Nursing Elites

1. The school nurse has been alerted to the fact that an 8-year-old boy routinely playacts as a police officer, 'locking up' other children on the playground to the point where the children get scared. The nurse recognizes that this behavior is most likely an indication of:

• A. The need to dominate others
• B. Inventing traumatic events
• C. A need to develop close relationships
• D. A potential symptom of traumatization

Correct answer: D

Rationale: The behavior of an 8-year-old boy playacting as a police officer and 'locking up' other children to the point of scaring them is likely a symptom of traumatization. Children may reenact traumatic experiences through play, and acting out aggressive or controlling roles can be a sign of underlying trauma. This behavior should be further assessed and addressed with appropriate support and intervention to help the child process and cope with any potential trauma.

2. A healthcare professional is conducting education on anxiety and stress management. Which of the following should be identified as the most important initial step in learning how to manage anxiety?

• A. Diagnostic blood tests
• B. Awareness of factors creating stress
• C. Relaxation exercises
• D. Identifying support systems

Correct answer: B

Rationale: The correct answer is B: Awareness of factors creating stress. In managing anxiety, the first crucial step is recognizing and being aware of the factors that contribute to stress. Without this awareness, it becomes challenging to effectively address and manage anxiety. Diagnostic blood tests are not typically the initial step in managing anxiety; they may be used to rule out other medical conditions but are not the primary focus. While relaxation exercises can be helpful in managing anxiety, understanding the root causes of stress takes precedence. Identifying support systems is important but comes after recognizing the stress factors to develop a comprehensive management plan.

3. A client has been diagnosed with post-traumatic stress disorder (PTSD) and is having nightmares about the event. The client reports difficulty sleeping at night. Which of the following actions should the nurse take first?

• A. Encourage the client to talk about the event during the day.
• B. Encourage the client to avoid caffeine and alcohol.
• C. Administer a prescribed sedative at bedtime.
• D. Schedule a follow-up appointment with the client's therapist.

Correct answer: A

Rationale: The initial action the nurse should take is to encourage the client to talk about the traumatic event during the day. This approach can assist the client in processing the trauma in a controlled environment, potentially reducing the frequency and intensity of nightmares. It allows for emotional expression and may promote better sleep by addressing the underlying psychological distress associated with PTSD. Encouraging the client to talk about the event during the day promotes therapeutic processing of the trauma and emotional expression, which can lead to improved coping mechanisms and potentially decrease the distressing symptoms like nightmares. Encouraging the client to avoid caffeine and alcohol may be beneficial, but addressing the emotional aspects first is crucial. Administering a sedative should not be the first approach, as it does not address the root cause of the nightmares. Scheduling a follow-up appointment with the therapist is important but should follow addressing the immediate distressing symptoms and promoting coping strategies.

4. What assessment question will provide information to the healthcare provider regarding the effects of a woman's circadian rhythms on her quality of life?

• A. How much sleep do you usually get each night?
• B. Does your heart ever seem to skip a beat?
• C. When was the last time you had a fever?
• D. Do you have problems urinating?

Correct answer: A

Rationale: The correct assessment question to understand the effects of a woman's circadian rhythms on her quality of life is to inquire about her sleep duration. Circadian rhythms significantly influence sleep patterns, so knowing how much sleep she usually gets each night can provide valuable insight into potential circadian rhythm disturbances and their impact on her overall well-being.

5. During a manic episode in bipolar disorder, which intervention is most appropriate for a patient?

• A. Encourage the patient to engage in group activities.
• B. Provide a structured and low-stimulus environment.
• C. Allow the patient to set their schedule.
• D. Engage the patient in high-energy physical activities.

Correct answer: B

Rationale: During a manic episode in bipolar disorder, individuals may experience heightened energy levels, impulsivity, and decreased need for sleep. Providing a structured and low-stimulus environment is crucial in managing manic episodes. This intervention helps reduce overstimulation and provides a calm and predictable setting, which can be beneficial in helping the patient regain control and stability. Group activities and high-energy physical activities may exacerbate the symptoms of mania by increasing stimulation and excitement. Allowing the patient to set their schedule may not provide the necessary structure needed during a manic episode, hence making it less appropriate.

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