A nurse is counseling a group of clients from a town that was affected by a hurricane 6 months ago. For which of the following clients should the nurse initiate a referral to assess for the presence of post-traumatic stress disorder? (Select all that apply)

A client who describes having persistent feelings of anger about the hurricane.

A client who expresses a realization that life will not return to the way it was before the hurricane.

A client who moved to an apartment located on higher ground than her previous home.

A client who has frequent nightmares about the hurricane.

A client who describes feeling disconnected from those around him following the hurricane.

Answer and Explanation

Correct Answer : A,D,E

Choice A reason: Persistent anger about the hurricane is a PTSD symptom, reflecting emotional dysregulation and hyperarousal post-trauma. This ongoing distress, per DSM-5 criteria, warrants referral for mental health evaluation to address potential PTSD, making it a correct indicator for intervention.
Choice B reason: Realizing life will not return to normal is a realistic adjustment, not necessarily a PTSD symptom. Without additional distress indicators, this does not meet diagnostic criteria for PTSD, making it incorrect for requiring a referral in this context.
Choice C reason: Moving to higher ground is a practical response to reduce future risk, not a PTSD symptom. It reflects adaptive coping rather than psychological distress, so it does not warrant a referral for PTSD assessment, making it incorrect.
Choice D reason: Frequent nightmares about the hurricane are a hallmark PTSD symptom, classified as intrusive re-experiencing per DSM-5. This significant distress disrupts sleep and daily functioning, necessitating a referral for mental health evaluation, making it a correct choice.
Choice E reason: Feeling disconnected from others indicates emotional numbing, a PTSD avoidance symptom per DSM-5. This social withdrawal post-hurricane suggests significant psychological impact, warranting a referral for PTSD assessment to address underlying trauma, making it correct.

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Correct Answer is A

Explanation

Choice A reason: Smoked salmon is high in tyramine, which phenelzine, an MAOI, prevents from being metabolized. This risks hypertensive crisis due to norepinephrine release, potentially causing stroke or cardiovascular complications. Avoiding tyramine-rich foods is critical for safety in clients on MAOI therapy.
Choice B reason: Cottage cheese is low in tyramine, safe for phenelzine users. Unlike aged cheeses, fresh dairy poses minimal risk of hypertensive crisis, as it lacks significant tyramine content. MAOIs require avoiding high-tyramine foods, making cottage cheese an acceptable dietary choice for these clients.
Choice C reason: Grapefruit affects CYP450 enzymes, interacting with some drugs, but is not contraindicated with phenelzine. It lacks significant tyramine, so it does not trigger hypertensive crises. Avoidance is unnecessary, as it does not impact MAOI metabolism or related cardiovascular risks.
Choice D reason: Fresh apples are low in tyramine and safe for phenelzine users. MAOIs require avoiding tyramine-rich foods like aged meats, but fresh fruits do not cause hypertensive crises, as they lack amino acids interacting with MAOI metabolism, making them safe for consumption.

A. I prefer to wear loose clothing to hide my scars. B. I am ready to join a support group for cancer survivors. C. I feel confident about my recovery process. D. I am planning to resume my exercise routine next week.

Correct Answer is A

Explanation

Choice A reason: Preferring loose clothing to hide scars indicates an altered body image, as it reflects discomfort with physical changes post-mastectomy. This behavior suggests emotional distress about appearance, a common response to surgical body alterations, making it the correct indicator.
Choice B reason: Joining a support group shows proactive coping and acceptance, not necessarily an altered body image. It reflects social engagement and resilience, not distress about physical changes, making it incorrect for indicating body image concerns.
Choice C reason: Feeling confident about recovery suggests positive adjustment, not an altered body image. Confidence indicates emotional resilience rather than distress about physical appearance post-mastectomy, making this statement incorrect for this concern.
Choice D reason: Planning to resume exercise indicates focus on recovery and health, not body image distress. This proactive attitude reflects physical rehabilitation goals, not emotional concerns about appearance, making it incorrect for altered body image.

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A nurse is counseling a group of clients from a town that was affected by a hurricane 6 months ago. For which of the following clients should the nurse initiate a referral to assess for the presence of post-traumatic stress disorder? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client who has a depressive disorder and a new prescription for phenelzine. Which of the following foods should the nurse instruct the client to avoid?

Correct Answer is A

Explanation

A nurse is caring for a client who has breast cancer and is postoperative following a bilateral mastectomy. Which of the following statements indicates the client has an altered body image?

Correct Answer is A

Explanation

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