Stress Disorders (Sherpath)

The nurse has identified nursing diagnoses for the patient with low self-esteem related to acute stress disorder. The initial outcome for the patient is "enhanced self-esteem." How will this outcome be demonstrated by the patient?

Ability to self-validate Accurate self-appraisal or an ability to self-validate are outcomes associated with enhanced self-esteem.

A patient is being treated for PTSD using eye movement desensitization reprocessing (EMDR), along with psychodynamic psychotherapy. Which clinician is qualified to deliver this intervention?

Advanced-practice psychiatric nurse The advanced-practice psychiatric nurse uses a variety of evidence-based interventions, including psychotherapy and EMDR.

Why are nurses who work with patients diagnosed with a stress disorder at risk for secondary traumatic stress?

Because nurses may become overly involved with these patients Rationale Nurses who work with patients diagnosed with a stress disorder may experience over-involvement with the patients and may have unrealistic expectations of these patients that can lead to secondary traumatic stress or compassion burnout.

The interdisciplinary team is caring for a patient diagnosed with PTSD. During which phase of critical incident stress management (CISM) training does a discussion about the team's priority to reduce the patient's flashbacks occur?

Crisis counseling phase Crisis counseling begins with a discussion of goals, rules, and roles of the multidisciplinary team including family and friends of the individual.

An emergency department nurse has been working a rotation in the trauma unit for the past 6 months. Which behaviors displayed by the nurse would be a cause for concern?

Crying regularly at work Crying regularly at work indicates that the nurse may be suffering from depression, hopelessness, or decreased self-esteem, which are all symptoms of compassion fatigue. Repeated angry outbursts A decreased ability to control anger is a symptom of compassion fatigue that is common in emergency department nurses. Decreased tolerance for frustration A decreased tolerance to frustration is a symptom of compassion fatigue that is common in emergency department nurses.

The nurse is caring for a patient with ASD. Which nursing intervention is the primary consideration for this patient?

Establish a therapeutic relationship Rationale Establishing a therapeutic relationship with the patient experiencing ASD is a primary consideration for the mental health nurse, as this helps alleviate the patient's stress and fosters a safe environment for the patient to reach goals.

Which type of therapy would be most appropriate for a patient who wants to share feelings with people who have had similar experiences?

Group therapy Group therapy is beneficial for the person with PTSD as they are with others who have similar experiences.

Which of these PTSD symptoms could lead to spousal and child abuse?

Irritability Irritability in the person with PTSD may lead to spousal and child abuse. The individual may have exaggerated startle response and may become angry and aggressive toward others. Hypervigilance Hypervigilance in the person with PTSD may lead to spousal and child abuse. Hypervigilance, irritability, and chemical abuse to relieve pan can lead to spousal and/or child abuse.

The interdisciplinary health care team is treating a patient with PTSD who is experiencing chronic insomnia. Which therapy should the team recommend for this patient?

Milieu Inpatient and outpatient milieu therapy helps the patient learn coping mechanisms for stress and anxiety and other symptoms associated with PTSD.

The mental health nurse uses a PTSD checklist to screen a patient who meets the criteria for PTSD. Which action should the nurse take?

Perform a comprehensive assessment For individuals who screen positive for PTSD, a more thorough assessment is indicated.

A patient being treated for PTSD is entering an outpatient milieu activity aimed at reducing tension. Which activities would be included in this program?

Recreational programs Milieu activities for people with PTSD can promote tension release and relaxation through participation in recreational and exercise programs.

A patient is the victim of a devastating flood that has led to the diagnosis of a stress disorder. Which action taken by the interdisciplinary health care team best displays Critical Incident Stress Management (CISM)?

Referring the patient to crisis counseling Crisis counseling is the first step of CISM and begins with a discussion of the goals, rules, and roles of the health care team, patient, family, and friends of the patient.

The mental health nurse is caring for an adult with acute stress disorder (ASD). Which patient goals are most appropriate for this patient?

Returning to an acceptable level of functioning Rationale The psychiatric mental health nurse develops and implements a plan of care aimed at returning the patient to an acceptable level of functioning.

Which term describes the increased response to traumatic stimuli experienced by a patient with posttraumatic stress disorder (PTSD)?

Sensitization Sensitization is the amplified response to a stimulus, especially to repeated traumatic stimuli. Increased arousal and stress sensitivity are produced

A patient with PTSD has failed to improve with psychotherapy alone. The psychiatrist has decided to add medication to this patient's treatment plan. Which medication is most beneficial for this patient?

Sertraline The first line of psychopharmacology for PTSD is selective serotonin reuptake inhibitors (SSRIs).

Which statement is true regarding the development of ASD and PTSD?

Stress hormone receptors plays a role. Methylation occurs when the methyl groups on DNA that govern production of stress hormone receptors in the brain are altered. This occurs when the fetus experiences the effects of maternal stress.

PTSD and ASD have similar etiologies and manifestations but there are also some distinct differences. Which statements are true regarding these two disorders?

Substance abuse, depression, and anxiety are common in both disorders. Substance abuse, depression, and anxiety are common in both disorders. The development of PTSD or ASD is precipitated by the individual's reaction to a traumatic event. The development of PTSD or ASD is precipitated by the individual's reaction to a traumatic event, such as serious injury or sexual violence.

Which are characteristics of avoidance associated with PTSD?

Suppressing thoughts Avoidance is a key factor of PTSD that includes trying to suppress feelings or thoughts related to the traumatizing event. Displaying a blunted affect Patients with PTSD who demonstrate characteristics of avoidance typically display a blunted affect and a limited range of feelings. These patients do not typically show affection towards others. Lacking the ability to trust others A characteristic of avoidance as seen in patients with PTSD is the inability to trust others. These patients often withdraw and detach themselves from family and friends.

Which criteria according to the DSM-5 are used to diagnose PTSD?

Symptoms of arousal Symptoms of arousal, such as sleep disturbances, hypervigilance, and irritability are included in PTSD diagnosis. Physical or witnessed exposure to a traumatic event For PTSD diagnosis, exposure can be through actually witnessing an event or learning about it through a close friend or family member.

A war veteran is being treated for PTSD related to traumatic events that occurred 30 years ago. He is interested in a support group for veterans. Which advice does the nurse give to the patient?

Tell the patient to check with the Department of Veteran's Affairs for therapy for war veterans. Rationale The Department of Veteran's Affairs offers therapy for war veterans and their spouses.

The patient with PTSD informs the nurse that he feels like he is "going crazy" every time he has nightmares about the traumatic event he experienced. Which information should the nurse share with the patient?

The patient should understand that what he is feeling is normal. Education for the patient and family is important in helping them understand that what they are experiencing is normal.

Which statement most accurately describes why friends, family, or coworkers of a patient with PTSD may be unable to help the patient?

These individuals may have experienced the same trauma. Family, friends, or coworkers of an individual with PTSD who experience the same trauma may develop related psychological trauma themselves. These individuals are known as secondary victims.

Which bodily responses to trauma could lead to the development of PTSD?

ncreased heart rate Increased heart rate is a bodily response to trauma that can lead to the development of PTSD. Elevated cortisol levels An elevation in cortisol level is a bodily response to trauma that can lead to the development of PTSD. Adrenergic hyperactivity Adrenergic hyperactivity is a bodily response to trauma that can lead to the development of PTSD.