Nursing Elites

1. A client has been taking lithium for several years with good symptom control. The client presents in the emergency department with blurred vision, tinnitus, and severe diarrhea. Which lithium level should the nurse correlate with these symptoms?

• A. 3.7
• B. 1.7
• C. 2.6
• D. 1.3

Correct answer: B

Rationale: Symptoms such as blurred vision, tinnitus, and severe diarrhea are indicative of lithium toxicity. A lithium level of 1.7 is within the toxic range. When clients present with these symptoms, it is crucial for the nurse to correlate them with elevated lithium levels to ensure timely intervention and prevent further complications.

2. Which statement reflects an accurate understanding of the concepts of mental health and mental illness?

• A. The concepts are rigid and religiously based.
• B. The concepts are multidimensional and culturally defined.
• C. The concepts are universal and unchanging.
• D. The concepts are unidimensional and fixed.

Correct answer: B

Rationale: Understanding mental health and mental illness as multidimensional and culturally defined is essential for healthcare professionals. Mental health varies across cultures and is influenced by various dimensions such as biological, psychological, social, and spiritual factors. Recognizing these differences helps in providing culturally competent care and understanding the diverse expressions of mental health and illness. Choice A is incorrect because mental health and mental illness are not rigid or solely based on religion. Choice C is incorrect because mental health and mental illness are not universally experienced in the same way and can change over time. Choice D is incorrect because mental health and mental illness are not unidimensional; they involve various factors and are not fixed in nature.

3. Which client action is an example of the defense mechanism of displacement?

• A. A man kicks his dog after an argument with his boss.
• B. A woman yells at her children after a stressful day at work.
• C. A student immerses herself in studying to avoid thinking about a recent breakup.
• D. A person channels aggressive impulses into playing a sport.

Correct answer: B

Rationale: Displacement involves redirecting emotions, often anger or aggression, from their original source to a less threatening target. In this scenario, the woman redirects her frustration from work towards her children, who are perceived as less threatening and safer to express anger towards.

4. A client is being taught relaxation techniques to manage anxiety. Which of the following techniques should be included in the teaching? Select one that does not apply.

• A. Deep breathing exercises
• B. Progressive muscle relaxation
• C. Mindfulness meditation
• D. Cognitive restructuring

Correct answer: D

Rationale: Relaxation techniques commonly used to manage anxiety include deep breathing exercises, progressive muscle relaxation, mindfulness meditation, and guided imagery. Cognitive restructuring, on the other hand, is a cognitive-behavioral technique used to challenge and change negative thought patterns, not specifically a relaxation technique. Therefore, choice D, cognitive restructuring, does not apply to relaxation techniques for managing anxiety.

5. How do psychiatrists determine which diagnosis to give a patient?

• A. Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
• B. Hospital policy dictates how psychiatrists diagnose mental disorders.
• C. Psychiatrists assess the patient and identify diagnoses based on the patient's symptoms and contributing factors.
• D. The American Medical Association identifies 10 diagnostic labels that psychiatrists can choose from.

Correct answer: A

Rationale: Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to determine which diagnosis to give a patient. The DSM-5 is a comprehensive manual published by the American Psychiatric Association (APA) that outlines specific criteria for diagnosing mental disorders. It aims to ensure accurate and consistent diagnosis and treatment. Choices B and D provide inaccurate information. Hospital policy does not dictate psychiatric diagnoses, and the American Medical Association does not provide diagnostic labels for mental disorders. Choice C, although mentioning the assessment of patients, does not highlight the specific criteria and guidelines provided by the DSM-5 that psychiatrists use to assign diagnoses.

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