Nursing Elites

1. When working with a patient diagnosed with posttraumatic stress disorder (PTSD), which therapeutic approach is most appropriate?

• A. Encouraging the patient to avoid discussing the traumatic event.
• B. Using exposure therapy to help the patient confront their fears.
• C. Advising the patient to focus on positive thoughts.
• D. Suggesting that the patient keep busy to distract from traumatic memories.

Correct answer: B

Rationale: Exposure therapy is an evidence-based treatment for PTSD that involves gradually exposing the patient to their traumatic memories in a safe and controlled environment. This approach helps individuals confront and process their fears, reducing the impact of the traumatic event over time. Avoiding discussing the trauma (choice A) may lead to avoidance behaviors and hinder recovery. Focusing on positive thoughts (choice C) may provide temporary relief but does not address the underlying trauma. Keeping busy to distract from memories (choice D) is a form of avoidance that does not help in processing the traumatic experiences. Therefore, using exposure therapy (choice B) is the most appropriate approach to effectively treat PTSD.

2. The school staff 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 staff 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: This behavior of playacting as a police officer and 'locking up' other children to the point of causing fear may suggest that the child is displaying potential symptoms of traumatization. It could indicate that the child has experienced or witnessed traumatic events, leading to the replication of such scenarios as a coping mechanism or way to process the trauma. Choices A, B, and C are incorrect because the behavior described is more indicative of a potential trauma response rather than a need to dominate others, invent traumatic events, or develop close relationships.

3. A client is undergoing systematic desensitization for an extreme fear of elevators. Which of the following actions should be implemented with this form of therapy?

• A. Demonstrate riding in an elevator, then ask the client to imitate the behavior.
• B. Advise the client to say “stop” out loud every time they begin to feel an anxiety response related to an elevator.
• C. Gradually expose the client to an elevator while practicing relaxation techniques.
• D. Stay with the client in an elevator until the anxiety response diminishes.

Correct answer: C

Rationale: Systematic desensitization is a type of therapy used to help individuals overcome phobias or anxieties. It involves gradually exposing the client to the feared object or situation, in this case, an elevator, while simultaneously practicing relaxation techniques. This process helps the client associate relaxation with the previously feared stimulus, gradually reducing anxiety levels over time. Choice A is incorrect as it involves imitation rather than gradual exposure. Choice B is incorrect as it focuses on a verbal response rather than the systematic process of exposure and relaxation. Choice D is incorrect as it does not involve the systematic approach of gradually exposing the client while teaching relaxation techniques.

4. A patient with generalized anxiety disorder (GAD) is prescribed sertraline. What is a common side effect the nurse should monitor for?

• A. Dry mouth
• B. Weight gain
• C. Insomnia
• D. Nausea

Correct answer: D

Rationale: Nausea is a common side effect associated with sertraline, a medication commonly used in the treatment of generalized anxiety disorder (GAD). It is essential for the nurse to monitor for nausea as it can impact the patient's adherence to the medication regimen. Educating the patient about this potential side effect and advising ways to manage it can enhance treatment compliance and overall therapeutic outcomes.

5. What is the primary goal of eye movement desensitization and reprocessing (EMDR) when treating a patient with posttraumatic stress disorder (PTSD)?

• A. To help the patient confront and process traumatic memories
• B. To help the patient change negative thought patterns
• C. To help the patient develop relaxation techniques
• D. To help the patient avoid triggers

Correct answer: A

Rationale: The primary goal of eye movement desensitization and reprocessing (EMDR) in treating patients with posttraumatic stress disorder (PTSD) is to help them confront and process traumatic memories. EMDR uses bilateral stimulation to facilitate the processing of distressing memories, leading to their desensitization and reprocessing, ultimately reducing PTSD symptoms.

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