Nokea
A person with a fear of heights drives across a high bridge. Which structure will stimulate a response from the autonomic nervous system?
- A. Thalamus
- B. Parietal lobe
- C. Hypothalamus
- D. Pituitary gland
Correct Answer: C
Rationale: The individual will find this experience stressful. The hypothalamus functions as the command-and-control center when receiving stressful signals. The hypothalamus responds to signals of stress by engaging the autonomic nervous system. The parietal lobe is responsible for the interpretation of other sensations. The thalamus processes messages associated with pain and wakefulness. The pituitary gland may be involved in other aspects of the person's response but would not stimulate the autonomic nervous system.
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A soldier returns to the United States from active duty in a combat zone. The soldier is diagnosed with posttraumatic stress disorder (PTSD). The nurse's highest priority is to screen this soldier for which problem?
- A. Major depressive disorder
- B. Bipolar disorder
- C. Schizophrenia
- D. Dementia
Correct Answer: A
Rationale: Major depressive disorder frequently co-occurs with PTSD. The incidence of the disorders identified in the distractors is similar to the general population.
A veteran of military combat tells the nurse, 'I saw a child get blown up over a year ago, and now I keep seeing bits of flesh everywhere. I see something red and the visions race back to my mind.' Which phenomenon associated with posttraumatic stress disorder (PTSD) is this veteran describing?
- A. Re-experiencing
- B. Hyperarousal
- C. Avoidance
- D. Psychosis
Correct Answer: A
Rationale: Spontaneous or cued recurrent, involuntary, and intrusive distressing memories of the traumatic events are often associated with PTSD. The veteran has described intrusive thoughts and visions associated with re-experiencing the traumatic event. This description does not indicate psychosis, hypervigilance, or avoidance.
A soldier returned 1 year ago from Afghanistan and was diagnosed with posttraumatic stress disorder (PTSD). Which social event would most likely be disturbing for this soldier?
- A. Halloween festival with neighborhood children
- B. Singing carols around a Christmas tree
- C. Family outing to the seashore
- D. Fireworks display on July 4th
Correct Answer: D
Rationale: Exploding noises associated with fireworks are most likely to provoke exaggerated responses for this soldier. The distractors are not associated with offensive sounds.
A patient diagnosed with liver failure has been on the transplant waiting list 8 months. The patient says, 'Why is it taking so long to have the surgery? Maybe I'm meant to die for all the bad things I've done.' The nurse should document the patient's comment in which section of the assessment?
- A. Physical
- B. Spiritual
- C. Financial
- D. Psychological
Correct Answer: B
Rationale: Stress can be evident in a person's spirituality. This patient's comment indicates questioning of one's place in the universe and consequences for wrongdoing, both are elements of spirituality. Stress can be related to psychological, physical, or psychosocial well-being, but spirituality is the best answer.
A veteran of the war in Afghanistan was diagnosed with posttraumatic stress disorder (PTSD). The veteran says, 'If there's a loud noise at night, I get under my bed because I think we're getting bombed.' What type of experience has the veteran described?
- A. Illusion
- B. Flashback
- C. Nightmare
- D. Auditory hallucination
Correct Answer: B
Rationale: Flashbacks are dissociative reactions in which an individual feels or acts as if the traumatic event were recurring. Illusions are misinterpretations of stimuli; although the experience is similar, the more accurate term is flashback because of the diagnosis of PTSD. Auditory hallucinations have no external stimuli. Nightmares commonly accompany PTSD, but this experience is stimulated by an actual environmental sound.