A client is suspected to have dissociative identity disorder. Which characteristic does the nurse identify that the disturbed personal identity is most likely related to?

High risk for self-directed violence.

Chronic low self-esteem.

Childhood trauma and abuse.

Poor impulse control.

Answer and Explanation

The Correct Answer is C

Choice A reason: Self-directed violence is a risk in dissociative identity disorder but is a consequence, not the cause, of identity disruption. Trauma-induced changes in amygdala-hippocampal connectivity drive dissociation, not violence, which arises from emotional dysregulation secondary to fragmented identity states.

Choice B reason: Chronic low self-esteem may co-occur in dissociative identity disorder but is not the primary cause. Identity disruption stems from trauma-induced neural changes, particularly in the amygdala and prefrontal cortex, leading to fragmented self-states, not primarily from self-esteem deficits.

Choice C reason: Childhood trauma and abuse are the primary causes of dissociative identity disorder, disrupting neural integration in the prefrontal cortex and hippocampus via chronic cortisol elevation. This fragments identity formation, creating distinct personality states as a coping mechanism for overwhelming stress.

Choice D reason: Poor impulse control is a symptom in some dissociative identity disorder cases but not the cause. Identity disruption results from trauma-induced amygdala hyperactivity and hippocampal dysfunction, leading to dissociated states, not primarily from impulsivity, which is a secondary behavioral outcome.

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Correct Answer is ["10"]

Explanation

Step 1: Identify the required dose and concentration.
Required dose = 320 mg
Concentration = 160 mg per 5 mL
Result at step 1 = 320 mg ÷ (160 mg ÷ 5 mL)

Step 2: Calculate the volume in milliliters.
First, determine the milligrams per mL:
160 mg ÷ 5 mL = 32 mg/mL
Result at step 2a = 32 mg/mL
Now, calculate the volume:
320 mg ÷ 32 mg/mL = 10 mL
Result at step 2b = 10 mL

Step 3: Round to the nearest whole number.
10 mL is already a whole number.
Result at step 3 = 10 mL

A. A health care provider who worked a 12-hour shift in a busy level 1 trauma center. B. Nurse who works at an oncology clinic where patients receive chemotherapy. C. A home health nurse making visits to seriously mentally ill patients being cared for at home. D. Emergency medical technician who treated victims of a car bombing in a downtown area.

Correct Answer is D

Explanation

Choice A reason: A 12-hour shift in a trauma center is stressful but not a critical incident requiring debriefing. Chronic stress may elevate cortisol, but critical incident stress debriefing targets acute trauma exposure, not routine workplace demands.

Choice B reason: Oncology nursing involves chronic emotional stress, not an acute critical incident. Chemotherapy care may cause burnout via sustained cortisol elevation, but debriefing is for sudden, traumatic events, not ongoing patient care challenges.

Choice C reason: Home health nursing for mental illness involves ongoing stress, not a single traumatic event. Chronic exposure may dysregulate serotonin and cortisol, but critical incident stress debriefing is reserved for acute, overwhelming trauma, not routine care.

Choice D reason: Treating car bombing victims is a critical incident, causing acute stress via amygdala-driven fear and cortisol surges. Debriefing mitigates PTSD risk by processing trauma, restoring prefrontal cortex regulation, and reducing long-term neurochemical imbalances, making this the appropriate choice.

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A client is suspected to have dissociative identity disorder. Which characteristic does the nurse identify that the disturbed personal identity is most likely related to?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer acetaminophen 320 mg PO every four hours as needed for pain. The amount available from the pharmacy is acetaminophen liquid 160 mg/5 mL. How many mL should the nurse administer per dose? (Round to the nearest whole number.)

Correct Answer is ["10"]

Explanation

Which health care worker should be referred to critical incident stress debriefing?

Correct Answer is D

Explanation

A nurse states, "I evaluated a new patient using the modified SAD PERSONS scale and got a score of 10. Should I send the patient home?" Select the best reply.

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