Nursing Elites

1. 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.

2. When assessing a patient with major depressive disorder, which symptom would most likely be observed?

• A. Euphoria
• B. Anhedonia
• C. Increased energy
• D. Racing thoughts

Correct answer: B

Rationale: Anhedonia, the inability to feel pleasure in activities that were once enjoyable, is a hallmark symptom of major depressive disorder. Patients with major depressive disorder often experience a pervasive feeling of emptiness and loss of interest in activities they used to find pleasurable. Euphoria, increased energy, and racing thoughts are more commonly associated with conditions like bipolar disorder rather than major depressive disorder.

3. Which approach involves surgically implanting electrodes into specific areas of the brain to stimulate regions identified as underactive in depression?

• A. Transcranial magnetic stimulation
• B. Deep brain stimulation
• C. Vagus nerve stimulation
• D. Electroconvulsive therapy

Correct answer: B

Rationale: Deep brain stimulation is a treatment approach that involves the surgical implantation of electrodes into specific areas of the brain to stimulate regions identified as underactive in depression. This method aims to modulate brain activity and has shown effectiveness in treating certain cases of depression.

4. A healthcare provider is assessing a client with generalized anxiety disorder (GAD). Which of the following findings shouldn't the healthcare provider expect?

• A. Restlessness
• B. Fatigue
• C. Excessive worry
• D. Mania

Correct answer: D

Rationale: In clients with generalized anxiety disorder (GAD), common symptoms include restlessness, fatigue, excessive worry, and irritability. Mania is not typically associated with GAD; instead, it is a key feature of bipolar disorder. Therefore, the healthcare provider should not expect to find mania in a client with GAD.

5. A patient with schizophrenia is experiencing auditory hallucinations. Which nursing intervention is most appropriate?

• A. Encourage the patient to ignore the voices.
• B. Provide a structured and safe environment.
• C. Engage the patient in a debate about the reality of the voices.
• D. Ask the patient to describe the content of the hallucinations.

Correct answer: D

Rationale: The most appropriate nursing intervention when a patient with schizophrenia is experiencing auditory hallucinations is to ask the patient to describe the content of the hallucinations. This intervention helps assess the risk associated with the hallucinations and provides valuable insight into the patient's condition, aiding in developing an effective care plan. Encouraging the patient to ignore the voices (Choice A) may not address the underlying issues or risks associated with the hallucinations. Providing a structured and safe environment (Choice B) is important but does not directly address the hallucinations. Engaging the patient in a debate about the reality of the voices (Choice C) may worsen the situation by invalidating the patient's experiences.

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