Nokea
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.
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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 soldier served in combat zones in Iraq in 2010 and was deployed to Afghanistan in 2014. When is it most important for the nurse to screen for signs and symptoms of posttraumatic stress disorder (PTSD)?
- A. Immediately upon return to the United States from Afghanistan
- B. Before departing Afghanistan to return to the United States
- C. Two years after returning from Afghanistan
- D. Screening should be ongoing
Correct Answer: D
Rationale: PTSD can have a long lag time?months to years. Screening should be ongoing.
A soldier who served in a combat zone returned to the United States. The soldier's spouse complains to the nurse, 'We had planned to start a family, but now he won't talk about it. He won't even look at children.' The spouse is describing which symptom associated with posttraumatic stress disorder (PTSD)?
- A. Re-experiencing
- B. Hyperarousal
- C. Avoidance
- D. Psychosis
Correct Answer: C
Rationale: Physiological reactions to reminders of the event include a persistent avoidance of the stimuli associated with the trauma; the individual avoids talking about the event or avoids activities, people, or places that arouse memories of the trauma. Avoidance is exemplified by a sense of foreshortened future and estrangement. No evidence suggests that this soldier is having a hyperarousal reaction or is re-experiencing war-related traumas. Psychosis is not evident.
A soldier returned home last year after deployment to a war zone. The soldier's spouse reports, 'We were going to start a family but now he won't talk about it. He will not look at children. I wonder if we're going to make it as a couple.' What response best addresses the spouse's concerns?
- A. Posttraumatic stress disorder often changes a person's sexual functioning.'
- B. I encourage you to continue to participate in social activities where children are present.'
- C. Have you talked with your spouse about these reactions? Sometimes we just need to confront behavior.'
- D. Posttraumatic stress disorder often strains relationships. I will suggest some community resources for help and support.'
Correct Answer: D
Rationale: Posttraumatic stress disorder (PSTD) precipitates changes that often lead to divorce. Providing support to both the veteran and spouse is important. Confrontation will not be effective. Although providing information is important, ongoing support is more effective.
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.