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. During an assessment of a client with suspected substance use disorder, which of the following findings should the nurse expect? Select one that doesn't apply.

• A. Feelings of hopelessness
• B. Increased tolerance to the substance
• C. Withdrawal symptoms when not using the substance
• D. Unsuccessful attempts to cut down or control use

Correct answer: A

Rationale: In clients with substance use disorder, common findings include increased tolerance to the substance, withdrawal symptoms when not using it, and unsuccessful attempts to cut down or control use. Feelings of hopelessness are not typically a direct manifestation of substance use disorder. Instead, feelings of hopelessness may be associated with other mental health conditions or situational factors. Therefore, the correct answer is A. Choices B, C, and D are all expected findings in clients with substance use disorder.

3. A client who experiences stress on a regular basis asks a nurse what causes these feelings. Which is the most appropriate nursing response?

• A. Genetics have no influence on your temperament.
• B. How you reacted to past experiences influences how you feel now.
• C. Maintaining good physical health always keeps stress levels low.
• D. Stress can be avoided by using appropriate coping mechanisms.

Correct answer: B

Rationale: The correct answer is B: 'How you reacted to past experiences influences how you feel now.' This response is appropriate because past experiences can shape an individual's current response to stress. It acknowledges the impact of learned patterns and coping mechanisms on one's current adaptation to stressors. Choice A is incorrect because genetics can play a role in temperament to some extent. Choice C is incorrect because while physical health can contribute to stress management, it is not the sole determinant of stress levels. Choice D is incorrect as stress is not always avoidable, but coping mechanisms can help manage and reduce its impact.

4. Pablo is a homeless adult who has no family connection. Pablo passed out on the street, and emergency medical services took him to the hospital where he expresses a wish to die. The physician recognizes evidence of substance use problems and mental health issues and recommends inpatient treatment for Pablo. What is the rationale for this treatment choice? Select one that doesn't apply.

• A. Intermittent supervision is available in inpatient settings.
• B. He requires stabilization of multiple symptoms.
• C. How do you feel about talking to a mental health counselor?
• D. Medication adherence will be mandated.

Correct answer: D

Rationale: The correct answer is D because medication adherence being mandated is not a primary rationale for inpatient treatment. The main reasons for recommending inpatient treatment in this scenario include the need for stabilization of multiple symptoms, addressing nutritional and self-care needs, and ensuring safety due to the imminent danger of self-harm. Inpatient settings provide a more intensive level of care and supervision to address these complex issues effectively.

5. Which of the following are potential side effects of electroconvulsive therapy (ECT)? Select one that does not apply.

• A. Short-term memory loss
• B. Headache
• C. Confusion
• D. Tardive dyskinesia

Correct answer: D

Rationale: Potential side effects of ECT include short-term memory loss, headache, confusion, and nausea. Tardive dyskinesia is not a side effect of ECT; it is associated with long-term use of antipsychotic medications, particularly antipsychotics that block dopamine receptors over time. ECT is primarily used for severe depression, bipolar disorder, and certain psychotic disorders. The other choices, short-term memory loss, headache, and confusion, are known side effects of ECT and are usually short-term and manageable.

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