Nokea
As part of the stress response, the HPA axis is stimulated. Which structures make up this system?
- A. Hippocampus, parietal lobe, and amygdala
- B. Hypothalamus, pituitary gland, and adrenal glands
- C. Hind brain, pyramidal nervous system, and anterior cerebrum
- D. Hepatic artery, parasympathetic nervous system, and acoustic nerve
Correct Answer: B
Rationale: As part of the physiological response of stress, the hypothalamus stimulates the HPA axis, which is made up of the hypothalamus, pituitary gland, and adrenal glands.
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A nurse designs a plan of exercise for a patient experiencing stress. What rationale should the nurse cite when presenting this plan to the treatment team?
- A. Exercise will stimulate endorphins and improve the patient's feelings of well-being.
- B. Exercise prevents damage from overstimulation of the sympathetic nervous system.
- C. Exercise detoxifies the body by removing metabolic wastes and other toxins.
- D. Exercise will prevent exacerbation of the stress by the limbic system.
Correct Answer: A
Rationale: Exercise is a stress reduction strategy that stimulates endorphins and improves patient's feelings of well-being. The other options are not accurate.
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 nurse assesses the health status of veterans of the war in Afghanistan. Screening will be a priority for signs and symptoms of which health problems? (Select all that apply.)
- A. Schizophrenia
- B. Eating disorder
- C. Traumatic brain injury
- D. Seasonal affective disorder
- E. Posttraumatic stress disorder
Correct Answer: C,E
Rationale: TBI and PTSD each occur in approximately 20% of soldiers who experienced combat. Some soldiers have both problems. The incidence of disorders identified in the distractors would be expected to parallel the general population.
A soldier returns to the United States from active duty in a combat zone. The soldier is diagnosed with posttraumatic stress disorder (PTSD). Which comment by the soldier requires the nurse's immediate attention?
- A. It's good to be home. I missed my family and friends.'
- B. I saw my best friend get killed by a roadside bomb. It should have been me instead.'
- C. Sometimes I think I hear bombs exploding, but it's just the noise of traffic in my hometown.'
- D. I want to continue my education but I'm not sure how I will fit in with other college students.'
Correct Answer: B
Rationale: The correct response indicates the soldier is thinking about death and feeling survivor's guilt. These emotions may accompany suicidal ideation, which warrants the nurse's follow-up assessment. Suicide is a high risk among military personnel diagnosed with PTSD. One distractor indicates flashbacks, which is common with individuals with PTSD but is not solely indicative of further problems. The other distractors are normal emotions associated with returning home and change.
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.