Nursing Elites

1. A patient with posttraumatic stress disorder (PTSD) is prescribed prazosin. The nurse understands that this medication is used to treat which symptom of PTSD?

• A. Flashbacks
• B. Nightmares
• C. Hypervigilance
• D. Depression

Correct answer: B

Rationale: Prazosin is a medication often prescribed to manage nightmares in patients with PTSD. It works by blocking the action of adrenaline on specific receptors, which helps in reducing the intensity and frequency of nightmares. While flashbacks, hypervigilance, and depression are also common symptoms of PTSD, prazosin is specifically indicated for nightmares associated with the disorder. Flashbacks are typically addressed through therapies like cognitive-behavioral therapy, hypervigilance may be managed through counseling and coping strategies, and depression may necessitate antidepressant medications or therapy tailored for depression.

2. A school nurse is assessing a female high school student who is overly concerned about her appearance. The client's mother states, 'That's not something to be stressed about!' Which is the most appropriate nursing response?

• A. Teenagers! They don't know a thing about real stress.
• B. Stress occurs only when there is a loss.
• C. When you are in poor physical condition, you can't experience psychological well-being.
• D. Stress can be psychological. A threat to self-esteem may result in high stress levels.

Correct answer: D

Rationale: The most appropriate response is D: 'Stress can be psychological. A threat to self-esteem may result in high stress levels.' This response acknowledges the psychological aspect of stress and how a perceived threat to self-esteem can be just as stressful as a physiological change. Choices A, B, and C are incorrect because they do not address the client's concerns or provide a therapeutic response to the situation.

3. Which should the healthcare provider recognize as a DSM-5 disorder?

• A. Obesity
• B. Generalized anxiety disorder
• C. Hypertension
• D. Grief

Correct answer: B

Rationale: The DSM-5 categorizes mental health disorders for diagnostic purposes. Generalized anxiety disorder is one of the disorders listed in the DSM-5, characterized by persistent and excessive worry about various events or activities. This disorder falls under the category of anxiety disorders, which also include panic disorder, phobias, and others. Choices A, C, and D are not DSM-5 disorders. Obesity and hypertension are medical conditions, while grief, though a significant emotional response, is not classified as a mental health disorder in the DSM-5.

4. A client experiencing a manic episode is talking rapidly and jumping from one topic to another. Which term describes this symptom?

• A. Circumstantiality
• B. Flight of ideas
• C. Tangentiality
• D. Perseveration

Correct answer: B

Rationale: In a manic episode, 'Flight of ideas' is characterized by rapid speech, where the individual moves quickly between topics without a clear connection. This symptom reflects the racing thoughts and impulsivity often seen in manic episodes. Circumstantiality refers to unnecessary detail and delay in getting to the point, tangentiality involves going off on a tangent or unrelated topics, and perseveration is the persistent repetition of a response or behavior. Therefore, 'Flight of ideas' best describes the symptom of rapidly changing topics during a manic episode.

5. A patient with bipolar disorder has been prescribed lithium. Which dietary advice is important for the nurse to include?

• A. Avoid foods high in tyramine.
• B. Maintain a consistent salt intake.
• C. Increase protein intake.
• D. Avoid foods high in fat.

Correct answer: B

Rationale: Patients prescribed lithium should maintain a consistent salt intake to prevent fluctuations in lithium levels. Salt intake can impact lithium levels, and sudden changes in salt intake can affect how the body absorbs and excretes lithium. Therefore, advising the patient to maintain a stable salt intake is crucial for the effectiveness and safety of lithium therapy. Choices A, C, and D are incorrect. Avoiding foods high in tyramine is more relevant for patients taking MAOIs, not lithium. Increasing protein intake or avoiding foods high in fat are not specific dietary recommendations for patients on lithium therapy.

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