Which health care worker should be referred to critical incident stress debriefing?

A health care provider who worked a 12-hour shift in a busy level 1 trauma center.

Nurse who works at an oncology clinic where patients receive chemotherapy.

A home health nurse making visits to seriously mentally ill patients being cared for at home.

Emergency medical technician who treated victims of a car bombing in a downtown area.

Answer and Explanation

The Correct Answer is D

Choice A reason: A 12-hour shift in a trauma center is stressful but not a critical incident requiring debriefing. Chronic stress may elevate cortisol, but critical incident stress debriefing targets acute trauma exposure, not routine workplace demands.

Choice B reason: Oncology nursing involves chronic emotional stress, not an acute critical incident. Chemotherapy care may cause burnout via sustained cortisol elevation, but debriefing is for sudden, traumatic events, not ongoing patient care challenges.

Choice C reason: Home health nursing for mental illness involves ongoing stress, not a single traumatic event. Chronic exposure may dysregulate serotonin and cortisol, but critical incident stress debriefing is reserved for acute, overwhelming trauma, not routine care.

Choice D reason: Treating car bombing victims is a critical incident, causing acute stress via amygdala-driven fear and cortisol surges. Debriefing mitigates PTSD risk by processing trauma, restoring prefrontal cortex regulation, and reducing long-term neurochemical imbalances, making this the appropriate choice.

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Correct Answer is ["10"]

Explanation

Step 1: Identify the required dose and concentration.
Required dose = 320 mg
Concentration = 160 mg per 5 mL
Result at step 1 = 320 mg ÷ (160 mg ÷ 5 mL)

Step 2: Calculate the volume in milliliters.
First, determine the milligrams per mL:
160 mg ÷ 5 mL = 32 mg/mL
Result at step 2a = 32 mg/mL
Now, calculate the volume:
320 mg ÷ 32 mg/mL = 10 mL
Result at step 2b = 10 mL

Step 3: Round to the nearest whole number.
10 mL is already a whole number.
Result at step 3 = 10 mL

A. Explain the time lag before antidepressants relieve symptoms. B. Discuss with the health care provider the need to increase the dose. C. Critically assess the patient for symptoms of improvement. D. Reassure the patient that the medication will be effective soon.

Correct Answer is A

Explanation

Choice A reason: Citalopram, an SSRI, increases serotonin levels, requiring 4-6 weeks to upregulate serotonin receptors and modulate prefrontal-amygdala circuits for mood improvement. Explaining this delay addresses patient expectations, reducing frustration and enhancing adherence by clarifying the neurochemical timeline of antidepressant action.

Choice B reason: Increasing the dose after 4 days is premature, as SSRIs like citalopram require weeks to alter serotonin signaling and neural plasticity. Premature dose escalation risks side effects like serotonin syndrome without addressing the expected therapeutic lag, making it an inappropriate intervention.

Choice C reason: Assessing for improvement after 4 days is unlikely to yield significant findings, as citalopram’s serotonin modulation takes weeks to impact mood via prefrontal cortex changes. This approach may reinforce the patient’s frustration without addressing the neurochemical basis of the delayed response.

Choice D reason: Reassuring effectiveness without explaining the delay is misleading. Citalopram’s action on serotonin pathways requires time for receptor upregulation and neural circuit adaptation. This vague reassurance does not educate the patient on the neurochemical timeline, potentially reducing trust and adherence.

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Which health care worker should be referred to critical incident stress debriefing?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer acetaminophen 320 mg PO every four hours as needed for pain. The amount available from the pharmacy is acetaminophen liquid 160 mg/5 mL. How many mL should the nurse administer per dose? (Round to the nearest whole number.)

Correct Answer is ["10"]

Explanation

A patient diagnosed with major depressive disorder began taking citalopram (Celexa) 4 days ago. The patient now says, "This medicine isn't working." The nurse's best intervention would be to:

Correct Answer is A

Explanation

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