Nursing Elites

1. When preparing to administer a domestic violence screening tool to a female client, which statement should the RN provide?

• A. If you are experiencing abuse from your partner, I am required to ask you these questions.
• B. It is a requirement by law for me to inquire if you are a victim of domestic violence.
• C. Your healthcare provider must be informed if you are facing any domestic abuse.
• D. All clients undergo screening for domestic abuse due to its prevalence in our society.

Correct answer: D

Rationale: The correct answer is D because screening all clients for domestic abuse as a routine part of care helps in early identification and support. Choice A is incorrect as it may imply that the questions are only asked if abuse is already suspected. Choice B is incorrect because it emphasizes the legal obligation rather than the importance of routine screening. Choice C is incorrect as it focuses on the healthcare provider's need rather than the benefit to the client of routine screening.

2. While sitting in the day room of the mental health unit, a male adolescent avoids eye contact, looks at the floor, and talks softly when interacting verbally with the RN. The two trade places, and the RN demonstrates the client's behaviors. What is the main goal of this therapeutic technique?

• A. Initiate a non-threatening conversation with the client.
• B. Dialog about the ineffectiveness of his interactions.
• C. Allow the client to identify the way he interacts.
• D. Discuss the client's feelings when he responds.

Correct answer: C

Rationale: The main goal of the therapeutic technique described is to allow the client to identify the way he interacts. This technique helps promote self-awareness in the client by mirroring his behavior back to him, which can lead to insights about his own communication style. Option A is incorrect as the goal is not just to initiate conversation but to facilitate self-reflection. Option B is incorrect because the focus is not on discussing the ineffectiveness of the interactions but on self-awareness. Option D is incorrect as the primary aim is not to discuss the client's feelings but to help him recognize his interaction patterns.

3. A male hospital employee is pushed out of the way by a female employee because of an oncoming gurney. The pushed employee becomes very angry and swings at the female employee. Both employees are referred for counseling with the staff psychiatric nurse. Which factor in the pushed employee’s history is most related to the reaction that occurred?

• A. Is worried about losing his job to a woman.
• B. Tortured animals as a child.
• C. Was physically abused by his mother.
• D. Hates to be touched by anyone.

Correct answer: C

Rationale: The correct answer is 'C: Was physically abused by his mother.' The pushed employee's aggressive reaction can be attributed to his history of physical abuse. Research suggests that individuals who have experienced physical abuse may exhibit heightened aggressive responses due to trauma and learned behavior. Choices A, B, and D are incorrect: A is a stereotype-based assumption that does not have a direct correlation with the aggressive behavior observed; B, torturing animals, is concerning behavior but not directly linked to the aggressive response in this scenario; D, hating to be touched, is not the most relevant factor considering the situation described.

4. The RN is preparing medications for a client with bipolar disorder and notices that the client discontinued antipsychotic medication for several days. Which medication should also be discontinued?

• A. Lithium (Lithotabs).
• B. Benztropine (Cogentin).
• C. Alprazolam (Xanax).
• D. Magnesium (Milk of Magnesia).

Correct answer: B

Rationale: The correct answer is Benztropine (Cogentin). Benztropine is commonly prescribed to manage side effects of antipsychotic medications. Therefore, if the antipsychotic medication is discontinued, there would be no need for Benztropine. Lithium is a mood stabilizer used in bipolar disorder, not directly related to antipsychotic use. Alprazolam is an anxiolytic, and Magnesium (Milk of Magnesia) is a laxative, neither of which is typically associated with antipsychotic medication use.

5. A client with major depressive disorder is prescribed lithium carbonate. Which finding should the RN report to the healthcare provider?

• A. Serum lithium level of 0.8 mEq/L
• B. Blood urea nitrogen (BUN) level of 16 mg/dL
• C. Serum sodium level of 138 mEq/L
• D. Urine output of 800 mL in 24 hours

Correct answer: B

Rationale: The correct answer is B. Elevated BUN levels may indicate renal impairment, which is crucial to report for clients on lithium due to its potential kidney effects. Option A, a serum lithium level of 0.8 mEq/L, is within the therapeutic range for lithium and does not require immediate reporting. Option C, a serum sodium level of 138 mEq/L, is within the normal range and not directly related to lithium therapy. Option D, urine output of 800 mL in 24 hours, may indicate a need for further assessment but is not the most critical finding to report compared to potential renal impairment indicated by an elevated BUN level.

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