A nurse is caring for a client:
The client has returned to work at an accounting firm and has started going to a grief support group. She reports she is seeking care from a healthcare professional because her father is worried about her. The client says she only gets 2 to 3 hours of sleep due to nightmares about the crash. She informs that exercising right after work helps her get better sleep and to relax. She feels that she is "jumpy" after the accident, especially when she is in the car. She also stated, "I feel so sad that I can't seem to feel anything at all." In addition to her father, the client has a large family and friend support system. She denies alcohol or drug use.
Click to highlight the areas that the nurse should react to immediately. The client has returned to work at an accounting firm and has started going to a grief support group. She reports she is seeking care from a healthcare professional because her father is worried about her. The client says she only gets 2 to 3 hours of sleep due to nightmares about the crash. She informs that exercising right after work helps her get better sleep and to relax. She feels that she is "jumpy" after the accident, especially when she is in the car. She also stated, "I feel so sad that I can't seem to feel anything at all" In addition to her father, the client has a large family and friend support system. She denies alcohol or drug use.
she only gets 2 to 3 hours of sleep
She feels that she is "jumpy" after the accident
I feel so sad that I can't seem to feel anything at all"
The client has returned to work at an accounting firm
The Correct Answer is ["A","B","C"]
In the scenario presented, the nurse should prioritize addressing the client's sleep disturbances, heightened startle response, and feelings of sadness and numbness. These symptoms may indicate acute stress reaction or post-traumatic stress disorder, conditions that can occur after experiencing a traumatic event such as a car crash. Immediate interventions could include providing a safe and calm environment, offering support and reassurance, assessing for risk of harm to self or others, and referring to mental health professionals for further evaluation and treatment. It's also important to acknowledge the client's proactive steps, such as joining a grief support group and exercising, which are positive coping strategies. The nurse should collaborate with the client to build on these healthy habits while addressing the more distressing symptoms with appropriate care and referrals.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D","E"]
Explanation
A. Waiting until the client is completely calm is important because it allows the client to feel safe and secure, reducing anxiety and making it easier for them to open up about sensitive issues.
B. Asking difficult questions first is not typically advised as it can increase anxiety and make the client less likely to disclose information. It's important to build rapport and trust before tackling more challenging topics.
C. Using silence as a tool can give the client time to think and process their thoughts, which can lead to more meaningful communication. It also shows the nurse is patient and willing to listen.
D. Speaking with the client in private ensures confidentiality and helps establish a safe space where the client feels comfortable sharing personal information without fear of judgment or exposure.
E. Observing nonverbal behavior and reacting accordingly is crucial as it can provide insights into the client's emotional state and help the nurse respond in a way that is empathetic and supportive.
F. Asking several questions in a row can overwhelm the client and make it difficult for them to provide thoughtful answers. It's better to ask one question at a time and allow the client to fully respond before moving on to the next question.
Correct Answer is ["A","B","C","D"]
Explanation
Social withdrawal: This is a common symptom as individuals may avoid social interactions and isolate themselves due to ongoing distress.
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B) Exaggerated startle response: Individuals may have an increased startle reflex following trauma, which can persist over time.
C) Intrusive thoughts: These are unwanted and distressing thoughts related to the trauma that can continue to affect the individual.
D) Avoidance of places associated with the assault: This behavior is a protective mechanism to prevent re-experiencing the traumatic event.
E) Overeating: Overeating is not a characteristic sequalae of rape trauma. F) Hallucinations: Hallucinations are not typically associated with long-term symptoms of rape trauma syndrome. Hallucinations can occur in severe cases, particularly if there are co-occurring mental health disorders such as PTSD.
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