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Which of the following is true about the use of touch with a client with dissociative identity disorder?
- A. It is best not to touch the client without his or her permission.
- B. Make sure the client knows the touch is friendly and supportive.
- C. Touch the client only if you are in his or her direct line of vision.
- D. Touching will convey a sense of security to the client.
Correct Answer: A
Rationale: Given potential abuse histories, obtaining permission before touching respects the client's boundaries and comfort, unlike assuming touch is inherently supportive or safe.
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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.
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.
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.
A nurse is providing education about trauma and its effects to a community group in a community that has just been hit by a devastating tornado. One of the participants asked about what kind of support a survivor of the tornado will need. Which would be the best response of the nurse?
- A. If a person is willing to share his or her feelings about what has happened, he or she is not dealing with their feelings effectively.
- B. It is counterproductive for people to share what has happened to them and their feelings about it as there is nothing more to be done.
- C. If a person is reluctant to share his or her feelings, he or she may be denying his or her importance and may be at increased risk for future problems such as PTSD.
- D. It is best to wait until a survivor's life has returned to normal before dealing with the trauma.
Correct Answer: C
Rationale: Reluctance to share feelings may indicate denial, increasing PTSD risk, while early expression of feelings supports effective trauma processing.
Which of the following statements about posttraumatic stress disorder is accurate?
- A. Estimates are that the disorder is very rare.
- B. Estimates are that up to 60% of people at risk develop PTSD.
- C. Only 20% of victims of rape develop PTSD.
- D. PTSD symptoms usually begin at the time of the trauma
Correct Answer: B
Rationale: Up to 60% of at-risk individuals may develop PTSD, making it relatively common, with symptoms typically starting after a delay, not immediately, and higher prevalence in specific trauma cases.