A patient demonstrating behaviors associated with acute mania has exhausted the staff by noon. Staff members are feeling defensive and fatigued. Which action should the staff take initially to prevent this issue?

Confer with the health care provider to consider use of seclusion for this patient.

Hold a staff meeting to discuss consistency and limit-setting approaches.

Explain to the patient that the behavior is unacceptable.

Conduct a meeting with all staff and patients to discuss the behavior.

Answer and Explanation

The Correct Answer is B

A. Seclusion is a last-resort intervention, not an initial step.
B. Staff meetings to ensure consistent approaches, structure, and limit-setting prevent staff fatigue, reduce defensiveness, and provide therapeutic consistency for the client.
C. Confronting the patient directly about unacceptable behavior may escalate agitation and is not the most effective prevention strategy.
D. Group discussions with patients about one individual’s behavior would be inappropriate and non-therapeutic.

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Correct Answer is A

Explanation

A. This occurs when the nurse projects personal feelings about someone from their own life onto the patient (e.g., comparing the patient to a grandparent and feeling sadness).

B. This refers to severe emotional outbursts in cognitively impaired patients, not nurse behavior.

C. This would involve the nurse using defense mechanisms to protect themselves from anxiety, not relating to the patient as a grandparent.

D. Transference is when the patient projects feelings onto the nurse, not the other way around.

A. Thyroid function tests should be performed every 6 months. B. A pretreatment electroencephalogram (EEG) will be done. C. Liver function tests must be monitored. D. High serum sodium levels can cause toxic levels of valproate.

Correct Answer is C

Explanation

A. Thyroid function tests are not routinely required for valproate therapy; this applies more to lithium therapy.

B. A pretreatment EEG is not necessary before starting valproate; it is used primarily for seizure evaluation.

C. Valproate can cause hepatotoxicity, so monitoring liver function tests (LFTs) before and during therapy is essential for safety.

D. High serum sodium levels are not related to valproate toxicity; this concern is associated with lithium therapy, not valproate.

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A patient demonstrating behaviors associated with acute mania has exhausted the staff by noon. Staff members are feeling defensive and fatigued. Which action should the staff take initially to prevent this issue?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse assesses a confused older adult. The nurse experiences sadness and reflects. This patient is like one of my grandparents... so helpless." Which response is the nurse demonstrating?

Correct Answer is A

Explanation

A nurse is caring for a client who has bipolar disorder and a new prescription for valproate. Which of the following instructions should the nurse give the client al t about the use of this medication?

Correct Answer is C

Explanation

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