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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.
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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.
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.
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.
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 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.