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A healthcare provider is developing a care plan for a patient with posttraumatic stress disorder (PTSD). Which intervention should be included to help the patient manage flashbacks?
- A. Encouraging the patient to confront the trauma directly.
- B. Teaching the patient grounding techniques.
- C. Encouraging the patient to use relaxation techniques.
- D. Helping the patient develop a safety plan.
Correct Answer: B
Rationale: The correct answer is B: Teaching the patient grounding techniques. Grounding techniques help individuals with PTSD manage flashbacks by bringing their focus back to the present moment and reality. This can include techniques like deep breathing, mindfulness, and using the five senses to connect with the environment. Encouraging the patient to confront the trauma directly (A) can be overwhelming and retraumatizing. Relaxation techniques (C) may not be effective during a flashback when the individual is in a hyperaroused state. Developing a safety plan (D) is important but is more focused on preventing future crises rather than managing flashbacks in the moment.
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A patient with posttraumatic stress disorder (PTSD) is experiencing nightmares. Which intervention should the nurse include in the care plan?
- A. Encouraging the patient to journal before bedtime
- B. Teaching relaxation techniques
- C. Avoiding discussing the nightmares directly
- D. Developing a safety plan
Correct Answer: B
Rationale: The correct answer is B: Teaching relaxation techniques. This intervention is effective in managing PTSD-related nightmares by helping the patient reduce anxiety and promote better sleep. Relaxation techniques, such as deep breathing and progressive muscle relaxation, can calm the nervous system and improve sleep quality. Encouraging the patient to journal before bedtime (Choice A) may help with processing emotions but may not directly address the nightmares. Avoiding discussing the nightmares directly (Choice C) can lead to avoidance behaviors and hinder the therapeutic process. Developing a safety plan (Choice D) is important for overall safety but does not specifically target the nightmares.
When discharging a patient with schizophrenia on risperidone, what is an important point to include in the discharge teaching?
- A. Avoiding foods high in tyramine is essential.
- B. Getting blood levels checked regularly is necessary.
- C. Being cautious when driving due to possible drowsiness is crucial.
- D. Taking this medication on an as-needed basis is recommended.
Correct Answer: B
Rationale: The correct answer is B: Getting blood levels checked regularly is necessary. This is important because risperidone is a medication that requires monitoring of blood levels to ensure it is within the therapeutic range for effectiveness and to prevent side effects. Regular monitoring helps to adjust the dosage if needed.
Choice A is incorrect because foods high in tyramine are a concern when taking MAOIs, not risperidone. Choice C is incorrect because drowsiness is a common side effect initially, but it may improve over time and caution while driving should be based on individual response. Choice D is incorrect because risperidone is not meant to be taken on an as-needed basis; it should be taken consistently to maintain stability in treating schizophrenia.
A healthcare professional is assessing a patient with major depressive disorder. Which finding is most concerning?
- A. Decreased interest in activities
- B. Feelings of worthlessness
- C. Difficulty sleeping
- D. Changes in appetite
Correct Answer: C
Rationale: The correct answer is C: Difficulty sleeping. This finding is most concerning because it can indicate severe depression or potential suicidal ideation. Insomnia is a common symptom of major depressive disorder and can exacerbate the patient's condition. It is important to address sleep disturbances promptly to prevent further deterioration.
Rationale for why other choices are incorrect:
A: Decreased interest in activities is a common symptom of major depressive disorder but may not necessarily indicate immediate risk.
B: Feelings of worthlessness are also common in depression but may not be as urgent as sleep disturbances.
D: Changes in appetite can be a symptom of depression, but difficulty sleeping poses a more immediate concern for potential harm to the patient's well-being.
A patient with major depressive disorder is started on fluoxetine. What is a common side effect the nurse should monitor for?
- A. Weight gain
- B. Increased appetite
- C. Nausea
- D. Dry mouth
Correct Answer: C
Rationale: The correct answer is C: Nausea. Fluoxetine, an SSRI antidepressant, commonly causes gastrointestinal side effects such as nausea. This is due to its effect on serotonin levels in the gut. Weight gain (A) and increased appetite (B) are less common side effects of fluoxetine. Dry mouth (D) is more commonly associated with tricyclic antidepressants, not SSRIs. Monitoring for nausea is crucial to ensure patient compliance and well-being.
While being treated in an inpatient facility, what is the most appropriate intervention for a patient with anorexia nervosa?
- A. Allowing the patient to eat alone to reduce stress
- B. Monitoring the patient's weight daily
- C. Encouraging the patient to exercise daily
- D. Providing the patient with a high-calorie diet
Correct Answer: B
Rationale: The correct answer is B: Monitoring the patient's weight daily. This intervention is crucial in managing anorexia nervosa as it helps track the patient's progress and identify any concerning weight fluctuations promptly. Daily weight monitoring allows healthcare providers to adjust treatment plans accordingly and ensure the patient's safety.
Choice A: Allowing the patient to eat alone to reduce stress is incorrect because isolation during meals can exacerbate the patient's disordered eating behaviors and hinder the recovery process.
Choice C: Encouraging the patient to exercise daily is incorrect as excessive exercise is a common symptom of anorexia nervosa and can further contribute to the patient's physical and psychological health risks.
Choice D: Providing the patient with a high-calorie diet is incorrect without proper monitoring as it can lead to refeeding syndrome and other complications. Monitoring the patient's weight is essential before implementing dietary changes.