Deck 19: Trauma- and Stressor-Related Disorders

Question 1

The client diagnosed with an adjustment disorder says, "Tell me about medications that will cure this problem." Which responses by the nurse are appropriate? (Select all that apply.)

A) "Medications can interfere with your ability to find a more permanent solution."
B) "Medications may mask the real problem at the root of this diagnosis."
C) "Adjustment disorders are not commonly treated with medications."
D) "Psychoactive drugs carry the potential for physiological and psychological dependence."
E) "Psychoactive drugs will be prescribed only if your problems persist for more than three months."

Answer 1

"Medications can interfere with your ability to find a more permanent solution."
"Medications may mask the real problem at the root of this diagnosis."
"Adjustment disorders are not commonly treated with medications."
"Psychoactive drugs carry the potential for physiological and psychological dependence."

Question 2

As the sole survivor of a roadside bombing, a veteran is experiencing extreme guilt. Which nursing diagnosis would address this client's symptom?

A) Anxiety
B) Altered thought processes
C) Complicated grieving
D) Altered sensory perception

Answer 2

Complicated grieving

Question 3

A 22-year-old client and a 62-year-old client were involved in motor vehicle accidents and are both experiencing extreme anxiety. From a psychosocial theory perspective, which client would be predisposed to the diagnosis of adjustment disorder?

A) The 62-year-old, because of memory deficits
B) The 62-year-old, because of uncomplicated bereavement
C) The 22-year-old, because of decreased cognitive processing
D) The 22-year-old, because of lack of developmental maturity

Answer 3

The 22-year-old, because of lack of developmental maturity

Question 4

The nurse is describing the Transactional Model of Stress and Adaptation. When using this model, which factor would the nurse categorize as intrapersonal?

A) Occupational opportunities
B) Economic conditions
C) Degree of flexibility
D) Availability of social supports

Question 5

The client has a nursing diagnosis of complicated grieving related to the death of multiple family members from a tornado. Which action should the nurse take first?

A) Encourage the journaling of feelings.
B) Assess for the stage of grief in which the client is fixed.
C) Provide community resources to address the client's concerns.
D) Suggest attending a grief therapy group.

Question 6

Which of the following is the most commonly used treatment for clients with adjustment disorder (AD) and its appropriate rationale?

A) Psychotherapy; to examine the stressor and confront unresolved issues
B) Selective serotonin reuptake inhibitors; to stabilize mood and resolve symptoms
C) Eye movement desensitization therapy; to reprocess traumatic events
D) Antianxiety agents; a first-line treatment to address symptoms of anxiety

Question 7

Which action would the nurse take to provide trauma-informed care to a homeless client who is combative?

A) Place the client in seclusion
B) Apply soft wrist restraints
C) Allow the client some control
D) Encourage dependent behavior

Question 8

The nursing instructor is explaining the etiology of trauma-related disorders from a learning theory perspective. Which student statement indicates teaching has been effective?

A) "How clients perceive events and view the world affects their response to trauma."
B) "Psychic numbing in PTSD is a result of negative reinforcement."
C) "The individual becomes addicted to the trauma owing to an endogenous opioid response."
D) "Believing that the world is meaningful and controllable can protect an individual from PTSD."

Question 9

Which statement indicates a nurse has a correct understanding about how eye movement desensitization and reprocessing (EMDR) achieves its therapeutic effect?

A) "The exact biological mechanism is unknown."
B) "It causes an increase in imagery vividness."
C) "This therapy decreases memory access."
D) "EMDR disrupts the fear associated with trauma."

Question 10

The client receiving eye movement desensitization and reprocessing (EMDR) therapy says, "After only three sessions, I am feeling great. Now I can stop and get on with my life." Which response by the nurse is most appropriate?

A) "I am thrilled that you have responded so rapidly to EMDR."
B) "To achieve lasting results, all eight phases of EMDR must be completed."
C) "If I were you, I would complete the EMDR and comply with the health-care provider's orders."
D) "How do you feel about continuing the therapy?"

Question 11

The nurse is caring for a client diagnosed with posttraumatic stress disorder (PTSD). Which realistic goal should be included in this client's plan of care?

A) The client will have no flashbacks.
B) The client will be able to feel a full range of emotions by discharge.
C) The client will not require medication to obtain adequate sleep by discharge.
D) The client will refrain from discussing the traumatic event.

Question 12

The client diagnosed with posttraumatic stress disorder (PTSD) has a nursing diagnosis of posttrauma syndrome R/T surviving a workplace shooting. Which nursing intervention would the nurse add to this client's plan of care?

A) Monitor for substance use
B) Alternate staff members
C) Use a firm approach
D) Offer social skill training

Question 13

Which clinical presentation is associated with the most commonly diagnosed adjustment disorder (AD)?

A) Anxiety, feelings of hopelessness, and worry
B) Truancy, vandalism, and fighting
C) Nervousness, worry, and jitteriness
D) Depressed mood, tearfulness, and hopelessness

Question 14

Which information will help the nurse differentiate the diagnosis of posttraumatic stress disorder (PTSD) from the diagnosis of adjustment disorder (AD)?

A) PTSD results from exposure to an extreme traumatic event, whereas AD results from exposure to "normal" daily events.
B) AD is more common in women, whereas PTSD is more common in men.
C) AD can occur from severe motor vehicle accidents, while PTSD can occur from the birth of a stillborn.
D) PTSD occurs more often when compared to AD.

Question 15

The nurse is caring for a client with a diagnosis of adjustment disorder unspecified from a divorce after over 30 years of marriage. Which signs and symptoms would the nurse observe?

A) Re-experiences spouse asking for a divorce, is hyperalert, and has nightmares
B) Has anxiety, begins to shoplift, and exhibits reckless driving
C) Is belligerent, violates others' rights, and defaults on legal responsibilities
D) Reports many physical ailments, refuses to socialize, and has unproductive work performance

Question 16

The nurse is admitting a client who has been diagnosed with posttraumatic stress disorder (PTSD). Which symptoms might the nurse observe upon assessment? (Select all that apply.)

A) Feelings of guilt that precipitate social isolation
B) Aggressive behavior that affects job performance
C) Relationship problems
D) High levels of anxiety
E) Escalating symptoms lasting less than one month

Question 17

The client has been extremely anxious ever since relocating to another state because of a job transfer. When assessing for the diagnosis of adjustment disorder (AD), within what time frame should the nurse expect the client to exhibit symptoms?

A) Within 1 year of the move
B) Within 3 months of the move
C) Within 6 months of the move
D) Within 9 months of the move

Question 18

The client is receiving eye movement desensitization and reprocessing (EMDR) treatments. The nurse is most likely caring for which client?

A) One with schizophrenia
B) One with borderline personality disorder
C) One with manic episodes
D) One with posttraumatic stress disorder

Question 19

After a teaching session about grief, a client says to the nurse, "I seem to be stuck in the bargaining stage of grieving over the loss of my daughter." In which phase of the nursing process would this occur, and how would the nurse interpret this statement?

A) Assessment phase; nursing actions have been successful in achieving accurate data.
B) Evaluation phase; nursing actions have been successful in achieving the objectives of care.
C) Implementation phase; nursing actions have been successful in achieving the objectives of care.
D) Diagnosis phase; nursing actions have been successful in achieving accurate data.

Question 20

The nurse is teaching about trauma- and stressor-related disorders. Which statement by one of the staff members indicates that follow-up instruction is needed?

A) "The trauma that women experience is more likely to be sexual assault and child sexual abuse."
B) "The trauma that men experience is more likely to be accidents, physical assaults, combat, or viewing death or injury."
C) "After exposure to a traumatic event, less than 10 percent of victims develop posttraumatic stress disorder (PTSD)."
D) "Research shows that PTSD is more common in men than in women."

Question 21

An extremely distressing experience that causes severe emotional shock and may have long-lasting psychological effects is called ____________________.

Question 22

Parents ask the nurse why their daughter was diagnosed with posttraumatic stress disorder (PTSD) and others survivors of the terrorist attack were not. Which information should the nurse offer? (Select all that apply.)

A) An individual's stated religious affiliation can affect response to trauma.
B) Responses are affected by how an individual handled previous trauma.
C) Protectiveness of family and friends can help an individual deal with trauma.
D) Control over the possibility of recurrence can affect the response to trauma.
E) The duration of how long the trauma lasted can affect the individual's response.

Question 23

Based upon the research with Vietnam veterans, which factors are the best predictors of posttraumatic stress disorder (PTSD)? (Select all that apply.)

A) The severity of the stressor
B) The degree of ego strength
C) The degree of psychosocial isolation in the recovery environment
D) The attitudes of society regarding the experience
E) The presence of preexisting psychopathology

Question 24

The client diagnosed with posttraumatic stress disorder (PTSD) asks, "Why did my health-care provider prescribe an antidepressant rather than an antianxiety drug for me?" Which explanations should the nurse make? (Select all that apply.)

A) "I'm not sure, because antianxiety drugs have been approved by the FDA for PTSD."
B) "Antidepressants are now considered first-line treatment choice for PTSD."
C) "Many people experience side effects to antianxiety drugs."
D) "Because of their addictive properties, antianxiety drugs are less desirable."
E) "That is strange because antipsychotics have provided the best results for treatment of PTSD."