Chapter 16 - Trauma, Stressor-Related, and Dissociative Disorders Flashcards
A nurse works with a client diagnosed with posttraumatic stress disorder (PTSD) who has frequent flashbacks as well as persistent symptoms of arousal. Which intervention should be included in the plan of care?
a. Trigger flashbacks intentionally in order to help the client learn to cope with them.
b. Explain that the physical symptoms are related to the psychological state.
c. Encourage repression of memories associated with the traumatic event.
d. Support “numbing” as a temporary way to manage intolerable feelings.
b. Explain that the physical symptoms are related to the psychological state.
Four teenagers died in an automobile accident. One week later, which behavior by the parents of these teenagers most clearly demonstrates resilience?
a. visiting their teenager’s grave daily.
b. returning immediately to employment.
c. discussing the accident within the family only.
d. creating a scholarship fund at their child’s high school
d. creating a scholarship fund at their child’s high school
After the sudden death of his wife, a man says, “I can’t live without her … she was my whole life.” What is the nurse’s most therapeutic reply?
a. “Each day will get a little better.”
b. “Her death is a terrible loss for you.”
c. “It’s important to recognize that she is no longer suffering.”
d. “Your friends will help you cope with this change in your life.”
b. “Her death is a terrible loss for you.”
A woman just received notification that her husband died. She approaches the nurse who cared for him during his last hours and says angrily, “If you had given him your undivided attention, he would still be alive.” How should the nurse analyze this behavior?
a. The comment suggests potential allegations of malpractice.
b. In some cultures, grief is expressed solely through anger.
c. Anger is an expected emotion in an adjustment disorder.
d. The client had ambivalent feelings about her husband.
c. Anger is an expected emotion in an adjustment disorder.
A wife received news that her husband died of heart failure and called her family to come to the hospital. She angrily tells the nurse who cared for him, “He would still be alive if you had given him your undivided attention.” What is the nurse’s best intervention?
a. Say to the wife, “I understand you are feeling upset. I will stay with you until your family comes.”
b. Say to the wife, “Your husband’s heart was so severely damaged that it could no longer pump.”
c. Say to the wife, “I will call the health care provider to discuss this matter with you.”
d. Hold the wife’s hand in silence until the family arrives.
a. Say to the wife, “I understand you are feeling upset. I will stay with you until your family comes.”
A child drowned while swimming in a local lake 2 years ago. Which behavior indicates the child’s parents have adapted to their loss?
a. visiting their child’s grave daily.
b. maintaining their child’s room as the child left it 2 years ago.
c. keeping a place set for the dead child at the family dinner table.
d. throwing flowers on the lake at each anniversary date of the accident.
d. throwing flowers on the lake at each anniversary date of the accident.
A store clerk was killed during a robbery 2 weeks ago. His widow, who has a long history of schizoaffective disorder, cries spontaneously when talking about his death. What is the nurse’s most therapeutic response?
a. “Are you taking your medications the way they are prescribed?”
b. “This loss is harder to accept because of your mental illness. Do you think you should be hospitalized?”
c. “I’m worried about how much you are crying. Your grief over your husband’s death has gone on too long.”
d. “The unexpected death of your husband is very painful. I’m glad you are able to talk about your feelings.”
d. “The unexpected death of your husband is very painful. I’m glad you are able to talk about your feelings.”
Which scenario demonstrates a dissociative fugue?
a. After being caught in an extramarital affair, a man disappeared but then reappeared months later with no memory of what occurred while he was missing.
b. A man is extremely anxious about his problems and sometimes experiences dazed periods of several minutes passing without conscious awareness of them.
c. A woman finds unfamiliar clothes in her closet, is recognized when she goes to new restaurants, and complains of “blackouts” despite not drinking.
d. A woman reports that when she feels tired or stressed, it seems like her body is not real and is somehow growing smaller.
a. After being caught in an extramarital affair, a man disappeared but then reappeared months later with no memory of what occurred while he was missing.
The nurse who is counseling a client with dissociative identity disorder should understand that which assessment is of the highest priority?
a. risk for self-harm.
b. cognitive function.
c. memory impairment.
d. condition of self-esteem.
a. risk for self-harm.
A client states, “I feel detached and weird all the time. It is as though I am looking at life through a cloudy window. Everything seems unreal. It really messes up things at work and school.” This scenario is most suggestive of which health problem?
a. Acute stress disorder
b. Dissociative amnesia
c. Depersonalization disorder
d. Disinhibited social engagement disorder
c. Depersonalization disorder
The unlicensed assistive personnel (UAP) says to the nurse, “That client with amnesia looks fine, but when I talk to her, she seems vague. What should I be doing for her?” What is the nurse’s best reply?
a. “Spend as much time with her as you can and ask questions about her life.”
b. “Use short, simple sentences and keep the environment calm and protective.”
c. “Provide more information about her past to reduce the mysteries that are causing anxiety.”
d. “Structure her time with activities to keep her busy, stimulated, and regaining concentration.”
b. “Use short, simple sentences and keep the environment calm and protective.”
A client diagnosed with depersonalization disorder tells the nurse, “It’s starting again. I feel as though I’m going to float away.” Which intervention would be most appropriate at this point?
a. Notify the health care provider of this change in the client’s behavior.
b. Engage the client in a physical activity such as exercise.
c. Isolate the client until the sensation has diminished.
d. Administer a prn dose of antianxiety medication.
b. Engage the client in a physical activity such as exercise.
A person runs from a crowded nightclub after a pyrotechnics show causes the building to catch fire. Which division of the autonomic nervous system will be stimulated in response to this experience?
a. Limbic system
b. Peripheral nervous system
c. Sympathetic nervous system
d. Parasympathetic nervous system
c. Sympathetic nervous system
The gas pedal on a person’s car became stuck on a busy interstate highway, causing the car to accelerate rapidly. For 20 minutes, the car was very difficult to control. In the months after this experience, afterward, which assessment finding would the nurse expect?
a. Weight gain
b. Flashbacks
c. Headache
d. Diuresis
b. Flashbacks
A soldier returns to the United States from active duty in a combat zone. The soldier is diagnosed with post-traumatic stress disorder (PTSD). The nurse’s highest priority is to screen this soldier for
a. bipolar disorder.
b. schizophrenia.
c. depression.
d. dementia.
c. depression.
