Psych 13

The traumatized client has suddenly changed demeanor and voice pitch. 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.

A

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 containing a patient with the same diagnosis as her father. The nurse 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

A

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 to the client the judgment regarding his or her contributory behavior 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

A

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 three 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."

A

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? Select all that apply. A) Re-experiencing 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

A B C

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? Select all that apply. 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.

A B C

A nurse interviewing a client with suspected posttraumatic stress disorder (PTSD) should be alert to findings indicating the client has which traits? Select all that apply. a) experiences flashbacks B) demonstrates hypervigilance C) feels detached or empty inside D) feels driven to repeat behaviors E) avoids people and places that arouse painful memories F) experiences sympathetic nervous system symptoms suggestive of a heart attack

A B C E

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 is the man potentially suffering from? Select all that apply. A) Depersonalization disorder B) Dissociative identity disorder C) Repressed memories D) Dissociative amnesia E) False memory syndrome

A B D

Which of the following are events that a person may experience, witness, or be confronted by that may trigger posttraumatic stress disorder (PTSD)? Select all that apply. 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

A C D E

Which of the following statements about posttraumatic stress disorder (PTSD) 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.

B

Which of the following statements regarding the individual responses to trauma and stressors is a positive outcome? A) Many individuals are unable to cope with the event, manage their stress and emotions, or resume the daily activities of their lives. B) Some individuals may develop enhanced coping as a result of dealing with the stressor. C) These events are only significant in individuals who have risk for or actual mental health problems or issues. D) Large numbers or groups of people may be affected by a traumatic event.

B

Which of the following might the nurse recognize when dealing with a client, as longer-term responses to trauma and stress? Select all that apply. A) Acute stress disorder B) Posttraumatic stress disorder C) Adjustment disorder D) Reactive attachment disorder E) Dissociative disorder

B C D E

Which of the following outcomes would take priority for a client who has survived trauma or abuse? Select all that apply. 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.

B D

The client is experiencing night terrors. Which of the following would the nurse know are the major elements of posttraumatic stress disorder (PTSD)? Select all that apply. A) Trying to avoid any places, people or situations that may trigger memories of the trauma B) Re-experiencing 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

B D E

A client tells a nurse about recent episodes of strange behavior that the client cannot recall, but has discussed with family. The client reports being told of going out late at night dressed, but not in the usual wardrobe. Upon return, the client cannot recall any of the event. The nurse suspects the client is dealing with which personality disorder? A) antisocial personality B) borderline personality C) dissociative identity disorder D) body dysmorphic disorder

C

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 asks 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.

C

When working with a client with posttraumatic stress disorder (PTSD), who has frequent flashbacks, the nurse should include which intervention? A) encouraging repression of memories associated with the traumatic event B) explaining that physical symptoms are unrelated to the psychological state C) teaching various relaxation techniques D) discussing the event has no real meaning

C

A nurse is caring for a client who is a veteran with thoughts of missiles screaming and exploding. The client re-experiences feelings of terror first experienced in combat one year ago. Upon assessment, the nurse knows these recurrent events are part of which disorder? A) acute stress disorder B) generalized anxiety disorder C) adjustment disorder D) posttraumatic stress disorder

D

For a client with dissociative identity disorder, the nurse understands that the disturbed personal identity is most likely related to which characteristic? A) poor impulse control B) chronic low self-esteem C) high risk for self-directed violence D) unresolved childhood abuse issues

D

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.

D

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

D