a coping mechanism.

Correct answer: B

Rationale: Individuals with bipolar disorder may turn to alcohol as a form of self-medication to cope with their symptoms. This behavior is often seen as an attempt to manage mood swings and alleviate distress. It is important for healthcare providers to address and manage substance abuse issues in patients with bipolar disorder to ensure proper treatment and overall well-being.

2. What principle about patient-nurse communication should guide a nurse's fear of saying the wrong thing to a patient?

• A. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation.
• B. Patients are more interested in conversing with you than in hearing your perspective, making offense unlikely.
• C. Considering the patient's background, the likelihood of the comment causing harm is minimal.
• D. Individuals with mental illness often possess a heightened capacity for forgiveness.

Correct answer: A

Rationale: The correct answer is A. Patients value interactions with healthcare providers who express genuine acceptance, respect, and concern for their well-being. By focusing on conveying these qualities, a nurse can help alleviate fears of saying the wrong thing as patients appreciate the sincerity and empathy in the communication. This approach fosters trust and a positive therapeutic relationship, enhancing the effectiveness of patient-nurse communication.

3. Which mood stabilizer is commonly prescribed for bipolar disorder?

• A. Sertraline
• B. Lithium
• C. Clozapine
• D. Haloperidol

Correct answer: B

Rationale: Lithium is a well-established mood stabilizer commonly prescribed for the treatment of bipolar disorder. It helps to control manic episodes, stabilize mood swings, and reduce the risk of relapse in individuals with this condition. Sertraline is an antidepressant commonly used for treating depression, while Clozapine and Haloperidol are antipsychotic medications used for different psychiatric conditions. Therefore, the correct answer is B because it is specifically indicated and effective for bipolar disorder.

4. 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 nurse should recognize that the client is using rationalization, a common defense mechanism. Rationalization involves creating logical reasons to justify unacceptable feelings or behaviors. In this scenario, the client is justifying excessive drinking by linking it to hard work and the need for relaxation, masking the true underlying issue of alcohol abuse. Projection involves attributing one's thoughts or feelings to others, regression involves reverting to an earlier stage of development, and sublimation involves channeling unacceptable impulses into socially acceptable activities, none of which are demonstrated in the client's statement.

5. A 10-year-old boy breaks his mother's vase while playing. When the mother asks who broke the vase, the little boy says that his sister did it. The little boy is exhibiting which defense mechanism?

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

Correct answer: A

Rationale: Projection is a defense mechanism where one attributes their own unacceptable thoughts, feelings, or impulses onto another person. In this scenario, the little boy is projecting his actions onto his sister by falsely claiming she broke the vase. Displacement involves transferring emotions from the original source to a substitute target. Dissociation is a disconnection between thoughts, identity, consciousness, and memory. Sublimation is the redirection of unacceptable impulses into socially acceptable activities.

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