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A client describes flashbacks of a terrifying car crash in which he saw his best friend die. Which disorder should the nurse suspect in this situation?
- A. Panic disorder
- B. Obsessive-compulsive disorder
- C. Posttraumatic stress disorder
- D. Agoraphobia
Correct Answer: C
Rationale: Panic disorder involves unexpected and repeated episodes of intense fear, often without a specific trigger, and isn’t typically linked to flashbacks. Obsessive-compulsive disorder is characterized by unwanted repeated thoughts (obsessions) and actions (compulsions), not trauma-related flashbacks. PTSD involves re-experiencing a traumatic event through flashbacks and nightmares, directly matching the client’s symptoms of reliving the car crash. Agoraphobia is an anxiety disorder involving fear of places or situations that might cause panic, not tied to specific traumatic memories.
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A nurse is caring for a group of older adult clients. Which of the following client findings indicates delirium?
- A. A client expresses dislike of orange juice after reporting earlier that it was a favorite juice.
- B. A client wants to know what type of poison the nurse placed in her medication.
- C. A client asks when family members will be arriving after visiting 1 hr earlier.
- D. A client requests extra blankets when the thermostat in the room indicates 80°F.
Correct Answer: C
Rationale: Changing preferences isn’t delirium-specific. Suspecting poison suggests delusion, not necessarily delirium. Confusion about recent events, like family visits, indicates delirium’s hallmark disorientation. Requesting blankets in a warm room may reflect sensory issues, not delirium directly.
A nurse in an acute care facility is assisting with the admission of an older adult client who has late stage Alzheimer's disease. The nurse notes that the client's partner appears exhausted. He states that he is finding it more and more difficult to care for his partner. Which of the following actions should the nurse take first?
- A. Suggest that the client's partner see a counselor to help him cope with his exhaustion.
- B. Encourage the client's partner to call a family meeting to ask for help.
- C. Ask the partner to talk about his difficulties in caring for the client.
- D. Recommend that the client's partner place the client in a long-term care facility.
Correct Answer: C
Rationale: Counseling helps later, not first. Family meetings follow understanding needs. Asking about difficulties assesses the situation, guiding support. Recommending placement is premature without discussion.
For several days, an elderly client becomes confused and agitated after supper. This is an example of which of the following?
- A. Sundown syndrome
- B. Dementia
- C. Age-associated memory impairment
- D. Delirium
Correct Answer: A
Rationale: Sundown syndrome is increased confusion and agitation in the evening, matching the pattern. Dementia is broader and not time-specific. Age-associated memory impairment is mild and doesn’t include agitation. Delirium is acute and not tied to a daily cycle.
A nurse is caring for a client who has an anxiety disorder. Which of the following findings should the nurse recognize as a manifestation of mild anxiety?
- A. Incoherent speech
- B. Irritability
- C. Insomnia
- D. Chest pain
Correct Answer: B
Rationale: Incoherent speech indicates severe anxiety. Irritability is a mild anxiety sign, with maintained function. Insomnia suggests chronic anxiety. Chest pain aligns with severe anxiety or panic.
A nurse is reviewing the plan of care for a client who has depression. Which of the following actions should the nurse plan to take?
- A. Reinforce how to use assertive communication techniques.
- B. Schedule the client's daily self-care activities.
- C. Discourage the client from expressing anger.
- D. Set short-term and long-term goals for the client.
Correct Answer: D
Rationale: Assertiveness is secondary to overall planning. Scheduling self-care helps but isn’t comprehensive. Suppressing anger hinders emotional health. Goal setting provides direction and motivation, key to depression management.