Nursing Elites

1. A healthcare provider is assessing a client with suspected post-traumatic stress disorder (PTSD). Which of the following findings should the provider expect? Select one that does not apply.

• A. Flashbacks
• B. Avoidance of reminders of the trauma
• C. Increased arousal and hypervigilance
• D. Manic episodes

Correct answer: D

Rationale: Post-traumatic stress disorder (PTSD) is characterized by various symptoms, including flashbacks, avoidance of reminders of the trauma, increased arousal, and hypervigilance. Additionally, individuals with PTSD often experience negative changes in thoughts and mood. Manic episodes, which are periods of abnormally elevated mood and energy, are not typically associated with PTSD. Therefore, the correct answer is 'Manic episodes.' Choices A, B, and C are all common findings in individuals with PTSD.

2. A client prescribed diazepam for anxiety is receiving education from a healthcare professional. Which statement by the client indicates a need for further teaching?

• A. I can drink alcohol while taking this medication.
• B. I should avoid drinking alcohol while taking this medication.
• C. I should take this medication only when I feel anxious.
• D. I can stop taking this medication when I feel better.

Correct answer: A

Rationale: The correct answer is A. Clients should avoid alcohol while taking diazepam (Valium) as it can potentiate the effects of the medication, leading to excessive sedation and other adverse effects. Mixing alcohol with diazepam can also increase the risk of overdose and other serious complications. Therefore, it is crucial for the client to refrain from consuming alcohol while on this medication to ensure their safety and optimize the therapeutic benefits of diazepam for managing anxiety.

3. A client has been diagnosed with illness anxiety disorder. Which of the following behaviors should the nurse expect?

• A. Preoccupation with having a serious illness
• B. Fear of social situations
• C. Dramatic expressions of emotion
• D. Preoccupation with a perceived physical defect

Correct answer: A

Rationale: The correct answer is A: Preoccupation with having a serious illness. Illness anxiety disorder, formerly known as hypochondriasis, is characterized by a preoccupation with having or acquiring a serious illness, despite medical reassurance. This preoccupation leads individuals to misinterpret normal bodily sensations as signs of a severe illness, causing distress and impairment in daily functioning. Choices B, C, and D are incorrect because fear of social situations, dramatic expressions of emotion, and preoccupation with a perceived physical defect are not typical behaviors associated with illness anxiety disorder.

4. A client displays signs and symptoms indicative of hypochondriasis. The nurse would initially expect to see:

• A. Self-preoccupation
• B. La belle indifference
• C. Fear of physicians
• D. Insight into the source of their fears

Correct answer: A

Rationale: In hypochondriasis, individuals are excessively preoccupied with and worried about having a serious illness, despite reassurance from medical professionals. This self-preoccupation is a key characteristic of hypochondriasis. 'La belle indifference' refers to a lack of concern or distress about symptoms, which is not typically seen in hypochondriasis. Fear of physicians may be present due to the individual's persistent belief in their illness despite medical reassurance. Insight into the source of their fears is usually lacking in hypochondriasis, as individuals often believe their physical symptoms are evidence of a serious illness.

5. An unemployed college graduate is experiencing severe anxiety over not finding a teaching position and has difficulty with independent problem-solving. During a routine physical examination, the graduate confides in the clinic nurse. Which is the most appropriate nursing intervention?

• A. Encourage the graduate to use alternative coping mechanisms such as relaxation exercises.
• B. Complete the problem-solving process for the graduate.
• C. Work through the problem-solving process with the graduate.
• D. Encourage the graduate to keep a journal.

Correct answer: C

Rationale: In situations where a client is experiencing severe anxiety and struggles with independent problem-solving, it is essential for the nurse to work through the problem-solving process together with the client. By doing so, the nurse can provide support and guidance to help the client navigate through their challenges effectively. Choice A is not the most appropriate as just encouraging alternative coping mechanisms may not address the root of the problem. Choice B of completing the problem-solving process for the graduate does not promote independence or skill development. Choice D of encouraging the graduate to keep a journal may be helpful but does not directly address the need for assistance in problem-solving during heightened anxiety.

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