Nursing Elites

1. What assessment question will provide information to the healthcare provider regarding the effects of a woman's circadian rhythms on her quality of life?

• A. How much sleep do you usually get each night?
• B. Does your heart ever seem to skip a beat?
• C. When was the last time you had a fever?
• D. Do you have problems urinating?

Correct answer: A

Rationale: The correct assessment question to understand the effects of a woman's circadian rhythms on her quality of life is to inquire about her sleep duration. Circadian rhythms significantly influence sleep patterns, so knowing how much sleep she usually gets each night can provide valuable insight into potential circadian rhythm disturbances and their impact on her overall well-being.

2. When a husband accuses his wife of infidelity, which situation would indicate to the nurse the husband's use of the ego defense mechanism of projection?

• A. The husband cries and stamps his feet, demanding that his wife be true to her marriage vows.
• B. The husband ignores the wife's continued absence from the home.
• C. The husband has already admitted to having an affair with a coworker.
• D. The husband takes out his marital frustrations through employee abuse.

Correct answer: C

Rationale: Projection is a defense mechanism where one attributes their unacceptable feelings or impulses to another person. In this scenario, the husband, by admitting to having an affair with a coworker, is projecting his infidelity onto his wife, indicating the use of the projection defense mechanism. Choice A is incorrect as it describes a different behavior, not projection. Choice B does not demonstrate projection but rather avoidance or denial. Choice D shows displacement of aggression, not projection.

3. When assessing a client with bipolar disorder who is experiencing a depressive episode, which of the following findings should the nurse not expect?

• A. Low energy
• B. Feelings of hopelessness
• C. Insomnia or hypersomnia
• D. Difficulty concentrating

Correct answer: D

Rationale: In a client experiencing a depressive episode in bipolar disorder, common findings include low energy, feelings of hopelessness, insomnia or hypersomnia, and decreased appetite. Difficulty concentrating is more indicative of attention deficit disorders or cognitive impairment rather than a typical presentation of a depressive episode in bipolar disorder.

4. A client with generalized anxiety disorder (GAD) is being discharged. Which of the following instructions should the nurse not include in the discharge teaching?

• A. Practice relaxation techniques daily
• B. Avoid caffeine and alcohol
• C. Engage in regular physical activity
• D. Use benzodiazepines as the first-line treatment

Correct answer: D

Rationale: Discharge instructions for a client with GAD should include practicing relaxation techniques daily, avoiding caffeine and alcohol, engaging in regular physical activity, and seeking support from friends and family. Benzodiazepines are not recommended as the first-line treatment due to their potential for dependence and should not be included in the discharge teaching.

5. A client prescribed diazepam for anxiety is receiving education from a healthcare professional. Which statement by the client indicates a need for further teaching?

• A. I can drink alcohol while taking this medication.
• B. I should avoid drinking alcohol while taking this medication.
• C. I should take this medication only when I feel anxious.
• D. I can stop taking this medication when I feel better.

Correct answer: A

Rationale: The correct answer is A. Clients should avoid alcohol while taking diazepam (Valium) as it can potentiate the effects of the medication, leading to excessive sedation and other adverse effects. Mixing alcohol with diazepam can also increase the risk of overdose and other serious complications. Therefore, it is crucial for the client to refrain from consuming alcohol while on this medication to ensure their safety and optimize the therapeutic benefits of diazepam for managing anxiety.

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