Nursing Elites

1. What are neurotransmitters?

• A. Chemical messengers that cause brain cells to turn on or off.
• B. Areas of the brain that are responsible for controlling emotions.
• C. Clumps of cells that alert the other brain cells to receive messages.
• D. Web-like structures that provide connections among parts of the brain.

Correct answer: A

Rationale: Neurotransmitters are chemicals in the brain that act as messengers between neurons, influencing various psychological functions. Choice A correctly defines neurotransmitters by stating that they are chemical messengers that cause brain cells to turn on or off. This is the function of neurotransmitters in transmitting signals between neurons. Choices B, C, and D are incorrect because they do not accurately describe neurotransmitters and their role in the brain.

2. The LPN/LVN is caring for a client who has been prescribed lithium carbonate. What is the most important instruction for the nurse to provide?

• A. Take the medication with food to avoid stomach upset.
• B. Do not change your salt intake while on this medication.
• C. Drink plenty of water and maintain a consistent salt intake.
• D. Avoid excessive intake of caffeine while on this medication.

Correct answer: B

Rationale: The most important instruction for a client prescribed lithium carbonate is not to change their salt intake. Alterations in sodium levels can impact lithium levels, leading to an increased risk of toxicity. Choice A is not crucial for lithium carbonate administration. While hydration is essential, maintaining a consistent salt intake is more critical than just increasing water intake (Choice C). Although caffeine can interact with lithium, it is not as important as maintaining a consistent salt intake (Choice D).

3. Which statement about contemporary mental health nursing practice is accurate?

• A. There is one approved theoretical framework for psychiatric nursing practice.
• B. Psychiatric nursing has yet to be recognized as a core mental health discipline.
• C. Contemporary practice of psychiatric nursing is primarily focused on inpatient care.
• D. The psychiatric nursing client may be an individual, family, group, organization, or community.

Correct answer: D

Rationale: The accurate statement about contemporary mental health nursing practice is that the psychiatric nursing client may be an individual, family, group, organization, or community. Mental health nursing extends beyond individual care to address the impact of psychiatric stressors on families, groups, and entire communities. Choices A, B, and C are incorrect: A is false as there are various theoretical frameworks used in psychiatric nursing, B is inaccurate as psychiatric nursing is a core discipline in mental health, and C is wrong as contemporary psychiatric nursing involves various settings beyond just inpatient care.

4. An outpatient clinic that has been receiving haloperidol (Haldol) for 2 days develops muscular rigidity, altered consciousness, a temperature of 103, and trouble breathing on day 3. The LPN/LVN interprets these findings as indicating which of the following?

• A. Neuroleptic Malignant Syndrome
• B. Tardive dyskinesia
• C. Extrapyramidal adverse effects
• D. Drug-induced parkinsonism

Correct answer: A

Rationale: Neuroleptic Malignant Syndrome (NMS) is a life-threatening condition characterized by hyperthermia, muscle rigidity, altered consciousness, and autonomic dysregulation. It is a rare but serious side effect of antipsychotic medications like haloperidol (Haldol). NMS requires immediate intervention, including discontinuation of the offending medication and supportive care. Tardive dyskinesia (Choice B) is a different condition characterized by involuntary movements of the face and extremities that can occur with long-term antipsychotic use. Extrapyramidal adverse effects (Choice C) encompass a range of movement disorders like dystonia, akathisia, and parkinsonism that can result from antipsychotic medications, but they do not present with hyperthermia and altered consciousness as in NMS. Drug-induced parkinsonism (Choice D) is a form of parkinsonism caused by certain medications, but it typically presents with symptoms similar to Parkinson's disease, such as tremor, bradykinesia, and rigidity, without the severe hyperthermia and autonomic dysregulation seen in NMS.

5. A client is admitted to a medical nursing unit with a diagnosis of acute blindness. Many tests are performed, and there seems to be no organic reason why this client cannot see. The client became blind after witnessing a hit-and-run car accident, when a family of three was killed. A LPN/LVN suspects that the client may be experiencing a:

• A. Psychosis
• B. Repression
• C. Conversion Disorder
• D. Dissociative Disorder

Correct answer: C

Rationale: In this scenario, the client's acute blindness without any organic cause following a traumatic event indicates a case of Conversion Disorder. Conversion Disorder involves the manifestation of physical symptoms due to psychological stressors. Psychosis (choice A) involves a loss of contact with reality, which is not evident here. Repression (choice B) is a defense mechanism that involves unconsciously blocking out thoughts. Dissociative Disorder (choice D) involves disruptions in memory, awareness, identity, or perception, which is not the primary issue in this case.

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