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FLAG A nurse is caring for a client following a suicide attempt. Which of the following statements by the nurse reflects a trauma-informed approach? "This must be difficult. Can you tell me about what has happened to you?" "You are new to the unit. Why are you here?" "You sit alone. Do you really want to be here?" "You seem in pain. Why did you try to harm yourself?"

"This must be difficult. Can you tell me about what has happened to you?"

FLAG A nurse has attended an in-service regarding nursing care for clients who have experienced trauma. Which of the following statements by the nurse represent an understanding of trauma?

"Trauma is a broad term that refers to a person's physical, psychological, or emotional response to an adverse event."

FLAG A nurse is developing education for a parenting class about adverse childhood events (ACEs). Which of the following statements should the nurse include in the education? "Prior to age 1, children have natural protection from stressors and are unlikely to experience physiological changes from stress." "Children who are exposed to repeated adverse childhood events are at an increased risk for developing physical and mental health issues." "Experiences of trauma or adverse childhood events result in permanent changes to the brain that cannot be altered." "Children's brains are fully developed by the age 10, and this provides psychological protection from ACEs that occur prior to that age."

"Children who are exposed to repeated adverse childhood events are at an increased risk for developing physical and mental health issues."

FLAG A nurse is preparing a teaching for high school students regarding trauma and interpersonal violence. Which of the following statements should the nurse plan to include in the teaching? "Interpersonal violence includes physical, sexual, and emotional maltreatment, which are types of trauma." Interpersonal violence is a type of trauma where force or power is threatened or enacted against another person. This act includes physical, sexual, and emotional maltreatment and neglect. "Interpersonal violence are acts of aggression occurs between two adults and is a form of sexual maltreatment."Interpersonal violence can be between two adults, or an adult and a child. It is a type of trauma where force or power is threatened or enacted against another person. This act includes physical, sexual, or emotional maltreatement or neglect. "Interpersonal violence occurs most frequently between people who do not know each other."MY ANSWERInterpersonal violence occurs most frequently between two people who were in a trusting relationship. It is an intentional betrayal of trust comprised of physical, sexual, or emotional maltreatment or neglect. "Interpersonal violence is the result of unintentional f

"Interpersonal violence includes physical, sexual, and emotional maltreatment, which are types of trauma."

FLAG A nurse is caring for a client who was recently diagnosed with posttraumatic stress disorder (PTSD). The client asks, "What is the difference between acute stress disorder and PTSD?" Which of the following responses should the nurse make?

"PTSD is diagnosed if the symptoms persist for longer than 1 month."

FLAG A nurse overhears a coworker say, "I get that some people have a hard childhood, but eventually they need to get over it." Which of the following responses should the nurse make?

"People who experience adverse childhood events are changed biologically and genetically."

00:22:50 FLAG A nurse has attended an in-service education regarding trauma-informed care approach. Which of the following statements by the nurse reflects an accurate description for the goal of a trauma-informed approach? "A trauma-informed approach to care is a process of steps which evaluates injury to determine priority of care." "Nurses should focus on immediate client care rather than the trauma that has happened to the client." "Trauma-informed care is most important in the emergency department and with first responders. They see the most trauma."

. "Nurses should understand the effects of trauma and structure client care to promote positive outcomes."

FLAG A nurse is caring for a client who was brought to the emergency room following displacement from their home due to a flood. When assessing the client, which of the following clinical manifestations would the nurse anticipate are related to the experience of trauma? (Select all that apply.) Anxiety Sleep disturbance Anger Depression Hallucinations Elevated mood MY ANSWER Anxiety is correct. Clinical manifestations such as anxiety are common in clients who have experienced a disaster such as a flood.Sleep disturbance is correct. Clinical manifestations such as sleep disturbances are common in clients who have experienced a disaster such as a flood.Anger is correct. Clinical manifestation of anger is common in persons who have experienced a traumatic event or disaster such as a flood.Depression is correct. Clinical manifestations of depression are common in clients who have experienced a traumatic event or disaster such

. "Nurses should understand the effects of trauma and structure client care to promote positive outcomes."

FLAG A nurse is analyzing assessment data for a group of clients. Which of the following clients is at greatest risk of developing posttraumatic stress disorder (PTSD)? A 23-year-old client who has a tibial fracture following a motor vehicle accidentA motor vehicle accident is a stressful experience and may result in an acute stress disorder due to crisis, but this client is not the one who is most vulnerable to developing PTSD. A 72-year-old client who lost their partner to metastatic breast cancerLoss of a loved one is a stressful event and may cause an acute stress disorder due to grief, but this client is not the one who is most vulnerable to developing PTSD. A 29-year-old client who has Type 1 diabetes mellitus and is postoperative following an appendectomy MY ANSWERHospitalization can be a stressful experience, but it is not a factor linked to developing PTSD.

A 36-year-old client who has a maxillofacial fracture caused by their partner Assessment findings support that this client is potentially a victim of interpersonal violence and, as a result, at high risk for developing PTSD.

FLAG A nurse is planning care for a client who has acute stress disorder. Exhibit 1 Exhibit 2 Exhibit 3 Nurses' Notes Day 2 1500: Client remains in room crying and refuses to drink, eat, or socialize with others. Attempts by nurse to engage client in conversation often result in one-word responses or a shrugging of shoulders. Stated, "What else can I say? I killed my spouse!"

Assess for environmental safety risks is expected. Nurses should assess the environment for any safety risks for clients who are at risk of self-harm. Repeat vital signs every hour is nonessential. The client's vital signs are within the expected reference range. Use screening tools to monitor manifestations is expected. The use of screening tools and questionnaires can provide the nurse with valuable information regarding risk factors, mental health symptoms, and safety information. Rotate staff as often as possible is contraindicated. Assigning the same staff to the client will promote an environment of stability, trust, and transparency. Ask close-ended questions is contraindicated. The nurse should ask open-ended questions to facilitate empowerment of the client to engage in their care. Encourage client to share details regarding trauma is contraindicated. Avoiding asking for trauma history details allows the client to control what and when they share and promotes psychological safety.

FLAG A nurse is working with an interdisciplinary disaster response team planning care for a coastal community following a category 5 hurricane. Place the following steps of disaster management in the correct order. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.) Determine the challenges the community is facing. Determine the resources the client has available to them. Assess the client's ability to function and cope with the current situation. Partner with the client to develop a plan. After a disaster, those involved will require guidance and support to formulate a course of action that will meet physical and psychological needs. This begins with consideration of any challenges the individuals and the community are experiencing. Next, the nurse should complete a needs assessment of the individuals' ability to cope and function with the current situation and going forward. Once the needs assessment is completed, a list of resources should be determined and made available to the client and community. Finally, collaboration with the client and community in reviewing the impact of the disaster and creating of a plan for going forwar

Challenges cope Determine resources Partner and create plan

uestion: 2 of 25 Time Elapsed: 00:02:12 FLAG A nurse is caring for a newly admitted client who has experienced a traumatic event. Exhibit 1 Exhibit 2 History and Physical Day 1 1000: Client presented to emergency department after witnessing a coworker being killed during a robbery 2 weeks ago. Client experienced no physical injury during this event but expresses guilt, stating, "I should have tried to help, instead I just hid in a closet." Client has refused to return to work and has been having nightmares that interrupt their sleep, so they have been self-medicating with alcoho

Client's statement regarding harming others is correct. The nurse should assess the client's behavior for indications of violence or self-harm and notify the health care provider to ensure client's safety and the safety of others. Client's inability to relax is incorrect. Feelings of tense muscles is a common manifestation following exposure to a traumatic experience. Lack of physical injury to client is incorrect. The lack of injury to the client during the traumatic event is not relevant to the client's current safety status. Client's statement regarding feelings when awakening is correct. The nurse should assess the client's behavior for indications of violence or self-harm and notify the health care provider to ensure client's safety and the safety of others. Client's reluctance to speak to friends is incorrect. Lack of interest in previously enjoyed activities and friends is a common manifestation following exposure to a traumatic experience.

FLAG A nurse is working with a local crisis response team to evaluate students following a school shooting. After ensuring the safety of the students, which of the following trauma-informed approaches should the team take next? Establish a supportive environment that facilitates trust and transparency. Provide resources to students for trauma support and recovery. Explain what trauma is and the symptoms of trauma. Report any students exhibiting inability to cope with the traumatic event.

Establish a supportive environment that facilitates trust and transparency.

Question: 21 of 25 CORRECT Time Elapsed: 00:21:14 FLAG A nurse is developing a plan of care for a 14-year-old client who has a history of child maltreatment. The staff have reported that any time an alarm occurs, the client is found sitting in a closet. Which of the following most accurately describes the client's response? Fear conditioning

Fear conditioning

Question: 17 of 25 Time Elapsed: 00:18:27 FLAG A nurse is preparing educational material for guardians on trauma prevention, and developing childhood resilience. Which of the following techniques should the nurse include? (Select all that apply.) Foster a hopeful perspective of the future. Encourage development of thinking and learning. Provide secure and supportive relationships and places. Ignore tantrums. Discourage expression of anger. Insist the child verbalizes emotional needs.

Foster a hopeful perspective of the future is correct. Fostering a hopeful perspective of the future allows the child the deal with the present situation and look forward to future events.Encourage development of thinking and learning is correct. Encouraging a child to continue to learn and think provides the opportunity for growth and cognitive development.Provide secure and supportive relationships and places is correct. Positive relationships and places ensure a sense of security and promote development of a resilient child.

FLAG A nurse is providing care for a client who has posttraumatic stress disorder (PTSD). The client states, "I always have to watch my back!" Which of the following manifestations of PTSD is the client experiencing? Anosognosia This is an example of hypervigilance, which is a state of high and constant alertness to potential threats in their surroundings. The individual has a sense of being in constant danger. Anosognosia is when a person is unaware of their own mental health condition or cannot perceive their condition accurately. Hypervigilance

Hypervigilance

FLAG A nurse is assigned to triage clients following an explosion at an oil refinery. Which of the following symptoms are consistent with a trauma response involving the sympathetic nervous system? (Select all that apply.)

Increased heart rate Shallow breathing Muscle tension Anxiety

FLAG A nurse is providing care to a 4-year-old child who has recently been diagnosed with reactive attachment disorder. Which of the following statements by the nurse accurately describes this disorder?

Reactive attachment disorder can occur when there is an absence of adequate caregiving, including the child going many hours without being held or touched as an infant.

FLAG A nurse is caring for a client who has depression, diabetic polyneuropathy, and significant neuropathic pain. The nurse hears an assistive personal say, "They are admitted frequently and always report being in pain. I think they are just a drug seeker." Which of the following responses should the nurse make? "You certainly call things like you see them. I am going to ignore that you said that!" This response ignores the bias and does not address the effect of bias on client care. "Yes, this client is always in pain. You should remember that it is our job to take care of people like them."MY ANSWERThis response explains that the client is in pain but does not address bias or the effect of bias on client care. "What is bothering you? Just keep your comments and opinions to yourself."This response ignores the bias and does not address the effect of bias on client care. "It is not appropriate to stereotype clients. It seems like you may have bias which could affect client care." Being direct and explaining the effect of bias is an appropriate response. Bias creates barriers to client care, and the health care team should pause and consider how bias affects client care.

It is not appropriate to stereotype clients. It seems like you may have bias which could affect client care."

A nurse is caring for a client who recently experienced a traumatic event and is experiencing flashbacks. Exhibit 1 Exhibit 2 Nurses' Notes​ Day 2 1200:Client eating lunch in cafeteria with other clients. Has sad expression, eyes downcast, and does not react to others trying to speak to them. 1400:Shared in group therapy session how their job as a law enforcement officer exposes them to many "bad situ

Overheard another employee saying to client, "Maybe if you weren't always bothering innocent people and trying to give everyone a ticket, you wouldn't be here." Shared in group therapy session how their job as a law enforcement officer exposes them to many "bad situations, like parents hurting their children and seeing dead people."

FLAG A nurse is providing parenting education to a group of new parents at the area community center. Which of the following types of trauma prevention is the nurse providing? Secondary preventionThis is an example of primary prevention. Secondary prevention focuses on screening to identify and follow up with those who have experienced past trauma or are at high risk for developing mental health problems. Primary preventionMY ANSWERThis is an example of primary prevention. Primary prevention focuses on preventing adverse experiences before they occur. This can include providing parenting classes to new parents to enhance positive parenting skills and create protective factors for their children. Primordial preventionThis is an example of primary prevention. Primordial prevention focuses on helping the population as a whole. This can include support of public health policies and identification of environmental and behavioral risk factors. Tertiary preventionThis is an example of primary prevention. Tertiary prevention focuses on helping those who have been diagnosed with a mental health condition. This can include improving their current quality of life and well-being, as well as preventi

Primary prevention

FLAG FLAG A nurse is providing care for an adolescent who sustained injuries in assault. Which of the following actions should the nurse take first? Identify the adolescent's coping strategies and skills.Identifying the adolescent's coping skills and strategies is an important part of trauma care, but it is not the priority action. Establishing a secure and safe environment is the first step in trauma-informed nursing practice. Explore the adolescent's feelings about the assault.Exploring the adolescent's thoughts and feelings about the traumatic experience is an important part of trauma care, but it is not the priority action. Establishing a secure and safe environment is the first step in trauma-informed nursing practice. Provide a safe, secure environment for the adolescent.MY ANSWEREstablishing a secure and safe environment is the first step in trauma-informed nursing practice. Provide the adolescent with information on support groups.Providing information on support groups i

Provide a safe, secure environment for the adolescent.

FLAG A nurse is caring for a client who was diagnosed with adjustment disorder after losing their job 2 months ago. For which of the following manifestations should the nurse monitor the client? Persistent avoidancePersistent avoidance is a clinical manifestation of posttraumatic stress disorder. The client avoids memories, thoughts, or situations which remind them of traumatic event. Based on the clinical presentation, this client is potentially experiencing adjustment disorder. PsychosisMY ANSWERPsychosis has not been identified as a clinical manifestation of adjustment disorder. Dissociative amnesiaDissociative amnesia has not been identified as a manifestation of adjustment disorder. Suicidal ideation

Suicidal ideation

FLAG A community health nurse observes an 8-month-old child being reunited with their parent after being found alone in an automobile. Which of the following responses should the nurse identify as an indication that the child might be experiencing poor attachment? (Select all that apply.) The child continues to play with a toy when their parent steps into the room. The child does not respond when held and embraced by the parent. The child reaches out to the parent when they enter the room. The child selects a toy offered them and begins to play while sitting on their parent's lap. The child cries when the nurse tries to give the child to the parent.

The child continues to play with a toy when their parent steps into the room is correct. Not responding to the parent is an example of inadequate bonding between the parent and child. A child with secure bonding would be happy when reunited with their parent or regular caregiver.The child does not respond when held and embraced by the parent is correct. The child's response is a result of inadequate or poor bonding between the parent and child. When bonding is missing or is replaced by adverse experiences, the child's reward system is not initiated, resulting in inadequate attachment, an avoidant or ambivalent connection to their parent.The child reaches out to the parent when they enter the room is incorrect. This child's response is an example of secure bonding. If the parent-child bond is missing, the child may react with avoidant or ambivalent behaviors.The child selects a toy offered them and begins to play while sitting on their parent's lap is incorrect. Playing with a toy and sitting comfortably on the parent's lap is consistent with a safe and trusting relationship. When bonding is missing or is replaced by adverse or abusive experiences the reward system is not initiated, and the experience is negative behaviors are not reinforced resulting in inadequate attachment, an avoidant or ambivalent connection. The child cries when the nurse tries to give the child to the parent is correct. The child avoiding their parent can be indicative of inadequate attachment, an avoidant or ambivalent parent-child bond.

: 16 of 25 INCORRECT Time Elapsed: 00:17:51 FLAG A nurse at a clinic is screening clients for trauma. The nurse should identify that which of the following factors increases a client's risk for developing a trauma-related disorder? (Select all that apply.) The client has a history of physical abuse. The client belongs to a marginalized group. The client was active military during the Iraq war. The client is from a large family. The client is male. The client has stable income. MY ANSWER The client has a history of physical abuse is correct. The nurse should identify those clients who have experienced physical abuse are at greater risk for developing a trauma-related disorder.The client belongs to a marginalized group is correct. The nurse should identify those clients who belong to a marginalized group and have experienced health disparity due to their race, religion, culture, or social group are at greater risk for developing a trauma-related disorder.The client was active military during the Iraq war is correct. Military personnel who have experienced combat are at greater risk for developing a trauma-related disorder.The client is from a large family is incorrect. Family size is not a

The client has a history of physical abuse is correct r.The client belongs to a marginalized group is correct client was active military during the Iraq war is correc