Nursing Elites

1. Tatiana has been hospitalized for an acute manic episode. On admission, the nurse suspects lithium toxicity. What assessment findings would indicate the nurse's suspicion as correct?

• A. Shortness of breath, gastrointestinal distress, chronic cough
• B. Ataxia, severe hypotension, large volume of dilute urine
• C. Gastrointestinal distress, thirst, nystagmus
• D. Electroencephalographic changes, chest pain, dizziness

Correct answer: B

Rationale: The correct answer is B. Ataxia, severe hypotension, and a large volume of dilute urine are classic signs of lithium toxicity. Ataxia refers to a lack of muscle coordination, severe hypotension indicates dangerously low blood pressure, and the large volume of dilute urine is a result of the kidneys' inability to concentrate urine properly, a common feature of lithium toxicity.

2. Which should the individual recognize as an example of the defense mechanism of repression?

• A. A student aware of the need to study for tomorrow's test goes to a movie instead.
• B. A woman whose son was killed in Iraq does not believe the military report.
• C. A man who is unhappily married goes to school to become a marriage counselor.
• D. A woman was raped when she was 12 and no longer remembers the incident.

Correct answer: D

Rationale: Repression is a defense mechanism where distressing thoughts, feelings, or memories are pushed out of conscious awareness to protect the individual from emotional pain. In this scenario, the woman's inability to recall the traumatic event of being raped at the age of 12 indicates repression in action. Choices A, B, and C do not represent repression. Choice A reflects procrastination, choice B suggests denial, and choice C indicates sublimation as the man is channeling his unhappiness into a constructive pursuit.

3. A healthcare provider is assessing a client who has been diagnosed with conversion disorder. Which of the following findings should the provider expect?

• A. Paralysis of a limb
• B. Auditory hallucinations
• C. Dissociative amnesia
• D. Compulsive behaviors

Correct answer: A

Rationale: Conversion disorder is characterized by the development of neurological symptoms, such as paralysis of a limb, that cannot be explained by medical evaluation. The paralysis is typically due to a psychological conflict or stress rather than a physical issue. Auditory hallucinations, dissociative amnesia, and compulsive behaviors are not commonly associated with conversion disorder, making them incorrect choices. Therefore, the healthcare provider should expect to find paralysis of a limb in a client with conversion disorder.

4. A client has been diagnosed with histrionic personality disorder. Which of the following behaviors should the nurse expect?

• A. Attention-seeking behavior
• B. Dramatic expressions of emotion
• C. Seductive behavior
• D. Dependency on others

Correct answer: A

Rationale: Individuals with histrionic personality disorder often display attention-seeking behaviors as a way to draw focus and validation from others. This behavior may manifest as exaggerated emotions and dramatic expressions to maintain the spotlight. While seductive behavior and dependency on others are potential characteristics of histrionic personality disorder, attention-seeking behavior is the hallmark trait. Therefore, the correct answer is attention-seeking behavior (Choice A). Dramatic expressions of emotion (Choice B) can be a feature of histrionic personality disorder, but it is not as characteristic as attention-seeking behavior. Seductive behavior (Choice C) may also be present in individuals with histrionic personality disorder, but it is not the primary behavior to expect. Dependency on others (Choice D) is not a core feature of histrionic personality disorder, although individuals with this disorder may seek attention and validation from others.

5. A client has been prescribed lorazepam (Ativan) for the treatment of anxiety. Which of the following instructions should the nurse include?

• A. Take the medication with food to avoid stomach upset.
• B. Avoid driving until you know how the medication affects you.
• C. Take the medication on an empty stomach.
• D. Double the dose if you miss a dose.

Correct answer: B

Rationale: The correct answer is B because lorazepam (Ativan) can cause dizziness and drowsiness, so the client should avoid driving until they know how the medication affects them. This instruction is crucial for ensuring the client's safety and preventing any potential accidents or harm. Choice A is incorrect because lorazepam does not necessarily need to be taken with food. Choice C is incorrect as it contradicts the usual recommendation of taking lorazepam with or without food. Choice D is incorrect and dangerous advice as doubling the dose of lorazepam can lead to overdose and serious complications.

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