Nursing Elites

1. A client is experiencing occasional feelings of sadness due to the recent death of a beloved pet. The client's appetite, sleep patterns, and daily routine have not changed. How should the nurse interpret the client's behaviors?

• A. The client's behaviors demonstrate mental illness in the form of depression.
• B. The client's behaviors are extensive, indicating the presence of mental illness.
• C. The client's behaviors are not congruent with cultural norms.
• D. The client's behaviors demonstrate no functional impairment, indicating no mental illness.

Correct answer: D

Rationale: In this scenario, the nurse should interpret the client's behaviors as not indicative of mental illness. The client is experiencing normal feelings of sadness following the loss of a pet, and the fact that the client's appetite, sleep patterns, and daily routine remain unchanged suggests no functional impairment. It is essential to recognize that experiencing occasional feelings of sadness in response to a significant life event, such as the death of a pet, does not necessarily signify mental illness, especially when there is no significant impairment in daily functioning. Choices A, B, and C are incorrect because they incorrectly suggest that the client's behaviors indicate mental illness, which is not the case in this context.

2. A client with a history of alcohol use disorder is admitted to the hospital. Which assessment finding would indicate early alcohol withdrawal?

• A. Bradycardia
• B. Hypotension
• C. Diaphoresis
• D. Hypothermia

Correct answer: C

Rationale: In a client experiencing early alcohol withdrawal, one of the key assessment findings is diaphoresis (excessive sweating). This is due to autonomic hyperactivity commonly seen during this phase, along with other signs like tremors and tachycardia. Bradycardia (slow heart rate), hypotension (low blood pressure), and hypothermia (low body temperature) are not typically associated with early alcohol withdrawal, making them incorrect choices.

3. A physically and emotionally healthy client has just been fired. During a routine office visit, he states to a nurse: 'Perhaps this was the best thing to happen. Maybe I'll look into pursuing an art degree.' How should the nurse characterize the client's appraisal of the job loss stressor?

• A. Irrelevant
• B. Harm/loss
• C. Threatening
• D. Challenging

Correct answer: D

Rationale: The client's statement indicates that he views the job loss as an opportunity for growth and a new direction in life rather than a threat or harm/loss. He sees it as a challenge and is considering it positively, demonstrating resilience and adaptability in the face of adversity. Choice A, 'Irrelevant,' is incorrect as the client's response shows relevance and a positive outlook. Choice B, 'Harm/loss,' is incorrect as the client does not express a sense of harm or loss but rather opportunity. Choice C, 'Threatening,' is incorrect as the client's response does not convey fear or threat but rather a positive reframe of the situation.

4. The healthcare provider is preparing to provide medication instruction for a patient. Which of the following understandings about anxiety will be essential to effective instruction?

• A. Learning is best when anxiety is moderate to severe.
• B. Learning is enhanced when anxiety is mild.
• C. Panic-level anxiety helps the provider teach better.
• D. Severe anxiety is characterized by intense concentration and enhances the attention span.

Correct answer: B

Rationale: Mild anxiety sharpens the senses, increases the perceptual field, and results in heightened awareness of the environment, which enhances learning. As anxiety increases, attention span decreases, making learning more difficult. Therefore, mild anxiety is more conducive to effective instruction compared to moderate to severe anxiety, panic-level anxiety, or severe anxiety. Choice A is incorrect because moderate to severe anxiety impairs learning. Choice C is incorrect as panic-level anxiety can be overwhelming and hinder the learning process. Choice D is incorrect because severe anxiety typically leads to impaired attention span rather than enhancing it.

5. When educating a client prescribed diazepam for anxiety, which statement indicates an accurate understanding of the medication?

• A. I should take this medication only when I feel anxious.
• B. I should avoid drinking alcohol while taking this medication.
• C. I should avoid driving until I know how this medication affects me.
• D. I can stop taking this medication abruptly if I feel better.

Correct answer: B

Rationale: The correct answer is B. Clients prescribed diazepam for anxiety should avoid drinking alcohol while taking this medication. Alcohol can potentiate the side effects of diazepam, such as drowsiness and dizziness, increasing the risk of harm. Choice A is incorrect because diazepam is typically taken regularly as prescribed, not just when feeling anxious. Choice C is also important but not directly related to the medication itself. Choice D is dangerous advice; stopping diazepam abruptly can lead to withdrawal symptoms and should only be done under medical supervision.

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