NCLEX^® QUESTION OF THE WEEK

Question of the Week – January 25, 2023

January 25, 2023

The nurse is collecting data from a client who survived a fire 2 months ago that killed two roommates. The client is reporting insomnia, difficulty concentrating, nervousness, and hypervigilance. Which problem has priority and should be included in the client’s plan of care?

Show Answer Answer

Correct! The answer is number 2

Rationale:

Answer: 2

Rationale: Anxiety is the client problem most evidenced by the symptoms. Post-traumatic stress disorder is precipitated by events that are overwhelming, unpredictable, and sometimes life threatening. Typical symptoms of post-traumatic stress disorder include difficulty concentrating, sleep disturbances, intrusive recollections of the traumatic event, hypervigilance, and anxiety. A phobia is an irrational fear of something or someone that interferes with daily living; this client is not exhibiting fear. Ineffective coping is defined as an inability to form an understanding of the stressors. This client may have ineffective coping, but it is not defined by the symptoms of nervousness and hypervigilance. Complicated grieving occurs from the distress of death and manifests in functional impairment. This individual is not functionally impaired.

Level of Cognitive Ability: Analyzing

Client Needs: Psychosocial Integrity

Integrated Process: Nursing Process/Planning

Content Area: Mental Health

Health Problem: Mental Health: Post-Traumatic Stress Disorder

Practice Question Sourced From: Evolve Resources for Saunders Q & A Review for the NCLEX-PN® Examination, 5th Edition