Nursing Elites

1. The occupational health nurse is working with a female employee who was just notified that her child was involved in a motor vehicle accident (MVA) and taken to the hospital. The employee states, “I can’t believe this. What should I do?” Which response is best for the nurse to provide in this crisis?

• A. Tell me what you think should be done.
• B. How serious was the collision?
• C. What do you think you should do?
• D. Call for transportation to the hospital.

Correct answer: D

Rationale: In a crisis situation where the female employee's child is involved in a motor vehicle accident (MVA) and taken to the hospital, the most appropriate response for the nurse is to provide immediate practical assistance. Calling for transportation to the hospital ensures that the employee can quickly reach her child in need of urgent medical attention. The other options (A, B, and C) do not address the immediate need for assistance and may not provide the necessary support required in such a critical situation.

2. During an exacerbation of schizophrenia symptoms, which intervention should the nurse prioritize for a client with a history of schizophrenia?

• A. Encourage adherence to the medication regimen.
• B. Increase social interactions with peers.
• C. Provide a high-stimulation environment.
• D. Assess for safety risks related to the exacerbation.

Correct answer: D

Rationale: During an exacerbation of schizophrenia symptoms, the nurse should prioritize assessing for safety risks. This is critical because individuals with schizophrenia may experience heightened risks to themselves or others during this period. Encouraging adherence to the medication regimen (Choice A) is important but ensuring immediate safety takes precedence. Increasing social interactions with peers (Choice B) and providing a high-stimulation environment (Choice C) can potentially exacerbate symptoms and should be avoided during an exacerbation.

3. What assessment question will provide healthcare providers with information regarding the effects of a woman's circadian rhythms on her quality of life?

• A. How much sleep do you usually get each night?
• B. Does your heart ever seem to skip a beat?
• C. When was the last time you had a fever?
• D. Do you have problems urinating?

Correct answer: A

Rationale: Asking about the amount of sleep a woman gets each night is crucial in understanding her circadian rhythms and how they may affect her quality of life. Circadian rhythms are the body's internal clock that regulates the sleep-wake cycle. Monitoring sleep patterns can provide insights into how well these rhythms are functioning and impacting daily life. Choices B, C, and D are unrelated to circadian rhythms and do not directly assess the effects of these rhythms on quality of life.

4. A client with postpartum depression receives a prescription for sertraline (Zoloft). What information is most important to include in client teaching?

• A. Avoid foods high in tyramine, such as processed meats, red wine, and Swiss cheese.
• B. Contact the healthcare provider immediately if suicidal thoughts occur.
• C. Increase activity level to include regular exercise.
• D. Contact the healthcare provider immediately if muscle stiffness occurs.

Correct answer: B

Rationale: The most critical information to include in client teaching for a client with postpartum depression starting sertraline (Zoloft) is to contact the healthcare provider immediately if suicidal thoughts occur. This is vital for the client's safety as antidepressants, including sertraline, can sometimes increase the risk of suicidal thoughts, especially at the start of treatment. Choices A, C, and D are not the most crucial information in this scenario. Choice A about avoiding foods high in tyramine is not directly related to sertraline use. Choice C about increasing activity level is important but not as critical as addressing suicidal ideation. Choice D about muscle stiffness is a potential side effect of sertraline but is not as urgent as monitoring for suicidal thoughts.

5. A client who is being treated with lithium carbonate for bipolar disorder develops diarrhea, vomiting, and drowsiness. What action should the nurse take?

• A. Notify the healthcare provider immediately and prepare for administration of an antidote.
• B. Hold the medication and refrain from administering additional amounts of the drug.
• C. Record the symptoms as potential signs of lithium toxicity and hold further medication.
• D. Notify the healthcare provider of the symptoms for evaluation before the next administration of the drug.

Correct answer: A

Rationale: Diarrhea, vomiting, and drowsiness in a client being treated with lithium carbonate for bipolar disorder may indicate lithium toxicity. The nurse should promptly notify the healthcare provider to ensure immediate medical intervention. The correct action is to prepare for the administration of an antidote if necessary. Holding the medication (Choice B) without immediate intervention could delay necessary treatment. Recording the symptoms as potential signs of lithium toxicity (Choice C) is more appropriate than considering them as normal side effects but does not emphasize the urgency of immediate action. Notifying the healthcare provider before the next administration of the drug (Choice D) may delay urgent intervention required for lithium toxicity.

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