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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.
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Which of the following statements by the nurse would be most appropriate to a colleague who very quietly and numbly tells the nurse that she had arrived at the scene of an automobile/pedestrian accident and unsuccessfully performed CPR on a victim 3 days ago? The nurse and her colleague are sitting in the break room and no one else is present.
- A. Tell me what you saw.
- B. That is horrible!
- C. Why did you perform CPR?
- D. I know how you feel. The same thing happened to me several years ago and I never recovered.
Correct Answer: A
Rationale: Encouraging the colleague to describe the event facilitates processing the trauma, reducing the risk of pathological responses, unlike judgmental or unsupportive statements.
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.
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.
Which of the following should be an action of a nurse who is having feelings of judgment regarding a client's contributory behavior to an automobile accident that resulted in deaths?
- A. Discussing the nurse's personal feelings with a peer or a counselor
- B. Acknowledging the judgment regarding the client's contributory behavior to the client
- C. Sharing the client's horror and encouraging him or her to avoid thinking about it
- D. Letting the client know that he or she is now traumatized beyond repair
Correct Answer: A
Rationale: Discussing personal feelings with a peer or counselor helps the nurse remain nonjudgmental, supporting the client effectively without confirming their trauma as irreparable.
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.