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. During a manic episode, which nursing intervention is most appropriate?

• A. Encourage group activities to increase socialization.
• B. Provide a structured environment with limited stimuli.
• C. Allow the patient to engage in physical activities freely.
• D. Give the patient detailed and complex tasks to complete.

Correct answer: B

Rationale: During a manic episode, individuals may experience heightened energy levels and reduced impulse control. Providing a structured environment with limited stimuli is the most appropriate nursing intervention. This approach helps reduce excessive stimulation and potential triggers for further escalation of manic behavior. It promotes a calming and controlled setting, assisting in managing symptoms and promoting the patient's well-being. Encouraging group activities (Choice A) may lead to overstimulation, allowing the patient to engage in physical activities freely (Choice C) could be risky due to impulsivity, and giving detailed tasks (Choice D) might overwhelm the individual.

3. A client diagnosed with schizophrenia is receiving discharge teaching. Which of the following instructions should the nurse exclude?

• A. Continue taking medications as prescribed
• B. Avoid all social interactions
• C. Report any side effects of medications to the healthcare provider
• D. Develop a daily routine

Correct answer: B

Rationale: The nurse should exclude the instruction to 'Avoid all social interactions' when providing discharge teaching to a client with schizophrenia. It's important for individuals with schizophrenia to continue taking medications as prescribed, report any medication side effects to the healthcare provider, and develop a daily routine to promote stability. Social interactions, albeit with appropriate boundaries, can be beneficial for the client's well-being and integration into the community.

4. During an assessment of a client with suspected substance use disorder, which of the following findings should the nurse expect? Select one that doesn't apply.

• A. Feelings of hopelessness
• B. Increased tolerance to the substance
• C. Withdrawal symptoms when not using the substance
• D. Unsuccessful attempts to cut down or control use

Correct answer: A

Rationale: In clients with substance use disorder, common findings include increased tolerance to the substance, withdrawal symptoms when not using it, and unsuccessful attempts to cut down or control use. Feelings of hopelessness are not typically a direct manifestation of substance use disorder. Instead, feelings of hopelessness may be associated with other mental health conditions or situational factors. Therefore, the correct answer is A. Choices B, C, and D are all expected findings in clients with substance use disorder.

5. A client with obsessive-compulsive disorder (OCD) is being cared for by a nurse. Which intervention should the nurse include in the plan of care?

• A. Encourage the client to suppress compulsive behaviors.
• B. Set strict limits on the amount of time the client can engage in compulsive behaviors.
• C. Allow the client to perform compulsive behaviors as needed.
• D. Gradually limit the amount of time allotted for compulsive behaviors.

Correct answer: D

Rationale: In caring for a client with OCD, it is essential to gradually limit the time allotted for compulsive behaviors. This intervention helps the client develop alternative coping mechanisms. Encouraging suppression or setting strict limits on compulsive behaviors can exacerbate the client's anxiety, making it crucial to approach the care plan with a gradual reduction strategy. Allowing the client to perform compulsive behaviors as needed does not promote progress towards managing OCD symptoms and may reinforce maladaptive patterns of behavior.

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