A 29-year-old female client with posttraumatic stress disorder (PTSD) is resistant to eye movement desensitization and reprocessing therapy (EMDR) because she has heard that past traumas must be re-experienced. She said she avoids thinking about the trauma and does not want to re-live it. What is the most appropriate response?
"If you don't do EMDR, you'll keep having flashbacks for the rest of your life.”
"Don't you want to get better? This is the only way."
"The symptoms of PTSD you experience are the brain's way of trying to heal from the trauma. Avoidance keeps the trauma alive."
"Don't worry. You won't have the same level of emotion that you felt at the same time you experienced the original trauma."
The Correct Answer is C
Choice A reason: This response is fear-based and could increase the client’s anxiety and resistance rather than foster understanding.
Choice B reason: This is coercive and does not respect client autonomy, potentially reducing therapeutic engagement.
Choice C reason: This is correct. It educates the client about the role of avoidance in maintaining PTSD symptoms, promoting insight and motivation for therapy without coercion.
Choice D reason: While reassuring, this minimizes the client’s concerns and does not provide education about symptom maintenance or avoidance behaviors.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: PTSD requires symptoms to persist for at least 1 month post-trauma. Since this event occurred only two weeks ago, a PTSD diagnosis is premature.
Choice B reason: Acute stress disorder occurs within 3 days to 4 weeks following a traumatic event and includes symptoms such as flashbacks, intrusive thoughts, anxiety, and panic. This timing and symptomatology match this patient’s presentation.
Choice C reason: Adjustment disorder involves emotional or behavioral symptoms in response to a stressor but is generally less severe and does not typically include panic attacks or flashbacks.
Choice D reason: Dissociative identity disorder is a chronic condition characterized by the presence of two or more distinct identity states and memory gaps, unrelated to a single traumatic event, making it inappropriate here.
Correct Answer is A
Explanation
Choice A reason: This is correct. The patient demonstrates both obsessions and compulsions. Obsessions are intrusive, unwanted thoughts or images, such as hearing knocking or voices that are not real. Compulsions are repetitive behaviors performed to reduce distress or prevent a feared outcome, demonstrated by the patient feeling compelled to check the door repeatedly. The symptoms have persisted for over six months and cause significant impairment, meeting diagnostic criteria for OCD.
Choice B reason: Schizophrenia involves persistent psychotic symptoms, such as hallucinations, delusions, disorganized speech, or negative symptoms, typically accompanied by functional decline. This patient recognizes the hallucinations as his imagination, which is inconsistent with schizophrenia.
Choice C reason: Social anxiety disorder is characterized by fear or anxiety in social situations due to concern about being judged or embarrassed. The patient's behaviors are not motivated by social evaluation and thus do not align with social anxiety disorder.
Choice D reason: Delusional disorder involves fixed, false beliefs that are not amenable to reason. The patient acknowledges that the experiences are imagined, which does not meet criteria for delusional disorder.
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