Nursing Elites

1. A healthcare professional is assessing a client who appears to be experiencing moderate anxiety during questioning. Which symptom shouldn't the healthcare professional expect?

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

Correct answer: C

Rationale: Palpitations are not typically associated with moderate anxiety. Fidgeting, laughing inappropriately, and nail biting are common behavioral symptoms of heightened stress levels. Palpitations may be more indicative of physiological responses, such as increased heart rate, which can occur in severe anxiety or panic attacks. Other signs of severe anxiety include restlessness, difficulty concentrating, muscle tension, and sleep disturbances.

2. A client diagnosed with post-traumatic stress disorder (PTSD) is being assessed by a healthcare professional. Which symptom would the healthcare professional expect the client to exhibit?

• A. Delusions of grandeur
• B. Hypervigilance
• C. Obsessive-compulsive behaviors
• D. Periods of excessive sleeping

Correct answer: B

Rationale: In individuals with post-traumatic stress disorder (PTSD), hypervigilance is a common symptom. Hypervigilance refers to a state of increased alertness, awareness, and sensitivity to potential threats or danger. This heightened state of vigilance can manifest as being easily startled, having difficulty relaxing or sleeping, and constantly scanning the environment for signs of danger. It is an adaptive response to the trauma experienced and can significantly impact the individual's daily functioning. The other options are not typically associated with PTSD. Delusions of grandeur are more commonly seen in certain psychiatric disorders like bipolar disorder or schizophrenia. Obsessive-compulsive behaviors are characteristic of obsessive-compulsive disorder (OCD), not PTSD. Periods of excessive sleeping may be seen in conditions like depression, but they are not a hallmark symptom of PTSD.

3. A patient with obsessive-compulsive disorder (OCD) is undergoing treatment with an SSRI. Which SSRI is commonly utilized for this condition?

• A. Fluoxetine
• B. Citalopram
• C. Paroxetine
• D. Escitalopram

Correct answer: C

Rationale: Paroxetine is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed for obsessive-compulsive disorder due to its efficacy in managing OCD symptoms. While different SSRIs may be used based on individual patient response and tolerability, Paroxetine stands out as a well-established option for treating OCD. Fluoxetine (Choice A) is another SSRI commonly used for OCD, but Paroxetine is more commonly associated with this indication. Citalopram (Choice B) and Escitalopram (Choice D) are also SSRIs but are not typically the first choice for treating OCD.

4. 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.

5. A physically and emotionally healthy client has just been fired. During a routine office visit, he states to a nurse: 'Perhaps this was the best thing to happen. Maybe I'll look into pursuing an art degree.' How should the nurse characterize the client's appraisal of the job loss stressor?

• A. Irrelevant
• B. Harm/loss
• C. Threatening
• D. Challenging

Correct answer: D

Rationale: The client's statement indicates that he views the job loss as an opportunity for growth and a new direction in life rather than a threat or harm/loss. He sees it as a challenge and is considering it positively, demonstrating resilience and adaptability in the face of adversity. Choice A, 'Irrelevant,' is incorrect as the client's response shows relevance and a positive outlook. Choice B, 'Harm/loss,' is incorrect as the client does not express a sense of harm or loss but rather opportunity. Choice C, 'Threatening,' is incorrect as the client's response does not convey fear or threat but rather a positive reframe of the situation.

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