Nursing Elites

1. A healthcare provider is assessing a client with suspected post-traumatic stress disorder (PTSD). Which of the following findings should the provider expect? Select one that does not apply.

• A. Flashbacks
• B. Avoidance of reminders of the trauma
• C. Increased arousal and hypervigilance
• D. Manic episodes

Correct answer: D

Rationale: Post-traumatic stress disorder (PTSD) is characterized by various symptoms, including flashbacks, avoidance of reminders of the trauma, increased arousal, and hypervigilance. Additionally, individuals with PTSD often experience negative changes in thoughts and mood. Manic episodes, which are periods of abnormally elevated mood and energy, are not typically associated with PTSD. Therefore, the correct answer is 'Manic episodes.' Choices A, B, and C are all common findings in individuals with PTSD.

2. A client is experiencing a panic attack. Which action should the nurse take first?

• A. Remain with the client and offer reassurance.
• B. Administer an anti-anxiety medication as prescribed.
• C. Encourage the client to engage in physical activity.
• D. Encourage the client to breathe deeply and slowly.

Correct answer: A

Rationale: During a panic attack, the immediate priority for the nurse is to provide support and reassurance to the client. Remaining with the client helps establish a sense of safety and trust, which can help calm the client during an episode of panic. Administering medication, encouraging physical activity, and deep breathing techniques are beneficial interventions, but offering reassurance and support should be the initial step to address the immediate emotional distress and anxiety experienced by the client.

3. Identical twins vary in their responses to stress. One twin may become anxious and irritable, while the other may withdraw and cry. How should the nurse explain these different reactions to stress to the parents?

• A. Reactions to stress are relative rather than absolute; individual responses to stress vary.
• B. It is abnormal for identical twins to react differently to similar stressors.
• C. Identical twins should share the same temperament and respond similarly to stress.
• D. Environmental influences weigh more heavily than genetic influences on reactions to stress.

Correct answer: A

Rationale: Individual responses to stress can vary significantly due to factors such as perception, past experiences, and environmental influences, in addition to genetic factors. It is not unusual for identical twins to exhibit different reactions to stress as their individual personalities and coping mechanisms play a significant role in how they respond to stressful situations. Choice A is the correct answer because it acknowledges the variability in responses to stress among individuals. Choice B is incorrect because it wrongly labels differing reactions in identical twins as abnormal, when in reality, it is a natural phenomenon. Choice C is incorrect as it assumes that identical twins should always have the same temperament and response to stress, which is not always the case. Choice D is incorrect because it oversimplifies the complex interplay between genetic and environmental factors in shaping responses to stress.

4. A patient is being educated about the difference between mental health and mental illness. Which statement by the patient reflects an accurate understanding of mental health?

• A. Mental health is the absence of any stressors.
• B. Mental health is successful adaptation to stressors in the internal and external environment.
• C. Mental health is incongruence between thoughts, feelings, and behavior.
• D. Mental health is a diagnostic category in the DSM-5.

Correct answer: B

Rationale: The correct answer is B. Mental health is defined as the successful adaptation to stressors in the internal and external environment. This includes having thoughts, feelings, and behaviors that are age-appropriate and congruent with cultural and societal norms. Mental health is not solely the absence of stressors or incongruence between thoughts, feelings, and behavior, nor is it a specific diagnostic category in the DSM-5. Choice A is incorrect because mental health is not just the absence of stressors but the ability to adapt to them. Choice C is wrong as mental health involves congruence, not incongruence, between thoughts, feelings, and behaviors. Choice D is inaccurate as mental health is a broader concept than a specific diagnostic category in the DSM-5.

5. During a treatment team meeting, the point is made that a client with schizophrenia has recovered from the acute psychosis but continues to demonstrate apathy, avolition, and blunted affect. The nurse who relates these symptoms to serotonin excess will suggest that the client receive?

• A. Chlorpromazine
• B. Phenelzine
• C. Haloperidol
• D. Olanzapine

Correct answer: D

Rationale: In this scenario, the symptoms of apathy, avolition, and blunted affect are indicative of negative symptoms commonly seen in schizophrenia. These symptoms are often associated with dopamine and serotonin imbalances in the brain. Olanzapine, an atypical antipsychotic, is known for its efficacy in treating both positive and negative symptoms of schizophrenia. It acts by blocking serotonin and dopamine receptors, helping to alleviate the symptoms mentioned. Chlorpromazine and Haloperidol are typical antipsychotics that primarily target dopamine receptors, while Phenelzine is an MAOI used to treat depression and anxiety disorders, not schizophrenia. Therefore, the most appropriate choice for this client displaying these symptoms related to serotonin excess would be Olanzapine.

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