Nursing Elites

1. A healthcare professional is caring for a patient with bipolar disorder who is experiencing a manic episode. Which 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 with bipolar disorder may have heightened sensitivity to stimuli and may struggle with organization and decision-making. Providing a structured environment with limited stimuli can help reduce triggers and maintain a sense of control for the patient. It is essential to create a calm and predictable setting to support the individual in managing their symptoms effectively. Choice A is incorrect as group activities may overwhelm the patient due to increased stimuli. Choice C is not the most appropriate because unstructured physical activities may exacerbate the manic symptoms. Choice D is not recommended as detailed and complex tasks can be overwhelming and may contribute to increased stress and agitation in a manic episode.

2. Which of the following symptoms shouldn't a healthcare professional expect to assess in a client diagnosed with generalized anxiety disorder (GAD)?

• A. Excessive worry
• B. Muscle tension
• C. Increased energy
• D. Restlessness

Correct answer: C

Rationale: In generalized anxiety disorder (GAD), common symptoms include excessive worry, muscle tension, restlessness, and irritability. Increased energy is not typically associated with GAD; instead, clients often experience fatigue due to the persistent anxiety and worry that characterize the disorder.

3. Which client should the nurse anticipate to be most receptive to psychiatric treatment?

• A. A Jewish female journalist
• B. A Baptist homeless male
• C. A Catholic black male
• D. A Protestant Swedish business executive

Correct answer: A

Rationale: The client who is Jewish and female, a journalist, is likely to be more receptive to psychiatric treatment due to cultural factors. In Jewish culture, there is often a high value placed on preventative healthcare, including mental health. Additionally, research suggests that women are more likely than men to seek treatment for mental health issues, making this client more open to psychiatric care. Choice B, a homeless male, might face barriers to accessing and accepting psychiatric treatment due to challenges related to homelessness. Choice C, a Catholic black male, and choice D, a Protestant Swedish business executive, do not provide specific cultural or gender-related factors that would indicate higher receptiveness to psychiatric treatment than the Jewish female journalist.

4. A client is prescribed lorazepam (Ativan) for the management of anxiety. Which statement by the client indicates the need for further teaching?

• A. I should take this medication at the same time every day.
• B. I can drink alcohol while taking this medication.
• C. I should avoid driving while taking this medication.
• D. I should avoid using this medication during pregnancy.

Correct answer: B

Rationale: The correct answer is B. Clients should avoid alcohol while taking lorazepam (Ativan) due to potential interactions. Alcohol can increase the side effects of lorazepam, such as drowsiness and dizziness, which can be dangerous, especially when combined with activities like driving or operating machinery. Choice A is correct as it promotes medication adherence. Choice C is correct as lorazepam can impair cognitive and motor skills, impacting driving ability. Choice D is correct as lorazepam is not recommended during pregnancy due to potential harm to the fetus.

5. Identical twins vary in their responses to stress. One twin may become anxious and irritable, while the other may withdraw and cry. How should the nurse explain these different reactions to stress to the parents?

• A. Reactions to stress are relative rather than absolute; individual responses to stress vary.
• B. It is abnormal for identical twins to react differently to similar stressors.
• C. Identical twins should share the same temperament and respond similarly to stress.
• D. Environmental influences weigh more heavily than genetic influences on reactions to stress.

Correct answer: A

Rationale: Individual responses to stress can vary significantly due to factors such as perception, past experiences, and environmental influences, in addition to genetic factors. It is not unusual for identical twins to exhibit different reactions to stress as their individual personalities and coping mechanisms play a significant role in how they respond to stressful situations. Choice A is the correct answer because it acknowledges the variability in responses to stress among individuals. Choice B is incorrect because it wrongly labels differing reactions in identical twins as abnormal, when in reality, it is a natural phenomenon. Choice C is incorrect as it assumes that identical twins should always have the same temperament and response to stress, which is not always the case. Choice D is incorrect because it oversimplifies the complex interplay between genetic and environmental factors in shaping responses to stress.

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