Nursing Elites

1. A client with a history of alcohol use disorder is admitted to the hospital for detoxification. Which of the following symptoms shouldn't the nurse expect to observe during withdrawal?

• A. Tremors
• B. Hallucinations
• C. Diaphoresis
• D. Bradycardia

Correct answer: D

Rationale: During alcohol withdrawal, the nurse should expect to observe symptoms such as tremors, hallucinations, and diaphoresis. Seizures may also occur during severe withdrawal. Bradycardia is not typically associated with alcohol withdrawal; instead, tachycardia (an increased heart rate) is more commonly observed due to the stimulant effects of alcohol withdrawal on the sympathetic nervous system.

2. Child protective services have removed 10-year-old Christopher from his parents' home due to neglect. Christopher reveals to the nurse that he considers the woman next door his 'nice' mom, that he loves school, and gets above-average grades. The strongest explanation of this response is:

• A. Temperament
• B. Genetic factors
• C. Resilience
• D. Paradoxical effects of neglect

Correct answer: C

Rationale: Christopher's positive outlook, strong school performance, and forming a bond with the neighbor indicate resilience. Resilience refers to the ability to adapt and thrive despite facing adversity, such as being removed from his parents' home due to neglect. His ability to maintain a positive attitude and excel in school despite the challenging circumstances highlights his resilience.

3. How does emotional trauma typically affect individuals physically?

• A. Emotional trauma is a distinct category and unrelated to physical symptoms.
• B. Physical manifestations of emotional trauma are usually temporary.
• C. Emotional trauma is often manifested as physical symptoms.
• D. Patients are more aware of physical problems caused by trauma.

Correct answer: C

Rationale: Emotional trauma can often manifest as physical symptoms, such as headaches, stomachaches, and other somatic complaints. These physical manifestations can be long-lasting and impact the individual's overall well-being.

4. A client is experiencing severe anxiety. Which of the following is an appropriate intervention?

• A. Encourage the client to participate in group therapy sessions.
• B. Encourage the client to verbalize feelings of anxiety.
• C. Encourage the client to limit caffeine intake.
• D. Encourage the client to avoid stressful situations.

Correct answer: B

Rationale: Encouraging the client to verbalize feelings of anxiety is an appropriate intervention for severe anxiety. Verbalizing emotions can help the client process their feelings and reduce the intensity of anxiety. It promotes emotional expression and may lead to a better understanding of the underlying causes of anxiety, paving the way for effective coping strategies. Choices A, C, and D are not the most appropriate interventions for severe anxiety. While group therapy can be beneficial, it may not be suitable for someone experiencing severe anxiety. Limiting caffeine intake and avoiding stressful situations are helpful strategies but may not address the root of the severe anxiety or provide immediate relief.

5. Which of the following is identified as a psychoneurotic response to severe anxiety as it appears in the DSM-5?

• A. Somatic symptom disorder
• B. Grief responses
• C. Psychosis
• D. Bipolar disorder

Correct answer: A

Rationale: The correct answer is A: Somatic symptom disorder. Somatic symptom disorder is characterized by preoccupation with physical symptoms for which there is no demonstrable organic pathology. One of the diagnostic criteria is a high level of anxiety about health concerns or illness. In the DSM-5, somatic symptom disorders are classified under the category of somatic symptom and related disorders, which encompass conditions where psychological factors play a significant role in the development, exacerbation, or maintenance of physical symptoms. Choices B, C, and D are incorrect. Grief responses, psychosis, and bipolar disorder are not specifically categorized as psychoneurotic responses to severe anxiety in the DSM-5.

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