The nurse is caring for four clients who are simultaneously being treated for chronic medical conditions and psychiatric conditions. Which client would the nurse anticipate as being most resistive to taking medications for both conditions?

Correct Answer: C

Rationale: The correct answer is C because the client who is convinced he is the president's twin brother may be experiencing delusions, a symptom of a psychiatric condition that could lead to resistance in taking medications. Delusions can alter one's perception of reality, making it challenging for the client to recognize the necessity of medications. A, B, and D do not demonstrate the same level of potential resistance to medication. A client exhibiting push of speech (A) may still understand the need for medication. Difficulty sleeping (B) is a common symptom that can be addressed with appropriate medication. Inability to establish eye contact (D) may indicate social difficulties but does not necessarily correlate with resistance to medication.

Correct Answer: B

Rationale: The correct answer is B because a lithium level of 1.7 mEq/L is above the therapeutic range (0.6-1.2 mEq/L), indicating potential toxicity. Instructing the patient to hold the next dose and contact the prescriber is the initial action to prevent further toxicity and adjust the medication regimen. Choice A is incorrect because the level is above the therapeutic range. Choice C is unnecessary unless the patient is experiencing severe symptoms. Choice D is not the initial intervention; holding the next dose is more immediate.

Correct Answer: C

Rationale: The correct answer is C: Limiting use of electronic devices in the hour before bedtime. Exposure to blue light emitted by electronic devices can disrupt the production of melatonin, a hormone that regulates sleep. By limiting electronic device use before bedtime, the nurse can help the individual maintain a more natural sleep-wake cycle. Choice A is not directly related to the impact of light on sleep patterns. Choice B, exercising before bedtime, can actually stimulate the body and make it harder to fall asleep. Choice D, dimming screens, is a good practice but may not be as effective as completely avoiding electronic devices before bedtime to optimize sleep quality.

Correct Answer: A

Rationale: The correct answer is A because an autocratic leader makes decisions for the group without consulting them. In this response, the leader dictates the topic without considering input from group members. Choice B involves democratic leadership by seeking input from everyone. Choice C also reflects democratic leadership by allowing the group to reach a decision collectively. Choice D demonstrates a collaborative approach, not autocratic, as the leader is working with the group to find a suitable topic.

Correct Answer: D

Rationale: The correct answer is D because the client's statement about the partner being 'sorry' for their breakup indicates potential harm or danger. This statement may suggest thoughts of retaliation or harm towards the partner, raising concerns for safety and potential violence. It should be the nurse's priority to assess the client's risk of harm to themselves or others. Explanation of why the other choices are incorrect: A: The client being silent during some interviews may indicate anxiety or distress, but it does not necessarily pose an immediate safety concern. B: A history of preeclampsia with a past pregnancy is important for medical history but does not indicate an immediate risk to the client's safety. C: The family bringing in magazines is not a critical detail that raises concerns about the client's safety or well-being.