The patient’s daughter was murdered while they were customers in a local bank. Which statements would support the patient’s diagnosis of posttraumatic stress disorder (PTSD)? Select all that apply:

Correct Answer: A

Rationale: The correct answer is A because feeling numb and detached from emotions is a common symptom of PTSD known as emotional numbing. This symptom is often seen in individuals who have experienced a traumatic event, such as the murder of a loved one. It is a defense mechanism that helps the person cope with overwhelming emotions. The other choices are incorrect: B: Being nervous and easily startled (hypervigilance) is more indicative of the hyperarousal symptom of PTSD, not emotional numbing. C: Difficulty sleeping is a common symptom of PTSD, known as insomnia, but it does not directly relate to emotional numbing. D: Reliving the traumatic event through flashbacks or intrusive memories is a symptom of PTSD, but it is not directly related to emotional numbing.

Correct Answer: B

Rationale: The correct answer is B: Enroll the patient in an exercise program that meets regularly. Regular exercise has been shown to have numerous benefits for brain health, including improving cognitive function and reducing the risk of cognitive decline. Exercise also helps in maintaining a healthy immune system by promoting the circulation of immune cells throughout the body. This can help support the protective abilities of immune cells related to Alzheimer's disease. Minimizing contact with the public during cold and flu season (Choice A) may reduce the risk of infections but does not directly address immune cell function. Providing supplements to enhance the patient's immune system (Choice C) may not be supported by scientific evidence and can potentially have adverse effects. Identifying creative ways to keep the patient mentally challenged (Choice D) is beneficial for cognitive health but does not directly target immune cell function as effectively as regular exercise.

Correct Answer: C

Rationale: The priority nursing diagnosis in this case is C: Risk for suicide. This is because the patient is exhibiting suicidal ideation, which poses an immediate threat to their safety and well-being. Suicidal ideation requires urgent intervention to ensure the patient's safety. The patient's major depression, weight gain, and lack of symptom remission from the antidepressant medication further emphasize the seriousness of the situation. Choices A, B, and D are not the priority in this scenario as they do not address the immediate risk of harm to the patient. Imbalanced nutrition and chronic low self-esteem are important concerns but do not take precedence over the risk of suicide. Hopelessness, while relevant, is not as urgent as addressing the immediate risk of suicide.

Correct Answer: A

Rationale: Rationale for Correct Answer (A): Reporting the findings to the health care provider is the next best action because elevated BUN and creatinine levels indicate possible renal dysfunction, which could be causing the psychiatric symptoms. The health care provider needs this information to determine appropriate treatment and further evaluation. Summary of Incorrect Choices: B: Assessing the patient for a history of renal problems is not the next best action because the lab results already indicate potential renal issues. C: Assessing the patient’s family history for cardiac problems is irrelevant to the elevated BUN and creatinine levels and the psychiatric symptoms. D: Arranging for the patient’s hospitalization on the psychiatric unit is premature without addressing the underlying medical issue indicated by the lab results.

Correct Answer: D

Rationale: The correct answer is D because showing no emotion when discussing a personal tragedy is indicative of blunted affect, a negative symptom commonly seen in residual schizophrenia. This behavior aligns with the diagnostic criteria for residual schizophrenia, which includes the presence of negative symptoms like flat affect. Choices A, B, and C do not directly relate to negative symptoms of schizophrenia. A communicating style or claims about worms do not specifically indicate negative symptoms, and maintaining arms awkwardly overhead is not a typical symptom of residual schizophrenia.