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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.
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Which scenario best demonstrates an example of eustress?
- A. A child loses a beloved family pet.
- B. A single male prepares to take a 1-week vacation to a tropical island with a group of close friends.
- C. A couple receives a bank notice there were insufficient funds in their account for a recent rent payment.
- D. A married female receives notification that their current employer is experiencing financial problems and some workers will be terminated.
Correct Answer: B
Rationale: Eustress is beneficial stress; it motivates people to develop skills they need to solve problems and meet personal goals. Positive life experiences produce eustress. Going on a tropical vacation is an exciting, relaxing experience and an example of eustress. Losing the family pet, worrying about employment security, and having financial problems are examples of distress, a negative experience that drains energy and can lead to significant emotional problems.
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 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.
A nurse talks with the caregiver of a combat veteran diagnosed with severe traumatic brain injuries. The caregiver says, 'I don't know how much longer I can do it. My whole life is consumed with taking care of my partner.' Which response best addresses the needs of the caregiver?
- A. How are you taking care of yourself?'
- B. Let's review your partner's diagnostic results.'
- C. I have some web-based programs for you to visit.'
- D. Your partner is lucky to have someone so devoted.'
Correct Answer: A
Rationale: The caregiver is the focus of the nurse's attention. The caregiver is suffering. The nurse must be empathetic and assess how the caregiver is caring for self. Reassurance and isolated computer activities do not help. The partner is already aware of the diagnostic results.
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.