Question: Cortisol is released in response to a patient’s prolonged stress. Which initial effect would the nurse expect to result from the increased cortisol level?
Answer Choices: a. Diuresis and electrolyte imbalance b. Focused and alert mental status c. Drowsiness and lethargy d. Restlessness and anxiety
Answer: b
Question: A soldier returns to the United States from active duty in a combat zone. The soldier is diagnosed with posttraumatic stress disorder (PTSD). The nurse’s highest priority is to screen this soldier for which problem?
Answer Choices: a. Major depressive disorder b. Bipolar disorder c. Schizophrenia d. Dementia
Answer: a
Question: A soldier returns to the United States from active duty in a combat zone. The soldier is diagnosed with posttraumatic stress disorder (PTSD). Which comment by the soldier requires the nurse’s immediate attention?
Answer Choices: a. “It’s good to be home. I missed my family and friends.” b. “I saw my best friend get killed by a roadside bomb. It should have been me instead.” c. “Sometimes I think I hear bombs exploding, but it’s just the noise of traffic in my hometown.” d. “I want to continue my education but I’m not sure how I will fit in with other college students.”
Answer: b
Question: A veteran of the war in Afghanistan was diagnosed with posttraumatic stress disorder (PTSD). The veteran says, “If there’s a loud noise at night, I get under my bed because I think we’re getting bombed.” What type of experience has the veteran described?
Answer Choices: a. Illusion b. Flashback c. Nightmare d. Auditory hallucination
Answer: b
Question: A soldier returned 1 year ago from Afghanistan and was diagnosed with posttraumatic stress disorder (PTSD). Which social event would most likely be disturbing for this soldier?
Answer Choices: a. Halloween festival with neighborhood children b. Singing carols around a Christmas tree c. Family outing to the seashore d. Fireworks display on July 4th
Answer: d
Question: A soldier served in combat zones in Iraq in 2010 and was deployed to Afghanistan in 2014. When is it most important for the nurse to screen for signs and symptoms of posttraumatic stress disorder (PTSD)?
Answer Choices: a. Immediately upon return to the United States from Afghanistan b. Before departing Afghanistan to return to the United States c. Two years after returning from Afghanistan d. Screening should be ongoing
Answer: d
Question: A nurse designs a plan of exercise for a patient experiencing stress. What rationale should the nurse cite when presenting this plan to the treatment team?
Answer Choices: a. Exercise will stimulate endorphins and improve the patient’s feelings of well-being. b. Exercise prevents damage from overstimulation of the sympathetic nervous system. c. Exercise detoxifies the body by removing metabolic wastes and other toxins. d. Exercise will prevent exacerbation of the stress by the limbic system.
Answer: a
Question: A veteran of military combat tells the nurse, “I saw a child get blown up over a year ago, and now I keep seeing bits of flesh everywhere. I see something red and the visions race back to my mind.” Which phenomenon associated with posttraumatic stress disorder (PTSD) is this veteran describing?
Answer Choices: a. Re-experiencing b. Hyperarousal c. Avoidance d. Psychosis
Answer: a
Question: A soldier who served in a combat zone returned to the United States. The soldier’s spouse complains to the nurse, “We had planned to start a family, but now he won’t talk about it. He won’t even look at children.” The spouse is describing which symptom associated with posttraumatic stress disorder (PTSD)?
Answer Choices: a. Re-experiencing b. Hyperarousal c. Avoidance d. Psychosis
Answer: c
Question: A nurse assesses the health status of veterans of the war in Afghanistan. Screening will be a priority for signs and symptoms of which health problems? (Select all that apply.)
Answer Choices: a. Schizophrenia b. Eating disorder c. Traumatic brain injury d. Seasonal affective disorder e. Posttraumatic stress disorder
Answer: c, e
Question: A professor’s 4-year-old child has a temperature of 101.6° F, diarrhea, and complains of stomach pain. The professor is scheduled to teach three classes today. Which actions by the professor demonstrate effective parenting? (Select all that apply.)
Answer Choices: a. Telephoning a grandparent to stay with the child at home for the day b. Telephoning a colleague to teach his classes and staying home with the sick child c. Taking the child to the university and keeping the child in a private office for the day d. Taking the child to a daycare center and hoping daycare workers will not notice the child is sick e. Giving the child one dose of ibuprofen (Motrin) and taking the child to the daycare center
Answer: a, b
Question: A nurse wishes to teach alternative coping strategies to a patient experiencing severe anxiety. The nurse will first need to:
Answer Choices: a. verify the patient’s learning style. b. create outcomes and a teaching plan. c. lower the patient’s current anxiety level. d. assess how the patient uses defense mechanisms.
Answer: c
Question: A patient approaches the nurse and impatiently blurts out, “You’ve got to help me! Something is wrong. My heart is pounding.” The nurse responds, “It’s almost time for visiting hours. Let’s get your hair combed.” Which approach has the nurse used?
Answer Choices: a. Bringing up an irrelevant topic b. Responding to physical needs c. Addressing false cognitions d. Focusing
Answer: a
Question: A patient experiencing moderate anxiety says, “I feel undone.” An appropriate response for the nurse would be:
Answer Choices: a. “Why do you suppose you are feeling anxious?” b. “What would you like me to do to help you?” c. “I’m not sure I understand. Give me an example.” d. “You must get your feelings under control before we can continue.”
Answer: c
Question: A patient with a high level of motor activity runs from chair to chair and cries, “They’re coming! They’re coming!” The patient does not follow instructions or respond to verbal interventions from staff. The initial nursing intervention of highest priority is to:
Answer Choices: a. provide for patient safety. b. increase environmental stimuli. c. respect the patient’s personal space. d. encourage the clarification of feelings.
Answer: a
Question: A patient with a high level of motor activity runs from chair to chair and cries, “They’re coming! They’re coming!” The patient is unable to follow instructions or respond to verbal interventions from staff. Which nursing diagnosis has the highest priority?
Answer Choices: a. Risk for injury b. Self-care deficit c. Disturbed energy field d. Disturbed thought processes
Answer: a
Question: A supervisor assigns a worker a new project. The worker initially agrees but feels resentful. The next day, when asked about the project, the worker says, “I’ve been working on other things.” When asked 4 hours later, the worker says, “Someone else was using the copier, so I couldn’t finish it.” The worker’s behavior demonstrates the use of what mechanism?
Answer Choices: a. Acting out b. Projection c. Suppression d. Passive aggression
Answer: d
Question: A patient is undergoing diagnostic tests. The patient says, “Nothing is wrong with me except a stubborn chest cold.” The spouse reports that the patient smokes, coughs daily, has recently lost 15 pounds, and is easily fatigued. Which defense mechanism is the patient using?
Answer Choices: a. Displacement b. Regression c. Projection d. Denial
Answer: d
Question: A patient with a mass in the left upper lobe of the lung is scheduled for a biopsy. The patient has difficulty understanding the nurse’s comments and asks, “What are they going to do?” Assessment findings on the patient include a tremulous voice, respirations 28 breaths per minute, and pulse rate 110 beats/min. What is the patient’s level of anxiety?
Answer Choices: a. Mild b. Moderate c. Severe d. Panic
Answer: b
Question: A patient who is preparing for surgery has moderate anxiety and is unable to understand preoperative information. Which nursing intervention is appropriate?
Answer Choices: a. Reassure the patient that all nurses are skilled in providing postoperative care. b. Tell the patient that there is nothing to be afraid of and surgery is safe. c. Explain the procedure again using simpler language. d. Postpone the preoperative teaching until the patient is less anxious.
Answer: d