SNLE Question Discussion -Training4Nurse Academy

طلابي ومتابعي الكرام ،،

مؤخرا في اختبارات الهيئة لعام 2017 ورد مجموعة من الاسئلة متعلقة بمستويات القلق level of anxiety ،الاكتئابlevels of depression ، و حتى فيما يتعلق بدرجة الجدية للانتحار واطرح لكم في هذه المدونة مناقشة لهذا النوع من الاسئلة ومجموعة من الاسئلة التي وردت في اختبارات الهيئة .

Question (1)

MILD (learning is enhanced)

Heightened perception (e.g., noises may seem louder; details within the environment are clearer). 

Increased awareness. 

Increased alertness.

 

MODERATE (learning still occurs, but not at optimal ability. )

Decreased attention span. 

Decreased ability to concentrate.

Reduction in perceptual field. 

Reduced alertness to environmental events (e.g., someone talking may not be heard; part of the room may not be noticed).

 

SEVERE (extremely limited attention span.) 

Unable to concentrate or problem-solve. 

Effective learning cannot occur.

Greatly diminished; only extraneous details are perceived, or fixation on a single detail may occur. 

May not take notice of an event even when attention is directed by another.

 

PANIC (learning cannot occur. Unable to concentrate.) 

Unable to comprehend even simple directions.

Unable to focus on even one detail within the environment. 

Misconceptions of the environment common (e.g., perceived detail may be elaborated and out of proportion.)

 

MILD (restlessness irritability)

may remain superficial with other. 

Rarely experienced as distressful. 

Motivation is increased.

 

MODERATE (increased restlessness, heart and respiratory rate, perspiration. ) 

Gastric discomfort. 

Increased muscular tension. 

Increased in speech rate, volume, and pitch.

a feeling of discontent. 

May lead to a degree of impairment in interpersonal relationships as individual begins to focus on self and the need to relieve personal discomfort.

 

SEVERE (headaches, dizziness, nausea, trembling, insomnia, palpitations, tachycardia, hyperventilation, urinary frequency, diarrhea.

feelings of dread, loathing, horror. 

Total focus on self and intense desire to relieve the anxiety.

 

PANIC (dilated pupils, labored breathing, severe trembling, sleeplessness, palpitations, diaphoresis and pallor, muscular incoordination, immobility or purposeless hyperactivity, incoherence or inability to verbalize

sense of impending doom. 

Terror. Bizarre behavior, including shouting, screaming, running about wildly, clinging to anyone or anything from which a sense of safety and security is derived. Hallucinations, delusions. 

Extreme withdrawal into self.

 

Question (1) 

A 29 year old client newly diagnosed with breast cancer is pacing, with rapid speech headache and inability to focus with what the doctor was saying. 

 

The nurse assesses the level of anxiety as: 

A. moderate

B. mild

C. severe

D. panic 

 Correct Answer and Rational : severe

توضيح السؤال : مريضة بعمر 29 سنة تم تشخيصها حديثا بسرطان الثدي، تظهر عليها الاعراض التالية تخطو خطوات سريعة وطريقتها في الحديث سريعة لدرجة ان طريقتها في الكلام تسبب الصداع ، وغير قادرة على التركيز على مايقوله الطبيب ،، بناءا على هذه العلامات والأعراض ما هو مستوى القلق لدى هذه المريضة ؟؟

اذا المطلوب تحديد درجة وشدة القلق عند المريضة بناءا على مايظهر عليها من علامات واعراض   

The client’s manifestations indicate severe anxiety. وفي الحالة المذكورة تبدو المريضة في حالة قلق شديد

اذا من المهم جدا أن تميز بين درجات القلق اعتمادا على مايظهر من اعراض وعلامات

Mild anxiety القلق البسيط : is manifested by :
1-slight muscle tension توتر او تشنج طفبف في العضلات
2-slight fidgeting تململ طفيف
3-alertness تأهب
4-ability to concentrate قادر على التركيز
5-capable of problem solving. قادر على حل المشكلات

Moderate Anxiety :
1-Moderate muscle tension توتر متوسط بالعضلات
2-increased vital signs ارتفاع بالعلامات الحيوية
3-periodic slow pacing
4-increased rate of speech
5-difficulty in concentrating

Panic  الهلع level of anxiety is characterized by   نوبة الهلع تتميز ب
1-immobilization  التجمد الحركي ،،عدم القدرة على التحرك
2-incoherence  عدم ترابط الكلام والتشوش
3-feeling of being overhelmed and disorganization.  الشعور بالارباك والفوضى

Question (2) 

A nurse is caring for a client who is scheduled for cardiac catheterization. When arriving for the procedure, the client reports walking that morning with butterflies in the stomach, a sense of restlessness, urinary frequency, and some difficulty concentrating while driving to the hospital. 

The admitting nurse should assess the client's anxiety level as which of the following?

A. moderate

B. mild
   C. severe

D. panic 

Correct Answer is :  A. moderate

The combination of physical symptoms and some difficulty concentrating indicates a moderate level of anxiety. 

This is not unusual considering the intrusive medical procedure the client is about to undergo

Question (3)

A 22 year-old man presented to the mental health clinic with a low-mood ,a general loss of interest in activities and inability to experience pleasure .he admitted to suicidal thoughts and extreme lack of energy . He was prescribed a selective serotonin reuptake inhibitor to be taken daily. One month later ,he presented to the clinic and reports feeling more energetic ,but still has low-mood.

What is the patient's level of risk committing suicide at this time ?

A-None

B-Low

C-Medium

D-High

Correct Answer : D-High