Nursing Elites

1. A client diagnosed with bipolar disorder is experiencing a manic episode. Which of the following actions should the nurse take first?

• A. Encourage the client to participate in group therapy.
• B. Place the client in a private room to decrease stimulation.
• C. Encourage the client to participate in physical activity.
• D. Administer a prescribed sedative.

Correct answer: B

Rationale: During a manic episode, individuals with bipolar disorder may be easily overstimulated. Placing the client in a private room to decrease environmental stimuli is the priority intervention. This action can help reduce the risk of exacerbating manic symptoms and promote a calmer environment for the client. Choice A is not the priority as group therapy may be overwhelming during a manic episode. Choice C could potentially increase stimulation rather than decrease it. Choice D should not be the first action as sedatives are generally not the initial intervention for managing manic episodes.

2. Which of the following statements should a healthcare provider recognize as true about defense mechanisms? Select all that apply.

• A. They are employed when there is a threat to biological or psychological integrity.
• B. They are controlled by the id and deal with primal urges.
• C. They are used in an effort to increase anxiety.
• D. They are protective devices for the superego.

Correct answer: A

Rationale: Defense mechanisms are employed by the ego, not the id or superego, in response to threats to biological or psychological integrity. They aim to relieve anxiety, not increase it. By redirecting focus, they help manage mild to moderate anxiety and are often self-deceptive in nature.

3. In pediatric mental health, there is a lack of sufficient numbers of community-based resources and providers, and there are long waiting lists for services. This has resulted in: Select one that doesn't apply.

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

Correct answer: C

Rationale: The lack of resources in pediatric mental health leads to underserved populations, increased stress in the family unit, and premature termination of services. However, markedly increased funding does not align with the negative consequences of resource shortages; instead, it would be a potential solution to address the lack of resources and providers in pediatric mental health.

4. A client with borderline personality disorder exhibits self-mutilating behavior. Which nursing intervention should the nurse implement to address this behavior?

• A. Encourage the client to discuss underlying issues.
• B. Set firm limits on the client's behavior.
• C. Provide a safe environment to prevent self-harm.
• D. Discuss the consequences of self-mutilating behavior.

Correct answer: C

Rationale: The correct intervention when dealing with a client exhibiting self-mutilating behavior, especially with borderline personality disorder, is to provide a safe environment to prevent self-harm. This approach is crucial in ensuring the client's physical safety and well-being. Setting firm limits may be appropriate in some situations, but the immediate priority is to prevent self-harm. Encouraging the client to discuss underlying issues and discussing consequences are important aspects of therapy; however, in the case of acute self-mutilating behavior, the primary focus should be on creating a safe environment to prevent harm.

5. A healthcare professional is assessing a client who appears to be experiencing moderate anxiety during questioning. Which symptom shouldn't the healthcare professional expect?

• A. Fidgeting
• B. Laughing inappropriately
• C. Palpitations
• D. Nail biting

Correct answer: C

Rationale: Palpitations are not typically associated with moderate anxiety. Fidgeting, laughing inappropriately, and nail biting are common behavioral symptoms of heightened stress levels. Palpitations may be more indicative of physiological responses, such as increased heart rate, which can occur in severe anxiety or panic attacks. Other signs of severe anxiety include restlessness, difficulty concentrating, muscle tension, and sleep disturbances.

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