Nursing Elites

1. The LPN/LVN is assessing a client who is taking an antipsychotic medication. Which of the following symptoms is uniquely indicative of neuroleptic malignant syndrome (NMS) and requires immediate attention?

• A. Very high temperature
• B. Muscular rigidity
• C. Tremors
• D. Altered consciousness

Correct answer: A

Rationale: A very high temperature is a hallmark symptom of Neuroleptic Malignant Syndrome (NMS), which is a rare but potentially life-threatening side effect of antipsychotic medications. This symptom is uniquely indicative of NMS and requires immediate medical attention. Muscular rigidity, tremors, and altered consciousness can be seen in other conditions but are not as specifically linked to NMS as a very high temperature.

2. A 45-year-old female client is admitted to the psychiatric unit for evaluation. Her husband states that she has been reluctant to leave home for the last six months. The client has not gone to work for a month and has been terminated from her job. She has not left the house since that time. This client is displaying symptoms of which disorder?

• A. Claustrophobia.
• B. Acrophobia.
• C. Agoraphobia.
• D. Necrophobia.

Correct answer: C

Rationale: The correct answer is C, Agoraphobia. Agoraphobia involves the fear of situations where escape might be difficult, often leading to the individual avoiding public spaces or leaving their home. In this case, the client's reluctance to leave home, not going to work, and staying indoors for an extended period align with the symptoms of agoraphobia. Choices A, B, and D are incorrect. Claustrophobia is the fear of confined spaces, acrophobia is the fear of heights, and necrophobia is the fear of death or dead things, none of which are consistent with the client's symptoms described in the scenario.

3. The occupational health nurse is working with a female employee who was just notified that her child was involved in a MVA and taken to the hospital. The employee states, 'I can't believe this. What should I do?' Which response is best for the nurse to provide in this crisis?

• A. Tell me what you think should happen.
• B. How serious was the collision?
• C. What do you think you should do?
• D. Call for transportation to the hospital.

Correct answer: D

Rationale: Providing immediate practical support, such as arranging transportation to the hospital, is the best response in this crisis situation. It helps the employee to take immediate action and supports her in a highly stressful moment. Choice A focuses on the employee's thoughts rather than providing immediate aid. Choice B is not a priority as the severity can be addressed later. Choice C puts the decision-making burden on the employee at a time of distress, which is not ideal. Therefore, choice D is the most appropriate response in this situation.

4. At a support meeting of parents of a teenager with polysubstance dependency, a parent states, 'Each time my son tries to quit taking drugs, he gets so depressed that I'm afraid he will commit suicide.' The nurse's response should be based on which information?

• A. Addiction is a chronic, incurable disease
• B. Tolerance to the effects of drugs causes feelings of depression
• C. Feelings of depression frequently lead to drug abuse and addiction
• D. Careful monitoring should be provided during withdrawal from the drugs

Correct answer: D

Rationale: The priority is to teach the parents that their son will need monitoring and support during withdrawal to ensure that he does not attempt suicide. Option A is incorrect because addiction can be managed and treated effectively with appropriate interventions. Option B is incorrect as tolerance to drugs causing depression is not the primary concern in this scenario. Option C is incorrect as while depression can be a risk factor for drug abuse, in this case, the focus is on the son's safety during withdrawal.

5. A client with major depressive disorder is prescribed an SSRI. After one week, the client reports feeling no improvement in mood. What is the best response by the RN?

• A. It is common for antidepressants to take several weeks to have an effect.
• B. We may need to switch to a different medication.
• C. You should feel better by now, let's discuss this with your doctor.
• D. Maybe you are not taking the medication as prescribed.

Correct answer: A

Rationale: The correct response is A: 'It is common for antidepressants to take several weeks to have an effect.' This response is appropriate because SSRI and other antidepressants often require several weeks to exhibit improvement in mood. It is crucial to educate the client about this delay to manage expectations and promote adherence to the medication regimen. Choice B is incorrect as switching medications prematurely is not typically recommended after just one week. Choice C is incorrect because it sets unrealistic expectations for immediate improvement. Choice D is incorrect as it may come across as accusatory and should not be the initial response.

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