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. Pablo is a homeless adult who has no family connection. Pablo passed out on the street, and emergency medical services took him to the hospital where he expresses a wish to die. The physician recognizes evidence of substance use problems and mental health issues and recommends inpatient treatment for Pablo. What is the rationale for this treatment choice? Select one that doesn't apply.

• A. Intermittent supervision is available in inpatient settings.
• B. He requires stabilization of multiple symptoms.
• C. How do you feel about talking to a mental health counselor?
• D. Medication adherence will be mandated.

Correct answer: D

Rationale: The correct answer is D because medication adherence being mandated is not a primary rationale for inpatient treatment. The main reasons for recommending inpatient treatment in this scenario include the need for stabilization of multiple symptoms, addressing nutritional and self-care needs, and ensuring safety due to the imminent danger of self-harm. Inpatient settings provide a more intensive level of care and supervision to address these complex issues effectively.

3. Which statement about the concept of neuroses is most accurate?

• A. An individual experiencing neurosis is unaware of the distress they are experiencing.
• B. An individual experiencing neurosis feels helpless to change their situation.
• C. An individual experiencing neurosis is aware of psychological causes of their behavior.
• D. An individual experiencing neurosis has a loss of contact with reality.

Correct answer: B

Rationale: Neurosis involves feelings of distress and anxiety, but individuals experiencing neurosis are usually aware of their distress and its causes. They may recognize that their behaviors are maladaptive and are generally in contact with reality. The accurate statement about neurosis is that an individual feels helpless to change their situation. Choice A is incorrect because individuals with neurosis are usually aware of their distress. Choice C is incorrect because while individuals may be aware of psychological causes, it is not the defining characteristic of neurosis. Choice D is incorrect because a loss of contact with reality is more characteristic of psychosis, not neurosis.

4. Luc's family comes home one evening to find him extremely agitated, and they suspect he is in a full manic episode. The family calls emergency medical services. While one medic is talking with Luc and his family, the other medic is counting something on his desk. What is the medic most likely counting?

• A. Hypodermic needles
• B. Fast food wrappers
• C. Empty soda cans
• D. Energy drink containers

Correct answer: D

Rationale: Energy drink containers are often associated with exacerbating manic episodes due to their high caffeine content, which can worsen symptoms of agitation and restlessness.

5. A woman was abducted and raped at gunpoint by an unknown assailant. When found, she was confused and disoriented. The nurse makes the following observations about the client. She is talking rapidly in disjointed phrases, is unable to concentrate, and is indecisive when asked to make simple decisions. The client's level of anxiety can be assessed as

• A. moderate
• B. severe
• C. mild
• D. nonexistent

Correct answer: B

Rationale: The client's presentation, including rapid and disjointed speech, inability to concentrate, and indecisiveness, are indicative of severe anxiety. These symptoms suggest a high level of distress and impairment in cognitive functioning, which aligns with severe anxiety rather than mild or moderate levels. The traumatic experience of being abducted and raped at gunpoint would likely contribute to such a severe level of anxiety.

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