Nursing Elites

1. Within several days of hospitalization, a client is repeatedly washing the top of the same table. Which initial intervention is best for the nurse to implement to help the client cope with anxiety related to this behavior?

• A. Administer a prescribed PRN antianxiety medication.
• B. Assist the client in identifying stimuli that precipitate the ritualistic activity.
• C. Allow time for the ritualistic behavior, then redirect the client to other activities.
• D. Teach the client relaxation and thought-stopping techniques.

Correct answer: C

Rationale: Initially, the nurse should allow time for the ritualistic behavior (C) to prevent anxiety. Administering an antianxiety medication (A) may help reduce the client's anxiety temporarily but will not address the underlying issue of ineffective coping mechanisms leading to the behavior. While assisting the client in identifying triggers (B) is important for long-term therapy, the immediate focus should be on managing the behavior. Teaching relaxation and thought-stopping techniques (D) is beneficial but might be more effective once the client is more stable and receptive to learning new coping strategies.

2. An older female adult who lives in a nursing home is loudly demanding that the nurse call her son who has been deceased for five years. Which intervention should the nurse implement?

• A. Assist the client in making the phone call.
• B. Remind the client about her son's passing.
• C. Escort the client to a private area.
• D. Direct the client to a new activity.

Correct answer: D

Rationale: In this situation, the most appropriate intervention is to direct the client to a new activity. This approach can help redirect the client's attention, distract her from the distressing request, and engage her in a more positive interaction. Choice A could exacerbate the client's distress by attempting to make the impossible call, and reminding the client about her son's passing (Choice B) may increase her emotional distress. Escorting the client to a private area (Choice C) does not address the underlying issue and may not effectively manage the situation.

3. An emergency department nurse is caring for an adult client who is a victim of family violence. Which priority instruction would be included in the discharge instructions?

• A. Information regarding shelters
• B. Instructions regarding calling the police
• C. Instructions regarding self-defense classes
• D. Explaining the importance of leaving the violent situation

Correct answer: A

Rationale: The correct answer is A: Information regarding shelters. Providing information about shelters is crucial in cases of family violence as it ensures the client has a safe place to go after discharge, prioritizing their immediate safety. Option B, instructions regarding calling the police, may be necessary but ensuring a safe place to stay is more immediate. Option C, instructions regarding self-defense classes, may not be appropriate as the priority is to ensure the client's safety rather than teaching self-defense. Option D, explaining the importance of leaving the violent situation, is relevant but providing information on immediate shelter options is the priority.

4. The LPN/LVN is caring for a client who has been prescribed lithium carbonate. What is the most important instruction for the nurse to provide?

• A. Take the medication with food to avoid stomach upset.
• B. Do not change your salt intake while on this medication.
• C. Drink plenty of water and maintain a consistent salt intake.
• D. Avoid excessive intake of caffeine while on this medication.

Correct answer: B

Rationale: The most important instruction for a client prescribed lithium carbonate is not to change their salt intake. Alterations in sodium levels can impact lithium levels, leading to an increased risk of toxicity. Choice A is not crucial for lithium carbonate administration. While hydration is essential, maintaining a consistent salt intake is more critical than just increasing water intake (Choice C). Although caffeine can interact with lithium, it is not as important as maintaining a consistent salt intake (Choice D).

5. The occupational health nurse is working with a female employee who was just notified that her child was involved in a 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 happen.
• 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: Providing immediate practical support, such as arranging transportation to the hospital, is the best response in this crisis situation. It helps the employee to take immediate action and supports her in a highly stressful moment. Choice A focuses on the employee's thoughts rather than providing immediate aid. Choice B is not a priority as the severity can be addressed later. Choice C puts the decision-making burden on the employee at a time of distress, which is not ideal. Therefore, choice D is the most appropriate response in this situation.

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