Nursing Elites

1. A healthcare professional is caring for a group of clients. Which of the following clients should the healthcare professional consider for referral to an assertive community treatment (ACT) group?

• A. A client in an acute care mental health facility who has fallen several times while running down the hallway
• B. A client who lives at home and keeps forgetting to come in for a scheduled monthly antipsychotic injection for schizophrenia
• C. A client in a day treatment program who reports increasing anxiety during group therapy
• D. A client in a weekly grief support group who reports still missing a deceased partner who has been dead for 3 months

Correct answer: B

Rationale: The client who lives at home and repeatedly forgets to come in for a scheduled monthly antipsychotic injection for schizophrenia should be considered for referral to an assertive community treatment (ACT) group. ACT teams provide intensive community-based treatment and support for individuals with severe mental illness who may have difficulty adhering to treatment on their own. Choices A, C, and D do not describe individuals with severe mental illness who have difficulty adhering to treatment or need intensive community-based support, which are the typical candidates for referral to an ACT group.

2. What is the priority nursing intervention for a patient experiencing a panic attack?

• A. Encouraging the patient to focus on deep breathing exercises.
• B. Encouraging the patient to avoid any physical activity.
• C. Asking the patient to describe their feelings in detail.
• D. Providing the patient with detailed information about panic attacks.

Correct answer: A

Rationale: The priority nursing intervention for a patient experiencing a panic attack is to encourage them to focus on deep breathing exercises. This intervention helps the patient manage the physiological symptoms of a panic attack by promoting relaxation and reducing hyperventilation, which are common during such episodes. Deep breathing exercises can help regulate breathing patterns and alleviate feelings of anxiety and panic.

3. What must be considered when preparing the teaching plan for a patient diagnosed with bipolar disorder who is being prescribed lithium therapy?

• A. Caffeine and alcohol can affect lithium levels.
• B. Lithium should be taken with meals to avoid gastrointestinal distress.
• C. Regular blood tests are required to monitor lithium levels.
• D. Lithium can cause weight gain.

Correct answer: C

Rationale: When preparing a teaching plan for a patient prescribed lithium therapy for bipolar disorder, it is crucial to emphasize the need for regular blood tests to monitor lithium levels. Monitoring levels is essential to ensure the drug's effectiveness and to manage potential side effects. While factors like caffeine and alcohol intake, taking lithium with meals, and the risk of weight gain may be relevant considerations, the primary focus should be on the necessity of regular blood tests for effective management of lithium therapy. Therefore, option C is the correct choice as it addresses a critical aspect of lithium therapy management.

4. What principle should guide a nurse's fear about 'saying the wrong thing' to a patient in nurse-patient communication?

• A. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation.
• B. The patient is more interested in talking to you than listening to what you have to say and is not likely to be offended.
• C. Considering the patient's history, there is little chance that the comment will do any actual harm.
• D. Most people with a mental illness have, by necessity, developed a high tolerance for forgiveness.

Correct answer: A

Rationale: Effective nurse-patient communication is guided by the principle that patients value sincere and respectful interactions. A nurse's well-meaning approach that conveys acceptance, respect, and concern helps establish trust and rapport with patients, even if the nurse is apprehensive about making mistakes. It is essential for the nurse to focus on genuine intent and respect for the patient's situation rather than being consumed by the fear of saying something wrong.

5. What is the most appropriate intervention for a patient experiencing a panic attack?

• A. Encourage the patient to talk about their feelings.
• B. Provide a quiet and non-stimulating environment.
• C. Administer prescribed medication immediately.
• D. Teach the patient relaxation techniques.

Correct answer: B

Rationale: During a panic attack, it is crucial to provide a quiet and non-stimulating environment to help the patient feel safe and reduce sensory overload. This approach can help the patient focus on calming down and regaining control. Encouraging the patient to talk about their feelings may exacerbate the panic attack by increasing stress and arousal levels. Administering medication should be done following healthcare provider's orders, as it may not be appropriate to give medication immediately without proper assessment. Teaching relaxation techniques might not be effective during the acute phase of a panic attack when the individual is overwhelmed by intense anxiety.

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