Nursing Elites

1. Which is an example of the ego defense mechanism of regression?

• A. A mother blames the teacher for her child's failure in school.
• B. A teenager becomes hysterical after seeing a friend killed in a car accident.
• C. A woman wants to marry a man exactly like her beloved father.
• D. An adult throws a temper tantrum when he does not get his own way.

Correct answer: D

Rationale: The correct answer is D. Regression involves reverting to an earlier stage of development for comfort. In this case, an adult throwing a temper tantrum is regressing to a childlike behavior when faced with not getting their way, which is a form of seeking comfort associated with earlier development. Choices A, B, and C do not exemplify regression. Blaming the teacher, becoming hysterical after a traumatic event, or seeking a partner similar to a beloved father are not instances of reverting to earlier developmental stages to cope with stress or conflict.

2. A client diagnosed with bipolar disorder is experiencing a manic episode. Which of the following actions should the nurse take first?

• A. Encourage the client to participate in group therapy.
• B. Place the client in a private room to decrease stimulation.
• C. Encourage the client to participate in physical activity.
• D. Administer a prescribed sedative.

Correct answer: B

Rationale: During a manic episode, individuals with bipolar disorder may be easily overstimulated. Placing the client in a private room to decrease environmental stimuli is the priority intervention. This action can help reduce the risk of exacerbating manic symptoms and promote a calmer environment for the client. Choice A is not the priority as group therapy may be overwhelming during a manic episode. Choice C could potentially increase stimulation rather than decrease it. Choice D should not be the first action as sedatives are generally not the initial intervention for managing manic episodes.

3. Which of the following are common symptoms of schizophrenia? Select one that does not apply.

• A. Delusions
• B. Hallucinations
• C. Organized speech
• D. Catatonia

Correct answer: C

Rationale: Common symptoms of schizophrenia include delusions, hallucinations, disorganized speech, and catatonia. Organized speech is not a typical symptom of schizophrenia. In schizophrenia, individuals often exhibit disorganized or incoherent speech patterns, rather than organized speech. Euphoria is not typically associated with schizophrenia, making it an incorrect choice.

4. During a treatment team meeting, the point is made that a client with schizophrenia has recovered from the acute psychosis but continues to demonstrate apathy, avolition, and blunted affect. The nurse who relates these symptoms to serotonin excess will suggest that the client receive?

• A. Chlorpromazine
• B. Phenelzine
• C. Haloperidol
• D. Olanzapine

Correct answer: D

Rationale: In this scenario, the symptoms of apathy, avolition, and blunted affect are indicative of negative symptoms commonly seen in schizophrenia. These symptoms are often associated with dopamine and serotonin imbalances in the brain. Olanzapine, an atypical antipsychotic, is known for its efficacy in treating both positive and negative symptoms of schizophrenia. It acts by blocking serotonin and dopamine receptors, helping to alleviate the symptoms mentioned. Chlorpromazine and Haloperidol are typical antipsychotics that primarily target dopamine receptors, while Phenelzine is an MAOI used to treat depression and anxiety disorders, not schizophrenia. Therefore, the most appropriate choice for this client displaying these symptoms related to serotonin excess would be Olanzapine.

5. A client with bipolar disorder is in the manic phase. Which nursing intervention should the nurse implement to ensure the client's safety?

• A. Provide a structured environment with minimal stimuli.
• B. Encourage the client to participate in group activities.
• C. Monitor the client closely for signs of exhaustion.
• D. Encourage the client to rest and sleep as needed.

Correct answer: A

Rationale: During the manic phase of bipolar disorder, individuals may engage in impulsive behaviors that can put them at risk of harm. Providing a structured environment with minimal stimuli can help reduce the risk of injury by minimizing triggers for impulsive actions. This intervention promotes a safe and controlled setting for the client, which is crucial in managing the symptoms of mania. Encouraging the client to participate in group activities (Choice B) may increase stimuli and potentially exacerbate manic symptoms. Monitoring for signs of exhaustion (Choice C) is important but does not directly address the safety concerns related to impulsive behaviors during mania. Encouraging the client to rest and sleep as needed (Choice D) may be challenging during the manic phase when individuals typically experience decreased need for sleep.

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