Nokea
A fireman survived a fire after escaping a blaze. Several other firefighters were trapped in the burning building and died. After working with this firefighter in counseling, the nurse evaluates which of the following as positive outcomes for this client?
- A. The client will verbalize feelings of stress related to returning to work.
- B. The client will express guilt openly through nondestructive means.
- C. The client will identify a social support system within the community.
- D. The client will report nightmares and flashbacks of the fire.
Correct Answer: A,B,C
Rationale: Positive outcomes include verbalizing stress, expressing guilt nondestructively, and establishing social support, while ongoing nightmares and flashbacks indicate unresolved PTSD.
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The police find a woman wandering around a parking lot, singing very loudly. They bring her to the hospital. She has no knowledge of what she has been doing for the past 12 hours and is dressed in unfamiliar clothing. This is an example of
- A. Dissociation
- B. Manipulation
- C. Psychosis
- D. Regression
Correct Answer: A
Rationale: The woman's memory loss and altered behavior indicate dissociation, a temporary disconnection from awareness, not manipulation, psychosis, or regression to an earlier developmental stage.
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.
Which of the following statements by the nurse would be most appropriate to a colleague who very quietly and numbly tells the nurse that she had arrived at the scene of an automobile/pedestrian accident and unsuccessfully performed CPR on a victim 3 days ago? The nurse and her colleague are sitting in the break room and no one else is present.
- A. Tell me what you saw.
- B. That is horrible!
- C. Why did you perform CPR?
- D. I know how you feel. The same thing happened to me several years ago and I never recovered.
Correct Answer: A
Rationale: Encouraging the colleague to describe the event facilitates processing the trauma, reducing the risk of pathological responses, unlike judgmental or unsupportive statements.
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.
Which of the following interventions would be most effective for friends and family members to implement in order to boost the self-esteem of a person who has just experienced trauma or abuse?
- A. To identify a list of support people or activities in the community
- B. To remind them to calm down when they appear to be experiencing a flashback
- C. To encourage them to tell their story repeatedly to everyone they meet
- D. To help them to refocus their view of themselves from being victims to being survivors
Correct Answer: D
Rationale: Reframing the person as a survivor rather than a victim fosters empowerment and boosts self-esteem, unlike social support lists or unhelpful flashback interventions.