Nursing Elites

1. A client is experiencing alcohol withdrawal. Which intervention should be included in the plan of care?

• A. Administer benzodiazepines as prescribed.
• B. Monitor the client's vital signs every 4 hours.
• C. Provide a high-protein diet.
• D. Encourage the client to drink plenty of fluids.

Correct answer: A

Rationale: Administering benzodiazepines as prescribed is a crucial intervention in managing alcohol withdrawal. Benzodiazepines help alleviate symptoms such as anxiety, agitation, and seizures commonly seen in alcohol withdrawal. Monitoring vital signs is important to assess the client's physiological stability, but addressing the withdrawal symptoms with benzodiazepines is a priority to prevent severe complications. Providing a high-protein diet and encouraging fluid intake are important for overall health but do not directly manage alcohol withdrawal symptoms.

2. 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.

3. A nurse is caring for a client who has been diagnosed with schizoaffective disorder. The client states, 'I am the president of the United States.' Which of the following responses should the nurse make?

• A. You are not the president. You are a client in the hospital.
• B. Tell me more about being the president.
• C. Why do you think you are the president?
• D. Let's talk about something else.

Correct answer: C

Rationale: The nurse should avoid challenging the client's delusions directly. Asking for more information can help the nurse understand the client's experience and build rapport.

4. A distraught, single, first-time mother cries and asks a nurse, 'How can I go to work if I can't afford childcare?' What is the nurse's initial action in assisting the client with the problem-solving process?

• A. Determine the risks and benefits for each alternative.
• B. Formulate goals for resolution of the problem.
• C. Evaluate the outcome of the implemented alternative.
• D. Assess the facts of the situation.

Correct answer: D

Rationale: In this scenario, the nurse's initial step should be to assess the facts of the situation. By gathering accurate information about the client's circumstances, the nurse can better understand the problem and make informed decisions moving forward. This foundational assessment is crucial before proceeding to formulate goals, evaluate outcomes, or consider risks and benefits. Options A, B, and C involve steps that should follow the initial assessment of the situation, making them less suitable as the initial action in this context.

5. A client with bipolar disorder is experiencing a depressive episode. Which of the following interventions should the nurse implement? Select one that does not apply.

• A. Encourage participation in activities
• B. Promote adequate nutrition and hydration
• C. Monitor for suicidal ideation
• D. Discourage verbalization of feelings

Correct answer: D

Rationale: Interventions for a client with bipolar disorder experiencing a depressive episode include encouraging participation in activities, promoting adequate nutrition and hydration, monitoring for suicidal ideation, and providing a structured daily schedule. Discussing feelings is an essential part of therapy for clients with bipolar disorder, thus discouraging verbalization of feelings is not therapeutic and should not be implemented. Choice D is incorrect because it goes against the principles of therapeutic communication and emotional expression, which are crucial in managing bipolar disorder.

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