Nursing Elites

1. A client on the psychiatric unit appears to imitate a certain nurse on the unit. The client seeks out this particular nurse and imitates her mannerisms. Which defense mechanism does the nurse recognize in this client?

• A. Sublimation.
• B. Identification.
• C. Introjection.
• D. Repression.

Correct answer: B

Rationale: Identification is the correct answer. It is a defense mechanism where an individual unconsciously models themselves after someone they admire or feel close to. In this scenario, the client is imitating the nurse's mannerisms, indicating identification. Sublimation involves channeling unacceptable impulses into socially acceptable activities. Introjection is the internalization of external attitudes or voices, while repression involves suppressing unwanted thoughts or desires.

2. A client with bipolar disorder is prescribed valproic acid (Depakote). What is the most important laboratory test for the LPN/LVN to monitor?

• A. Liver function tests.
• B. Kidney function tests.
• C. Thyroid function tests.
• D. Complete blood count.

Correct answer: A

Rationale: The correct answer is A: Liver function tests. Monitoring liver function tests is crucial for clients prescribed valproic acid (Depakote) due to the medication's potential to affect liver function and increase the risk of liver toxicity. While kidney function tests (choice B), thyroid function tests (choice C), and complete blood count (choice D) are important in various clinical scenarios, the priority when administering valproic acid is to monitor liver function to prevent adverse effects associated with this medication.

3. A client with bipolar disorder is experiencing a manic episode. Which nursing intervention is most appropriate?

• A. Encourage group activities to decrease isolation.
• B. Provide a structured environment with routine activities.
• C. Limit the client's physical activity to prevent exhaustion.
• D. Allow the client to choose activities freely.

Correct answer: B

Rationale: During a manic episode, individuals with bipolar disorder may exhibit excessive energy, impulsivity, and disorganized behavior. Providing a structured environment with routine activities is the most appropriate nursing intervention. This approach can help regulate the client's behavior, reduce impulsivity, and prevent engaging in potentially harmful activities. Encouraging group activities (Choice A) may exacerbate the client's symptoms due to overstimulation. Limiting physical activity (Choice C) may not address the need for structure and routine during a manic episode. Allowing the client to choose activities freely (Choice D) can lead to impulsive decision-making and may not provide the necessary boundaries required to manage the manic symptoms effectively.

4. A young adult male client, diagnosed with paranoid schizophrenia, believes that the world is trying to poison him. What intervention should the nurse include in this client's plan of care?

• A. Remind the client that his suspicions are not true.
• B. Ask one nurse to spend time with the client daily.
• C. Encourage the client to participate in group activities.
• D. Assign the client to a room closest to the activity room.

Correct answer: B

Rationale: A client with paranoid schizophrenia has difficulty with trust and developing a trusting relationship with one nurse (B) is likely to be therapeutic for this client. Choice (A) is argumentative and may increase the client's resistance. Choice (C) might be too overwhelming and anxiety-provoking for the client. Choice (D) could increase the client's stress and anxiety, which are counterproductive in managing paranoid ideations.

5. A client with bipolar disorder is started on a regimen of valproic acid (Depakote). Which laboratory test is most important for the nurse to monitor?

• A. Liver function tests
• B. Kidney function tests
• C. Blood glucose levels
• D. Serum sodium levels

Correct answer: A

Rationale: The correct answer is A: Liver function tests. Valproic acid can cause hepatotoxicity, leading to liver damage. Monitoring liver function tests is crucial to detect any early signs of liver impairment. Kidney function tests (Choice B) are not the most important to monitor in this case. Blood glucose levels (Choice C) and serum sodium levels (Choice D) are not directly affected by valproic acid and are not the priority for monitoring in a client taking this medication.

Similar Questions