Nursing Elites

1. A client who has recently been diagnosed with schizophrenia tells the LPN/LVN, 'I hear voices telling me to hurt myself.' What is the most appropriate nursing action?

• A. Encourage the client to ignore the voices.
• B. Tell the client that the voices will go away with medication.
• C. Monitor the client for signs of self-harm.
• D. Refer the client for a psychiatric evaluation.

Correct answer: D

Rationale: The correct answer is to refer the client for a psychiatric evaluation. The client's statement indicating hearing voices telling them to hurt themselves is a serious concern and suggests a risk for self-harm. Referring the client for a psychiatric evaluation is crucial for further assessment and intervention by mental health professionals. Choice A is incorrect because ignoring the voices may not address the client's safety. Choice B is incorrect as it oversimplifies the situation and does not address the immediate risk. Choice C is not as comprehensive as referring for a psychiatric evaluation, which is necessary in this situation.

2. 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.

3. What is the most important goal of care for a client diagnosed with generalized anxiety disorder (GAD) who has been taking the benzodiazepine alprazolam (Xanax) long-term? The client will:

• A. Describe a decrease in anxiety using a 1 to 10 anxiety scale.
• B. State the importance of not abruptly stopping the medication.
• C. Not experience dizziness, lightheadedness, or sedation.
• D. Attend scheduled individual and group therapy sessions.

Correct answer: B

Rationale: The correct answer is B. The most important goal of care for a client with generalized anxiety disorder (GAD) taking alprazolam long-term is to ensure they understand the importance of not abruptly stopping the medication. Abruptly stopping benzodiazepines can lead to withdrawal symptoms and potential complications. Choice A is not the most critical goal as the focus should be on the safe continuation of the medication. Choice C is important but not as crucial as preventing abrupt discontinuation. Choice D is beneficial for overall treatment but not the most important goal in this scenario.

4. A client with an eating disorder is planning to attend group meetings with Overeaters Anonymous. The LPN/LVN describes this group to the client, knowing that which finding(s) are characteristic of this form of self-help group? Select one that does not apply.

• A. A common goal is shared by all members
• B. Members are required to remain anonymous
• C. The leader is a professional mental health care provider
• D. Attendance must be prescribed by the health care provider

Correct answer: A

Rationale: Overeaters Anonymous is a self-help group characterized by shared goals among members to address eating disorders. This provides a supportive environment for personal change and growth. Choice B is incorrect as members are not required to remain anonymous in Overeaters Anonymous. Choice C is incorrect as the leader in such self-help groups is usually a member who has experienced similar issues, not necessarily a professional mental health care provider. Choice D is incorrect as attendance at Overeaters Anonymous meetings is voluntary and not prescribed by a healthcare provider.

5. A client with schizophrenia is prescribed olanzapine (Zyprexa). What is the most important side effect for the nurse to monitor?

• A. Hypotension
• B. Weight gain
• C. Dry mouth
• D. Tachycardia

Correct answer: B

Rationale: The correct answer is B: Weight gain. Olanzapine (Zyprexa) is known to cause significant weight gain in patients. This side effect is crucial to monitor because it can lead to metabolic syndrome, diabetes, and cardiovascular issues. Monitoring the client's weight regularly and providing appropriate dietary guidance is essential. Hypotension (choice A), dry mouth (choice C), and tachycardia (choice D) are not commonly associated with olanzapine use and are not the primary side effects to monitor in this case.

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