Nursing Elites

1. A healthcare professional is assessing a client for symptoms of post-traumatic stress disorder (PTSD). Which symptom should the healthcare professional expect to find?

• A. Persistent thoughts about the trauma.
• B. Increased energy and enthusiasm.
• C. Decreased need for sleep.
• D. Increased appetite and weight gain.

Correct answer: A

Rationale: The correct answer is A: Persistent thoughts about the trauma. In post-traumatic stress disorder (PTSD), individuals often experience persistent intrusive thoughts about the traumatic event, which can be distressing and disruptive. This symptom is a hallmark feature of PTSD. Choices B, C, and D are incorrect because increased energy, enthusiasm, decreased need for sleep, increased appetite, and weight gain are not typical symptoms of PTSD. Instead, individuals with PTSD may commonly experience symptoms such as flashbacks, nightmares, hypervigilance, avoidance of triggers related to the trauma, and negative changes in mood and cognition.

2. A client with Bulimia and depression who is taking phenelzine (Nardil) 90 mg daily is admitted to an acute care hospital for uncontrolled hypertension. What dietary choices should the RN instruct the client to avoid?

• A. Pan-seared catfish.
• B. Pepperoni pizza.
• C. Deep-fried shrimp.
• D. Beef strips with gravy.

Correct answer: D

Rationale: When a client is taking MAO inhibitors like phenelzine, foods containing tyramine should be avoided. Tyramine-rich foods can interact with MAO inhibitors and lead to a hypertensive crisis. Beef strips with gravy contain tyramine, making choice D the correct answer. Choices A, B, and C do not contain high levels of tyramine and are not specifically contraindicated with MAO inhibitors.

3. The healthcare provider is assessing a client who has been taking an antidepressant for several months. Which symptom would suggest that the medication is working?

• A. Improved mood and increased energy.
• B. Increased appetite and weight gain.
• C. Decreased anxiety and agitation.
• D. Enhanced sleep patterns and vivid dreams.

Correct answer: A

Rationale: When assessing the effectiveness of an antidepressant, improved mood and increased energy are positive indicators that the medication is working. Choice B, increased appetite and weight gain, are more commonly associated with side effects of some antidepressants, such as certain tricyclic antidepressants. Choice C, decreased anxiety and agitation, could be related to the therapeutic effects of antidepressants in treating anxiety disorders but may not specifically indicate the efficacy of the medication for depression. Choice D, enhanced sleep patterns and vivid dreams, while changes in sleep patterns can be influenced by antidepressants, they are not the primary indicators of antidepressant efficacy. Therefore, the correct choice is A as it directly reflects the desired outcomes of antidepressant therapy.

4. A client with post-traumatic stress disorder (PTSD) is struggling with flashbacks and nightmares. Which therapeutic approach should the nurse include in the care plan?

• A. Cognitive-behavioral therapy.
• B. Electroconvulsive therapy (ECT).
• C. Medication management only.
• D. Relaxation training and mindfulness.

Correct answer: A

Rationale: Corrected Question: A client with post-traumatic stress disorder (PTSD) experiencing flashbacks and nightmares would benefit from cognitive-behavioral therapy (CBT) in the care plan. CBT is an evidence-based therapeutic approach that focuses on identifying and changing negative thought patterns and behaviors associated with PTSD symptoms. This helps the client learn coping strategies to manage distressing symptoms like flashbacks and nightmares.\nIncorrect Choices Rationale: B) Electroconvulsive therapy (ECT) is not indicated for PTSD and is typically used for severe depression that has not responded to other treatments. C) Medication management alone may not address the underlying cognitive and behavioral aspects of PTSD. D) Relaxation training and mindfulness can be helpful as adjunctive therapies but may not be as effective as CBT in specifically targeting and modifying PTSD symptoms.

5. The RN is leading a group on the inpatient psychiatric unit. Which approach should the RN use during the working phase of group development?

• A. Establishing a rapport with group members.
• B. Clarifying the nurse’s role and clients’ responsibilities.
• C. Discussing ways to use new coping skills learned.
• D. Helping clients identify areas of problems in their lives.

Correct answer: C

Rationale: During the working phase of group development, the focus should be on discussing and applying new coping skills to promote progress. This helps group members to practice and implement the skills they have learned, leading to positive outcomes. Choices A, B, and D are not ideal during the working phase. While establishing rapport is important, it is more relevant during the initial orientation phase. Clarifying roles and responsibilities is important at the beginning of group formation, and helping clients identify areas of problem in their lives is often part of the exploration phase, not the working phase.

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