A patient with posttraumatic stress disorder (PTSD) is experiencing flashbacks. The most appropriate intervention is to:
- A. Encourage the patient to talk about the trauma.
- B. Help the patient reorient to the present.
- C. Leave the patient alone to process the flashback.
- D. Remind the patient that the flashback is not real.
Correct Answer: B
Rationale: When a patient with PTSD is experiencing flashbacks, the most appropriate intervention is to help them reorient to the present. This intervention can assist in reducing the intensity of the flashback and providing a sense of safety for the patient. Choice A is incorrect because encouraging the patient to talk about the trauma during a flashback may exacerbate their distress. Choice C is incorrect as leaving the patient alone can increase their feelings of isolation and fear. Choice D is incorrect because reminding the patient that the flashback is not real may invalidate their experience and increase their sense of disconnection.
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Which of the following is a negative symptom of schizophrenia?
- A. Hallucinations
- B. Delusions
- C. Alogia
- D. Paranoia
Correct Answer: C
Rationale: Alogia, also known as poverty of speech, is a negative symptom of schizophrenia. It refers to a reduction in the amount of speech or the feeling that one has nothing to say. Hallucinations and delusions are positive symptoms, characterized by the presence of abnormal experiences and beliefs. Paranoia is a symptom involving intense anxious or fearful feelings, which is not classified as a negative symptom of schizophrenia.
In the treatment of generalized anxiety disorder (GAD), what medication is frequently prescribed as a first-line treatment?
- A. Clonazepam
- B. Buspirone
- C. Propranolol
- D. Hydroxyzine
Correct Answer: B
Rationale: Buspirone is often chosen as a first-line treatment for generalized anxiety disorder (GAD) due to its efficacy and favorable side effect profile. Unlike benzodiazepines such as clonazepam (A), buspirone does not carry the risk of tolerance, dependence, or withdrawal symptoms, making it a preferred choice. While propranolol (C) and hydroxyzine (D) are sometimes used for anxiety, they are not typically considered first-line treatments for GAD.
During a panic attack, what is the nurse's priority intervention for a patient with panic disorder?
- A. Encourage the patient to verbalize their feelings.
- B. Provide reassurance and stay with the patient.
- C. Leave the patient alone to calm down.
- D. Distract the patient with a task.
Correct Answer: B
Rationale: During a panic attack, the priority intervention for the nurse is to provide reassurance and stay with the patient. This action helps reduce fear and provides a sense of safety, which can aid in calming the patient and preventing further escalation of the panic attack. Encouraging the patient to verbalize their feelings (Choice A) may be beneficial after the acute phase of the panic attack. Leaving the patient alone (Choice C) may increase feelings of abandonment and escalate the panic attack. Distracting the patient with a task (Choice D) is not recommended during a panic attack as it may divert attention but not address the underlying anxiety and fear.
During a routine health screening, a grieving widow whose husband died 15 months ago reports emptiness, a loss of self, difficulty thinking of the future, and anger at her dead husband. The nurse suggests bereavement counseling. The widow is most likely suffering from:
- A. Major depression
- B. Normal grieving
- C. Adjustment disorder
- D. Posttraumatic stress disorder
Correct Answer: C
Rationale: The widow's symptoms align more closely with an adjustment disorder rather than major depression, normal grieving, or posttraumatic stress disorder. The widow's prolonged struggle in coping with the loss, characterized by emptiness, loss of self, difficulty envisioning the future, and anger towards her deceased husband, indicates an inability to adapt to the loss. These symptoms are indicative of an adjustment disorder, which typically arises in response to a significant life stressor and persists beyond what is considered a normal grieving process. Bereavement counseling can help the widow navigate her emotions and coping strategies during this challenging period.
A patient with obsessive-compulsive disorder (OCD) is prescribed paroxetine. The nurse should educate the patient about which potential side effect?
- A. Insomnia
- B. Weight loss
- C. Sexual dysfunction
- D. Hypertension
Correct Answer: C
Rationale: The correct answer is C, 'Sexual dysfunction.' Paroxetine, an SSRI commonly prescribed for OCD, can lead to sexual dysfunction as a side effect. Patients should be educated about this potential adverse effect to ensure they are aware and can seek appropriate management if needed. Choices A, B, and D are incorrect because insomnia, weight loss, and hypertension are not typically associated with paroxetine use as common side effects in patients with OCD.