Nursing Elites

1. A healthcare professional is assessing a client for symptoms of post-traumatic stress disorder (PTSD). Which symptom should the healthcare professional expect to find?

• A. Persistent thoughts about the trauma.
• B. Increased energy and enthusiasm.
• C. Decreased need for sleep.
• D. Increased appetite and weight gain.

Correct answer: A

Rationale: The correct answer is A: Persistent thoughts about the trauma. In post-traumatic stress disorder (PTSD), individuals often experience persistent intrusive thoughts about the traumatic event, which can be distressing and disruptive. This symptom is a hallmark feature of PTSD. Choices B, C, and D are incorrect because increased energy, enthusiasm, decreased need for sleep, increased appetite, and weight gain are not typical symptoms of PTSD. Instead, individuals with PTSD may commonly experience symptoms such as flashbacks, nightmares, hypervigilance, avoidance of triggers related to the trauma, and negative changes in mood and cognition.

2. During an annual physical at a corporate clinic, a male employee tells the nurse that his high-stress job is causing trouble in his personal life. He further explains that he often gets so angry while driving to and from work that he has considered “getting even” with other drivers. How should the nurse respond?

• A. “Anger is contagious and could result in a major confrontation.”
• B. “Try not to let your anger cause you to act impulsively.”
• C. “Expressing your anger to a stranger could result in an unsafe situation.”
• D. “It sounds as if there are many situations that make you feel angry.”

Correct answer: B

Rationale: The correct response is to encourage the client to manage their anger and avoid impulsive actions, as stated in choice B. This approach helps the individual recognize the potential consequences of acting on their anger impulsively. Choice A is not the best response because it focuses on the contagious nature of anger rather than addressing the individual's behavior. Choice C is incorrect as it only highlights the potential dangers of expressing anger to a stranger without providing guidance on managing the underlying issue. Choice D acknowledges the client's feelings but does not offer practical advice on how to address the anger and potential impulsive actions.

3. A healthcare provider is evaluating a client's response to a new antianxiety medication. Which client statement indicates a positive response to the medication?

• A. “I feel more relaxed and less anxious.”
• B. “I am sleeping less and feel more energetic.”
• C. “I have not noticed any changes in my anxiety levels.”
• D. “I have more difficulty concentrating than before.”

Correct answer: A

Rationale: The correct answer is A: “I feel more relaxed and less anxious.” A positive response to antianxiety medication is characterized by reduced anxiety and increased relaxation. Choice B, which mentions sleeping less and feeling more energetic, suggests potential side effects rather than a positive response to the medication. Choice C indicates no change in anxiety levels, which is not indicative of a positive response. Choice D, mentioning difficulty concentrating, is also a sign of a negative response to antianxiety medication as it may suggest cognitive impairment.

4. The nurse is using the CAGE questionnaire as a screening tool for a client who is seeking help because his wife said he had a drinking problem. What information should the nurse explore in-depth with the client based on this screening tool?

• A. Consumption, liver enzymes, gastrointestinal complaints, and bleeding.
• B. Minimizing drinking, frequently missing family events, guilt about drinking, and amount of daily intake.
• C. Cancer screening results, anger, gastritis, daily alcohol intake.
• D. Efforts to cut down, annoyance with questions, guilt, drinking as an “Eye-opener.”

Correct answer: D

Rationale: The correct answer is D. The CAGE questionnaire is a screening tool for alcohol use disorder. Each letter in CAGE represents a key question: Cutting down, Annoyance by criticisms, Guilty feelings, and Eye-openers. These questions help assess problematic drinking behaviors and can provide valuable insights into the client's alcohol consumption habits. Choices A, B, and C do not directly align with the specific areas of inquiry covered by the CAGE questionnaire, making them incorrect. Therefore, the nurse should focus on exploring the client's efforts to cut down, annoyance with questions, feelings of guilt, and the use of alcohol as an “Eye-opener” based on this screening tool.

5. The RN is providing education about strategies for a safety plan for a female client who is a victim of intimate partner violence. Which strategies should be included in the safety plan? (SOA)

• A. Purchase a gun for protection.
• B. Establish a code with family and friends to signal violence.
• C. Take a self-defense course focused on protection.
• D. Prepare a bag with extra clothes for self and children.

Correct answer: B

Rationale: Establishing a code with family and friends is crucial in situations of intimate partner violence as it allows discreet communication for help without alerting the abuser. Having a pre-prepared bag with essentials like extra clothes is important to facilitate a quick exit if necessary. Purchasing a gun is not a recommended safety strategy as it can escalate violence and pose more danger. While taking a self-defense course focused on protection is beneficial, it is essential to avoid courses that emphasize retaliation, as they can increase the risk and escalate violence.

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