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Serving as a member on a crisis team, an adult psychiatric and mental health nurse practitioner provides crisis intervention to the survivors of a plane crash. Forty-eight hours after the accident, the survivors describe vivid flashbacks, startle reactions, and disrupted sleep patterns. The nurse practitioner responds by:
- A. advising the survivors to consider using a hypnotic medication for a brief period.
- B. educating the survivors about prodromal symptoms of posttraumatic stress disorder.
- C. encouraging the survivors to rest during the day.
- D. suggesting that the survivors join a posttrauma support group.
Correct Answer: B
Rationale: The symptoms described are early signs of PTSD. Educating survivors about these prodromal symptoms helps normalize their experience and encourages early intervention. Hypnotics may be premature without further evaluation, daytime rest could disrupt sleep further, and support groups are beneficial but not the immediate priority.
You may also like to solve these questions
Which of the following actions would NOT be helpful when dealing with Paranoid Hallucinations?
- A. Help the client relate with real persons
- B. Avoid giving attention to the content of hallucination or delusion after an initial investigation
- C. Acknowledge the clients belief in the perception but also indicate that is not shared by others
- D. Listen carefully to the content of hallucinations and delusion and encourage the client to describe them.
Correct Answer: D
Rationale: Even if you don't agree that they are under threat or at risk, try to understand how they are feeling. It's important to recognise that their feelings are very real, even if you feel the beliefs they are based on are unfounded. Focus on the level of distress they are feeling and offer comfort. It's possible to recognise their alarm and acknowledge their feelings without agreeing with the reason they feel that way.
A mother telephones an adult psychiatric and mental health nurse practitioner to report that her 13-year-old son has been unusually active, irritable, and unable to sleep for more than a few hours each night. The adolescent has been diagnosed with a major depressive disorder and has been taking fluoxetine (Prozac) for six weeks. The nurse practitioner is most concerned about the possibility that:
- A. a therapeutic level of the drug has not been reached.
- B. an addition of hypnotic medication is warranted.
- C. the adolescent has been misdiagnosed.
- D. the adolescent is experiencing side effects.
Correct Answer: C
Rationale: Symptoms of hyperactivity, irritability, and sleeplessness suggest mania, indicating a possible bipolar disorder misdiagnosed as depression. Fluoxetine can trigger mania in bipolar patients, making misdiagnosis the primary concern over levels , hypnotics , or side effects .
While the nurse was taking her blood pressure, the patient suddenly stated. 'They are talking about me!' She was referring to other patients who were waiting for their consultation. Which of the following should be the APPROPRIATE nursing action?
- A. Present the reality situation
- B. Distract patient's attention
- C. Disagree with the patient
- D. Validate the statement
Correct Answer: A
Rationale: The client is presenting false beliefs or delusions. Intervention would include focusing on and directing the client's attention to concrete things in the environment as a way to present reality.
A woman, aged 29, is admitted to the mental health hospital and diagnosed with Major Depressive Disorder with suicidal ideation. Her husband, aged 32, died in a tragic car accident 2 months prior to her admission. The nurse understands that the patient is experiencing
- A. dispositional crises
- B. crises of anticipated life transitions
- C. crises resulting from traumatic stress
- D. psychiatric emergencies
Correct Answer: C
Rationale: The sudden loss of her husband is a traumatic stress crisis, precipitating her depression and suicidal ideation.
Prior to administering chlorpromazine (Thorazine) to an agitated client, the nurse should:
- A. Assess skin color and sclera
- B. Assess the radial pulse
- C. Take the client's blood pressure
- D. Ask the client to void
Correct Answer: C
Rationale: Because chlorpromazine (Thorazine) can cause a significant hypotensive effect (and possible client injury), the nurse must assess the client's blood pressure (lying, sitting, and standing) before administering this drug. If the client had taken the drug previously, the nurse would also need to assess the skin color and sclera for signs of jaundice, a possible drug side affect; however, based on the information given here, there is no evidence that the client has received chlorpromazine before. Although the drug can cause urine retention, asking the client to avoid will not alter this anticholinergic effect.