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A client with bipolar disorder is started on a regimen of valproic acid (Depakote). Which laboratory test is most important for the nurse to monitor?
- A. Liver function tests
- B. Kidney function tests
- C. Blood glucose levels
- D. Serum sodium levels
Correct Answer: A
Rationale: The correct answer is A: Liver function tests. Valproic acid can cause hepatotoxicity, leading to liver damage. Monitoring liver function tests is crucial to detect any early signs of liver impairment. Kidney function tests (Choice B) are not the most important to monitor in this case. Blood glucose levels (Choice C) and serum sodium levels (Choice D) are not directly affected by valproic acid and are not the priority for monitoring in a client taking this medication.
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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.
The LPN/LVN is caring for a client who was recently diagnosed with a mental illness. The client asks, 'Will I be able to live a normal life?' What is the best response for the nurse to provide?
- A. Yes, you will be able to live a normal life.
- B. Many people with mental illness lead full and productive lives.
- C. It will depend on your treatment and the choices you make.
- D. There is no normal; everyone is unique in their own way.
Correct Answer: C
Rationale: The best response for the nurse is to provide the client with hope while acknowledging the importance of their treatment and choices. Choice C addresses the client's concern by highlighting the impact of their treatment and personal choices on their future. It encourages personal responsibility and active participation in their recovery. Choices A and B may sound reassuring, but they do not empower the client to take an active role in their well-being. Choice D, while promoting individuality, does not directly address the client's question about living a normal life after a mental illness diagnosis.
A female client with depression attends group and states that she sometimes misses her medication appointments because she feels very anxious about riding the bus. Which statement is the nurse's best response?
- A. Can your case manager take you to your appointments?
- B. Take your medication for anxiety before you ride the bus.
- C. Let's talk about what happens when you feel very anxious.
- D. What are some ways that you can cope with your anxiety?
Correct Answer: D
Rationale: The best response is to explore ways for the client to cope with anxiety (D). The nurse should encourage problem-solving rather than dependence on the case manager (A) for transportation. While taking medication for anxiety before riding the bus may be helpful, addressing coping strategies should come first (B). Although discussing the feelings of anxiety can be therapeutic (C), the most appropriate approach is to engage the client in finding ways to manage her anxiety effectively.
A male hospital employee is pushed out of the way by a female employee because of an oncoming gurney. The pushed employee becomes very angry and swings at the female employee. Both employees are referred for counseling with the staff psychiatric nurse. Which factor in the pushed employee's history is most related to the reaction that occurred?
- A. Is worried about losing his job to a woman
- B. Tortured animals as a child
- C. Was physically abused by his mother
- D. Hates to be touched by anyone
Correct Answer: C
Rationale: The correct answer is C: 'Was physically abused by his mother.' A history of physical abuse can lead to heightened responses to physical contact. In this scenario, the employee's reaction of becoming very angry and swinging at the female employee after being pushed may be influenced by past experiences of physical abuse. This history can contribute to increased sensitivity to physical interactions and may trigger defensive or aggressive responses. Choices A, B, and D are less directly related to the employee's reaction in this specific context. While worrying about losing his job to a woman could contribute to underlying stress or insecurity, torturing animals as a child reflects a different type of behavioral issue, and hating to be touched by anyone suggests personal boundaries unrelated to the observed behavior in this scenario.
A female client presents to the emergency center with confusion, emotional numbness, and expresses to the nurse a feeling of disbelief that she was raped. The nurse determines the client is in the acute phase of rape-trauma syndrome. What action should the nurse implement first?
- A. Secure samples of vaginal hair combings.
- B. Offer prophylactic antibiotic medication.
- C. Explain the rape protocol to the client.
- D. Implement crisis intervention counseling.
Correct Answer: C
Rationale: In cases of rape-trauma syndrome, it is crucial to provide clear information about what to expect during the examination and treatment. This can help the client regain a sense of control and reduce anxiety. Explaining the rape protocol to the client should be the first action to implement. Option A is not the priority at this stage as the immediate focus is on addressing the client's emotional needs and providing support. Option B is not the first action unless medically indicated. Option D, crisis intervention counseling, is important but should come after providing essential information and support to the client.