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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.
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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 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.
A person with a fear of closes spaces enters into an elevator. Which division of the autonomic nervous system is stimulated in response to this experience?
- A. Limbic system
- B. Peripheral nervous system
- C. Sympathetic nervous system
- D. Parasympathetic nervous system
Correct Answer: C
Rationale: The autonomic nervous system is made up of the sympathetic (fight-or-flight response) and parasympathetic (relaxation response) nervous systems. In times of stress, the sympathetic nervous system is stimulated. A person fearful of heights would experience stress associated with the experience of driving across a high bridge. The peripheral nervous system responds to messages from the sympathetic nervous system. The limbic system processes emotional responses but is not specifically part of the autonomic nervous system.
An individual has been diagnosed with a dissociative disorder. Which comorbid psychiatric disorders are most likely to accompany this type of mental illness? (Select all that apply.)
- A. Substance abuse disorders
- B. Depression
- C. Eating disorders
- D. Personality disorders
- E. Schizophrenia
Correct Answer: A,B,C,D
Rationale: Comorbid psychiatric disorders associated with dissociative disorders include: substance use disorders, depression and anxiety disorders, eating disorders, PTSD, and personality disorders. Schizophrenia is not associated with this type of disorder.
A family member asks the nurse, 'Do you think stress and physical illness are connected? Since my father's death, my mother has had shingles and the flu, but she's usually not one who gets sick.' Which answer by the nurse best reflects current knowledge about long term effects of stress?
- A. It is probably a coincidence. Emotions and physical responses travel on different tracts of the nervous system.'
- B. You may be paying more attention to your mother since your father died and noticing more things such as minor illnesses.'
- C. So far, research on emotions or stress and becoming ill more easily is unclear. We do not know for sure if there is a link.'
- D. Negative emotions and stress may interfere with the body's ability to protect itself and can increase the likelihood of infection.'
Correct Answer: D
Rationale: The correct answer best explains the research. Research supports a link between negative emotions and/or prolonged stress and impaired immune system functioning. Activation of the immune system signals the central nervous system to initiate myriad responses to stress. Prolonged stress suppresses the immune system and lowers resistance to infections.