Nursing Elites

1. A client with a recent diagnosis of bipolar disorder is attending a support group for the first time. Which statement made by the client indicates a need for further education about the disorder?

• A. “I will make sure to take my medications every day.”
• B. “I will avoid high-stress situations whenever possible.”
• C. “I know I can stop my medications when I am feeling better.”
• D. “I should monitor my mood changes closely.”

Correct answer: C

Rationale: The correct answer is C because it shows a misconception about bipolar disorder treatment. Stopping medications when feeling better can lead to a relapse or worsening of symptoms. Choice A is correct because medication adherence is crucial in managing bipolar disorder. Choice B is also a good strategy as stress management is important in symptom control. Choice D is a proactive approach to self-awareness and can help in recognizing early signs of mood changes.

2. In pediatric mental health, there is a lack of sufficient numbers of community-based resources and providers, resulting in long waiting lists for services. This has resulted in:

• A. Children of color and those in poor economic conditions being underserved
• B. Increased stress in the family unit
• C. Markedly increased funding
• D. Premature termination of services

Correct answer: D

Rationale: The correct answer is D, 'Premature termination of services.' The lack of sufficient numbers of community-based resources and providers, along with long waiting lists, can lead to premature termination of services for children in need of mental health support. Choice A, 'Children of color and those in poor economic conditions being underserved,' is not directly related to the consequence mentioned in the question. Choice B, 'Increased stress in the family unit,' while a potential consequence, is not explicitly stated in the question as a direct result of the lack of resources. Choice C, 'Markedly increased funding,' is not a consequence but rather a potential solution to address the lack of resources.

3. A client with a history of bipolar disorder is stabilized on a mood stabilizer and has been prescribed lamotrigine (Lamictal). Which outcome indicates that the medication is effective?

• A. Decrease in manic episodes.
• B. Improvement in depressive symptoms.
• C. Reduction in anxiety symptoms.
• D. Increased sleep duration.

Correct answer: B

Rationale: The correct answer is B: Improvement in depressive symptoms. Lamotrigine is commonly used as a mood stabilizer and is particularly effective in managing depressive symptoms in bipolar disorder. While it may also help with preventing manic episodes, its primary indication is for treating depressive symptoms. Choices A, C, and D are incorrect because lamotrigine is not specifically indicated for reducing manic episodes, anxiety symptoms, or increasing sleep duration in bipolar disorder.

4. A client with depression and a history of a recent suicide attempt is being discharged from the hospital. Which statement by the client indicates a need for further follow-up?

• A. “I will take my medication as prescribed.”
• B. “I have a plan to attend weekly therapy sessions.”
• C. “I feel that I am completely recovered now.”
• D. “I will avoid people who make me feel worse.”

Correct answer: C

Rationale: The correct answer is C. When a client with depression and a history of a recent suicide attempt states, “I feel that I am completely recovered now,” it indicates a need for further follow-up. This statement suggests a potential lack of insight into the ongoing nature of depression and may lead to discontinuation of necessary treatment and support. Choices A, B, and D demonstrate positive and proactive attitudes towards managing depression and suicidal ideation, indicating a willingness to engage in treatment, therapy, and self-care practices.

5. During an annual physical at a corporate clinic, a male employee tells the nurse that his high-stress job is causing trouble in his personal life. He further explains that he often gets so angry while driving to and from work that he has considered “getting even” with other drivers. How should the nurse respond?

• A. “Anger is contagious and could result in a major confrontation.”
• B. “Try not to let your anger cause you to act impulsively.”
• C. “Expressing your anger to a stranger could result in an unsafe situation.”
• D. “It sounds as if there are many situations that make you feel angry.”

Correct answer: B

Rationale: The correct response is to encourage the client to manage their anger and avoid impulsive actions, as stated in choice B. This approach helps the individual recognize the potential consequences of acting on their anger impulsively. Choice A is not the best response because it focuses on the contagious nature of anger rather than addressing the individual's behavior. Choice C is incorrect as it only highlights the potential dangers of expressing anger to a stranger without providing guidance on managing the underlying issue. Choice D acknowledges the client's feelings but does not offer practical advice on how to address the anger and potential impulsive actions.

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