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Three years after the death of her father in an ICU, the infection prevention nurse was visiting an ICU in a different hospital to complete a chart review. At one point, the nurse looked at a bed where the patient who had the same diagnosis as her father had and saw her father's facial features on the patient and had a sense of panic. In a few moments, the nurse realized that the patient in the bed was not her father. Which of these manifestations of PTSD was this nurse experiencing?
- A. A flashback
- B. Emotional numbing
- C. Hyperarousal
- D. A dream
Correct Answer: A
Rationale: The nurse experienced a flashback, reliving the trauma by perceiving her father's features, triggered by a similar ICU setting, distinct from numbing, hyperarousal, or dreaming.
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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.
Which of the following interventions would be most effective for friends and family members to implement in order to boost the self-esteem of a person who has just experienced trauma or abuse?
- A. To identify a list of support people or activities in the community
- B. To remind them to calm down when they appear to be experiencing a flashback
- C. To encourage them to tell their story repeatedly to everyone they meet
- D. To help them to refocus their view of themselves from being victims to being survivors
Correct Answer: D
Rationale: Reframing the person as a survivor rather than a victim fosters empowerment and boosts self-esteem, unlike social support lists or unhelpful flashback interventions.
A client is seeking counseling due to difficulty coping with being a victim of a violent attack 16 months ago. The initial medical diagnosis is to rule out posttraumatic stress disorder (PTSD). Which would the nurse assess for when determining the major elements of PTSD?
- A. Reexperiencing the trauma through dreams or recurrent and intrusive thoughts
- B. Showing emotional numbing such as feeling detached from others
- C. Being on guard, irritable, or experiencing hyperarousal
- D. Feeling mildly anxious
- E. Occurs 2 weeks after the trauma
Correct Answer: A,B,C
Rationale: PTSD's major elements include reexperiencing trauma, emotional numbing, and hyperarousal, while mild anxiety or early onset (2 weeks) suggest acute stress disorder instead.
Which of the following outcomes would take priority for a client who has survived trauma or abuse?
- A. The client will demonstrate healthy, effective ways of dealing with the stress.
- B. The client will be physically safe.
- C. The client will establish a social support system in the community.
- D. The client will distinguish between ideas of self-harm and taking action on those ideas.
- E. The client will express emotions nondestructively.
Correct Answer: B,D
Rationale: Ensuring physical safety and distinguishing self-harm thoughts from actions are top priorities to prevent immediate harm, surpassing other therapeutic goals.
Which of the following would the nurse know are the major elements of posttraumatic stress disorder (PTSD)?
- A. Trying to avoid any places or people or situations that may trigger memories of the trauma
- B. Reexperiencing the trauma through dreams or recurrent and intrusive thoughts
- C. Becoming increasingly more isolated
- D. Emotional numbing such as feeling detached from others
- E. Being on guard, irritable, or experiencing hyperarousal
Correct Answer: B,D,E
Rationale: The major elements of PTSD are reexperiencing trauma (dreams/intrusive thoughts), emotional numbing (detachment), and hyperarousal (irritability), with avoidance and isolation as secondary features.