A client diagnosed with post-traumatic stress disorder (PTSD) is being assessed by a healthcare professional. Which symptom would the healthcare professional expect the client to exhibit?

Correct Answer: B

Rationale: In individuals with post-traumatic stress disorder (PTSD), hypervigilance is a common symptom. Hypervigilance refers to a state of increased alertness, awareness, and sensitivity to potential threats or danger. This heightened state of vigilance can manifest as being easily startled, having difficulty relaxing or sleeping, and constantly scanning the environment for signs of danger. It is an adaptive response to the trauma experienced and can significantly impact the individual's daily functioning. The other options are not typically associated with PTSD. Delusions of grandeur are more commonly seen in certain psychiatric disorders like bipolar disorder or schizophrenia. Obsessive-compulsive behaviors are characteristic of obsessive-compulsive disorder (OCD), not PTSD. Periods of excessive sleeping may be seen in conditions like depression, but they are not a hallmark symptom of PTSD.

Correct Answer: B

Rationale: In cases of severe anxiety, creating a quiet and calm environment is crucial as it can help reduce stimulation and promote relaxation. This environment can provide a sense of safety and security, which are essential for individuals experiencing heightened anxiety levels. Encouraging the client to talk about their feelings may not be suitable during severe anxiety as it can further escalate distress by focusing on the source of anxiety. Vigorous exercise and group activities may not be appropriate initially, as they can increase arousal levels rather than promoting a sense of calm needed to manage severe anxiety.

Correct Answer: A

Rationale: In cognitive-behavioral therapy (CBT), one of the primary objectives is to help clients identify and challenge their negative thoughts. This process allows the individual to reframe their thinking patterns and develop more adaptive coping strategies. Reporting an increase in suicidal thoughts (Choice B) or experiencing an increase in anxiety (Choice C) are not desired outcomes and may indicate a need for further intervention. Showing no change in behavior (Choice D) suggests that the therapy has not been effective. Therefore, the correct indicator of effective therapy in this context is the client's ability to identify and challenge negative thoughts (Choice A).

Correct Answer: B

Rationale: The correct answer is to advise the client to avoid drinking alcohol while taking fluoxetine (Prozac) due to potential interactions. Alcohol consumption can increase the risk of certain side effects and may reduce the effectiveness of the medication. Choice A is incorrect because fluoxetine can be taken with or without food. Choice C is incorrect as fluoxetine is usually taken daily regardless of the client's mood. Choice D is not the priority teaching point; while reporting side effects is important, avoiding alcohol is critical due to the potential interactions.

Correct Answer: C

Rationale: Buspirone (Buspar) is a medication used to treat generalized anxiety disorder, and its pharmacological properties and clinical use explain why choice C is correct while the others are incorrect. **Correct Answer (C):** Buspirone has a delayed onset of action, typically requiring **2-4 weeks** for noticeable therapeutic effects. Unlike benzodiazepines, which provide rapid relief, buspirone works by modulating serotonin and dopamine receptors over time. This slow mechanism means patients must take it consistently—not as needed—to achieve anxiety reduction. The statement "It may take several weeks for this medication to take effect" demonstrates accurate understanding, as it aligns with the drug's pharmacokinetics and prescriber instructions. **Incorrect Answer (A):** "I should take this medication as needed for anxiety" is incorrect because buspirone is not a PRN (as-needed) medication. It does not provide immediate relief like benzodiazepines (e.g., lorazepam) due to its gradual effect on neurotransmitter systems. Taking it intermittently would undermine its efficacy, as steady blood levels are required for therapeutic benefits. **Incorrect Answer (B):** "I need to avoid aged cheeses" is incorrect because this precaution applies to **MAO inhibitors** (e.g., phenelzine), not buspirone. MAO inhibitors interact with tyramine-rich foods (like aged cheeses), causing hypertensive crises. Buspirone lacks this interaction, so dietary restrictions are unnecessary. This statement reflects confusion with another drug class. **Incorrect Answer (D):** "I can stop taking this medication abruptly if I feel better" is incorrect because sudden discontinuation, though not typically associated with severe withdrawal (unlike benzodiazepines), can lead to symptom recurrence. Buspirone should be tapered under medical supervision to prevent rebound anxiety. Abrupt cessation disregards the need for gradual adjustment and ongoing management of anxiety disorders. The key distinctions lie in buspirone's **mechanism (slow-acting, non-sedating), dosing regimen (scheduled, not PRN), and lack of dietary or abrupt-discontinuation risks** compared to other anxiolytics. Choice C correctly reflects these nuances, while the others misrepresent the drug’s use or confuse it with other medications.