Nokea
The police find a woman wandering around a parking lot, singing very loudly. They bring her to the hospital. She has no knowledge of what she has been doing for the past 12 hours and is dressed in unfamiliar clothing. This is an example of
- A. Dissociation
- B. Manipulation
- C. Psychosis
- D. Regression
Correct Answer: A
Rationale: The woman's memory loss and altered behavior indicate dissociation, a temporary disconnection from awareness, not manipulation, psychosis, or regression to an earlier developmental stage.
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Which of the following are events that a person may experience, witness, or be confronted by that may trigger posttraumatic stress disorder (PTSD)?
- A. Being a survivor of a tsunami that resulted in thousands of deaths
- B. Being stranded at the office during a typical winter storm that was anticipated
- C. Being a marine in a combat situation where the entire platoon was wiped out except for one person
- D. Being hidden in a closet and hearing the entire family murdered by someone who broke into the home
- E. Watching televised segments of the moment when the plane hit the second tower on 9/11
Correct Answer: A,C,D,E
Rationale: PTSD triggers involve exposure to actual or threatened death or serious injury, such as surviving a tsunami, combat, or hearing a family murder, or witnessing 9/11, but not a typical, anticipated storm.
Which of the following might the nurse recognize as longer-term responses to trauma and stress?
- A. Acute stress disorder
- B. Posttraumatic stress disorder
- C. Adjustment disorder
- D. Reactive attachment disorder
- E. Dissociative disorder
Correct Answer: B,C,D,E
Rationale: Longer-term responses include PTSD, adjustment disorder, reactive attachment disorder, and dissociative disorder, as they persist beyond the acute phase, unlike acute stress disorder.
A fireman survived a fire after escaping a blaze. Several other firefighters were trapped in the burning building and died. After working with this firefighter in counseling, the nurse evaluates which of the following as positive outcomes for this client?
- A. The client will verbalize feelings of stress related to returning to work.
- B. The client will express guilt openly through nondestructive means.
- C. The client will identify a social support system within the community.
- D. The client will report nightmares and flashbacks of the fire.
Correct Answer: A,B,C
Rationale: Positive outcomes include verbalizing stress, expressing guilt nondestructively, and establishing social support, while ongoing nightmares and flashbacks indicate unresolved PTSD.
A man is discovered wandering the street, looking confused and stepping out into traffic. When emergency responders approach the man, he cannot recall his name or where he lives. The responders transport the man to the mental health crisis unit for further evaluation. Which of the following are the man most likely suffering from?
- A. Depersonalization disorder
- B. Dissociative identity disorder
- C. Repressed memories
- D. Dissociative amnesia
- E. False memory syndrome
Correct Answer: A,B,D
Rationale: The man's symptoms suggest dissociative amnesia (memory loss), depersonalization disorder (detachment), or dissociative identity disorder (alternate identities), but not repressed or false memories.
What is the major difference between posttraumatic stress disorder (PTSD) and acute stress disorder?
- A. In acute stress disorder, the client is likely to develop exacerbation of symptoms.
- B. In PTSD, the recovery rate is 80% within 3 months.
- C. The severity and duration of the trauma are the most important variables in acute stress disorder.
- D. In PTSD, the symptoms occur 3 months or more after the trauma.
Correct Answer: D
Rationale: PTSD is characterized by symptoms starting 3 months or more after a trauma, while acute stress disorder occurs within 2 days to 4 weeks post-trauma, with different recovery patterns.