Nursing Elites

1. An anxious client expressing a fear of people and open places is admitted to the psychiatric unit. What is the most effective way for the nurse to assist this client?

• A. Plan an outing within the second week of admission.
• B. Distract the client whenever they express discomfort about being with others.
• C. Confront the client's fears and discuss the possible causes of these fears.
• D. Accompany the client outside for an increasing amount of time each day.

Correct answer: D

Rationale: The most effective way to assist a client with a fear of people and open places is through gradual desensitization by controlled exposure to the situation which is feared (D). This method helps the client confront their fears in a safe and supportive manner, allowing them to gradually build confidence and reduce anxiety. Planning an outing within the second week of admission (A) may be too soon and overwhelming for the client. Distracting the client whenever they express discomfort (B) does not address the underlying issue and may promote denial. Confronting the client's fears and discussing possible causes (C) could be too aggressive initially and may not be well-tolerated by the client.

2. During initial assessment of the teenager, what information is most important for the nurse to obtain from the parents?

• A. If he has seemed depressed recently.
• B. If a drug overdose has ever occurred before.
• C. If he might have taken any other drugs.
• D. If he has a desire to quit taking drugs.

Correct answer: C

Rationale: The correct answer is C. It's crucial to determine if the teenager might have taken other substances besides the pain pills mentioned by the mother. This information is vital for effective treatment because knowing the full scope of substances involved helps in managing potential interactions, side effects, and the overall condition of the patient. Options A, B, and D are not as critical in the immediate assessment compared to knowing if the teenager has ingested any other drugs.

3. A client with obsessive-compulsive disorder (OCD) repeatedly washes her hands throughout the day. What is the most therapeutic nursing intervention?

• A. Allow the client to continue the behavior to reduce anxiety.
• B. Encourage the client to talk about the underlying fears.
• C. Restrict the client's access to soap and water.
• D. Schedule a time for the client to perform the ritual.

Correct answer: B

Rationale: Encouraging the client to talk about the underlying fears is the most therapeutic nursing intervention for a client with OCD who repeatedly washes her hands. By discussing the fears, the client can gain insight into the behavior and work towards reducing the compulsion. Choice A is incorrect as allowing the client to continue the behavior can perpetuate the OCD symptoms. Choice C is incorrect as restricting access to soap and water can lead to increased anxiety and distress. Choice D is incorrect as scheduling a time for the client to perform the ritual does not address the underlying fears driving the behavior.

4. A client with schizophrenia is being discharged with a prescription for risperidone (Risperdal). What is the most important instruction for the nurse to provide?

• A. Stop taking the medication if you start feeling better.
• B. Be aware of the potential for weight gain with this medication.
• C. Report any unusual muscle movements immediately.
• D. You can drive as soon as you feel ready.

Correct answer: C

Rationale: The correct answer is C: "Report any unusual muscle movements immediately." Unusual muscle movements may indicate extrapyramidal symptoms (EPS) or tardive dyskinesia, which are serious side effects of antipsychotic medications like risperidone. It is crucial to address these symptoms promptly to prevent long-term effects. Choice A is incorrect because stopping the medication suddenly can be dangerous and should only be done under medical supervision. Choice B, while important, is not the most critical instruction in this scenario. Choice D is also incorrect as the ability to drive may be affected by the medication and should be discussed with a healthcare provider.

5. A client with schizophrenia is being treated with clozapine (Clozaril). What is the most important laboratory test for the LPN/LVN to monitor?

• A. White blood cell count.
• B. Liver function tests.
• C. Blood glucose levels.
• D. Platelet count.

Correct answer: A

Rationale: The most important laboratory test for an LPN/LVN to monitor for a client with schizophrenia being treated with clozapine is the white blood cell count. Clozapine treatment is associated with a risk of agranulocytosis, a severe drop in white blood cells, which can be life-threatening. Monitoring the white blood cell count regularly helps to detect this adverse effect early. Liver function tests (Choice B) are important to monitor with some antipsychotic medications but are not the most crucial for clozapine. Blood glucose levels (Choice C) are more relevant for monitoring in clients on medications like atypical antipsychotics that can cause metabolic side effects. Platelet count (Choice D) is not typically affected by clozapine therapy and is not the most important test to monitor in this case.

Similar Questions