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A client is seeking counseling due to difficulty coping with being a victim of a violent attack 16 months ago. The initial medical diagnosis is to rule out posttraumatic stress disorder (PTSD). Which would the nurse assess for when determining the major elements of PTSD?
- A. Reexperiencing the trauma through dreams or recurrent and intrusive thoughts
- B. Showing emotional numbing such as feeling detached from others
- C. Being on guard, irritable, or experiencing hyperarousal
- D. Feeling mildly anxious
- E. Occurs 2 weeks after the trauma
Correct Answer: A,B,C
Rationale: PTSD's major elements include reexperiencing trauma, emotional numbing, and hyperarousal, while mild anxiety or early onset (2 weeks) suggest acute stress disorder instead.
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Which of the following statements regarding the individual responses to trauma and stressors is a positive outcome?
- A. Many individuals are unable to cope with the event, manage their stress and emotions, or resume the daily activities of their lives.
- B. Some individuals may develop enhanced coping as a result of dealing with the stressor.
- C. These events are only significant in individuals who have risk for or actual mental health problems or issues.
- D. Large numbers or groups of people may be affected by a traumatic event.
Correct Answer: B
Rationale: Developing enhanced coping skills after dealing with a stressor is a positive outcome, unlike persistent inability to cope or the misconception that only those with mental health risks are affected.
A nurse is providing education about trauma and its effects to a community group in a community that has just been hit by a devastating tornado. One of the participants asked about what kind of support a survivor of the tornado will need. Which would be the best response of the nurse?
- A. If a person is willing to share his or her feelings about what has happened, he or she is not dealing with their feelings effectively.
- B. It is counterproductive for people to share what has happened to them and their feelings about it as there is nothing more to be done.
- C. If a person is reluctant to share his or her feelings, he or she may be denying his or her importance and may be at increased risk for future problems such as PTSD.
- D. It is best to wait until a survivor's life has returned to normal before dealing with the trauma.
Correct Answer: C
Rationale: Reluctance to share feelings may indicate denial, increasing PTSD risk, while early expression of feelings supports effective trauma processing.
Which of the following are events that a person may experience, witness, or be confronted by that may trigger posttraumatic stress disorder (PTSD)?
- A. Being a survivor of a tsunami that resulted in thousands of deaths
- B. Being stranded at the office during a typical winter storm that was anticipated
- C. Being a marine in a combat situation where the entire platoon was wiped out except for one person
- D. Being hidden in a closet and hearing the entire family murdered by someone who broke into the home
- E. Watching televised segments of the moment when the plane hit the second tower on 9/11
Correct Answer: A,C,D,E
Rationale: PTSD triggers involve exposure to actual or threatened death or serious injury, such as surviving a tsunami, combat, or hearing a family murder, or witnessing 9/11, but not a typical, anticipated storm.
What is the major difference between posttraumatic stress disorder (PTSD) and acute stress disorder?
- A. In acute stress disorder, the client is likely to develop exacerbation of symptoms.
- B. In PTSD, the recovery rate is 80% within 3 months.
- C. The severity and duration of the trauma are the most important variables in acute stress disorder.
- D. In PTSD, the symptoms occur 3 months or more after the trauma.
Correct Answer: D
Rationale: PTSD is characterized by symptoms starting 3 months or more after a trauma, while acute stress disorder occurs within 2 days to 4 weeks post-trauma, with different recovery patterns.
Which of the following is true about the use of touch with a client with dissociative identity disorder?
- A. It is best not to touch the client without his or her permission.
- B. Make sure the client knows the touch is friendly and supportive.
- C. Touch the client only if you are in his or her direct line of vision.
- D. Touching will convey a sense of security to the client.
Correct Answer: A
Rationale: Given potential abuse histories, obtaining permission before touching respects the client's boundaries and comfort, unlike assuming touch is inherently supportive or safe.