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. Which should the individual recognize as an example of the defense mechanism of repression?

• A. A student aware of the need to study for tomorrow's test goes to a movie instead.
• B. A woman whose son was killed in Iraq does not believe the military report.
• C. A man who is unhappily married goes to school to become a marriage counselor.
• D. A woman was raped when she was 12 and no longer remembers the incident.

Correct answer: D

Rationale: Repression is a defense mechanism where distressing thoughts, feelings, or memories are pushed out of conscious awareness to protect the individual from emotional pain. In this scenario, the woman's inability to recall the traumatic event of being raped at the age of 12 indicates repression in action. Choices A, B, and C do not represent repression. Choice A reflects procrastination, choice B suggests denial, and choice C indicates sublimation as the man is channeling his unhappiness into a constructive pursuit.

3. During an assessment, a client is demonstrating symptoms of moderate anxiety. Which of the following symptoms would be indicative of moderate anxiety?

• A. Fidgeting
• B. Laughing inappropriately
• C. Palpitations
• D. Nail biting

Correct answer: C

Rationale: Palpitations are a common physical symptom seen in clients experiencing moderate anxiety. Fidgeting, laughing inappropriately, and nail biting can also indicate heightened stress levels. It's important for healthcare providers to recognize these signs and provide appropriate support. While anxiety can manifest in various ways, other indicators of moderate anxiety may include restlessness, difficulty concentrating, muscle tension, and sleep disturbance. It's crucial for healthcare providers to assess these symptoms to provide effective care and interventions. Laughing inappropriately and nail biting are more commonly associated with nervousness or social discomfort, while fidgeting may signal mild anxiety.

4. A client with schizophrenia is experiencing auditory hallucinations. Which intervention should the nurse implement first?

• A. Ask the client to describe the content of the hallucinations.
• B. Instruct the client to ignore the hallucinations.
• C. Administer prescribed antipsychotic medication.
• D. Engage the client in reality-based activities.

Correct answer: A

Rationale: The initial intervention for a client experiencing auditory hallucinations, especially in schizophrenia, is to assess the content of the hallucinations. By asking the client to describe the hallucinations, the nurse can determine if they are command hallucinations that might pose a risk. This assessment is crucial in guiding further appropriate interventions to ensure the client's safety and well-being. Instructing the client to ignore the hallucinations (Choice B) may not be effective, as the hallucinations are real to the client. Administering antipsychotic medication (Choice C) may be necessary but should come after assessing the situation. Engaging the client in reality-based activities (Choice D) is important but not the first priority when dealing with auditory hallucinations.

5. A client with borderline personality disorder is receiving care. Which of the following interventions should be included in the plan of care?

• A. Set clear and consistent boundaries
• B. Encourage independence
• C. Avoid discussing the client's feelings
• D. Use a firm, authoritative approach

Correct answer: B

Rationale: When caring for a client with borderline personality disorder, it is essential to encourage independence rather than dependency. This helps promote autonomy and self-reliance, which are important aspects of treatment. Setting clear and consistent boundaries is also crucial, as it provides structure and predictability. Avoiding discussing the client's feelings is not recommended, as addressing emotions and promoting emotional awareness is a key part of therapy. Using a firm, authoritative approach may not be the most effective strategy as it can lead to power struggles and conflicts in individuals with borderline personality disorder.

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