Chapter 16: Trauma, Stressor-Related, and Dissociative Disorders Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical Approach, 8th Edition MULTIPLE CHOICE 1. A nurse works with a patient diagnosed with posttraumatic stress disorder (PTSD) who has
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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 patient 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.
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ANS: B
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Persons with PTSD often experience somatic symptoms or sympathetic nervous system arousal that can be confusing and distressing. Explaining that these are the body’s responses to psychological trauma helps the patient understand how such symptoms are part of the illness and something that will respond to treatment. This decreases powerlessness over the symptoms and helps instill a sense of hope. It also helps the patient to understand how relaxation, breathing exercises, and imagery can be helpful in symptom reduction. The goal of treatment for PTSD is to come to terms with the event so treatment efforts would not include repression of memories or numbing. Triggering flashbacks would increase patient distress.
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PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 16-29, 32 (Case Study and Nursing Care Plan) TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
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2. Four teenagers died in an automobile accident. One week later, which behavior by the parents
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of these teenagers most clearly demonstrates resilience? The parents who a. visit their teenager’s grave daily. b. return immediately to employment. c. discuss the accident within the family only. d. create a scholarship fund at their child’s high school. ANS: D
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Resilience refers to positive adaptation or the ability to maintain or regain mental health despite adversity. Loss of a child is among the highest risk situations for maladaptive grieving. The parents who create a scholarship fund are openly expressing their feelings and memorializing their child. The other parents in this question are isolating themselves and/or denying their feelings. Visiting the grave daily shows active continued mourning but is not as strongly indicative of resilience as the correct response. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 16-17, 18, 32 (Case Study and Nursing Care Plan) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
3. After the sudden death of his wife, a man says, “I can’t live without her … she was my whole
life.” Select the nurse’s most therapeutic reply.
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