A patient who is being seen in the community mental health center for post-traumatic stress disorder (PTSD) is being considered for eye movement desensitization and reprocessing (EMDR). The nurse is asked to conduct an assessment to validate the patient’s appropriateness for this treatment. Which of the following data collected by the nurse are most important to document when determining appropriateness for treatment with EMDR? Select all that apply.
The patient has a history of seizure disorder.
The patient has been treated for a detached retina.
The patient has been using alcohol in increasing quantities over the past 3 months.
The patient has a history of electroconvulsive therapy (ECT).
The patient reports suicidal ideation with a plan.
Correct Answer : A,B,C,E
Choice A reason: A history of seizure disorder is important because EMDR involves rapid eye movements and stimulation that may increase neurological stress. Seizures could be triggered or worsened by such interventions, making this a critical contraindication or precaution.
Choice B reason: A detached retina is significant because EMDR requires eye movement exercises. Any history of retinal damage could pose a risk of further injury or complications. Documenting this ensures that the treatment plan does not compromise ocular health.
Choice C reason: Increasing alcohol use over the past 3 months is relevant because substance abuse can impair cognitive processing, emotional regulation, and treatment effectiveness. Alcohol use may also mask or worsen PTSD symptoms, making EMDR less safe or effective.
Choice D reason: A history of electroconvulsive therapy (ECT) is less directly relevant to EMDR appropriateness. While ECT affects memory and mood regulation, it does not pose a direct contraindication for EMDR. Documentation is useful, but it is not as critical as seizure history, retinal issues, substance use, or suicidality.
Choice E reason: Suicidal ideation with a plan is crucial to document because EMDR can evoke intense emotions and traumatic memories. If the patient is actively suicidal, EMDR may exacerbate risk. Safety must be prioritized, and stabilization is required before initiating trauma-focused therapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Speaking from the left side may help if the left ear is the stronger ear, but positioning alone is not sufficient. Without direct face-to-face communication, the client cannot use lip reading or facial cues, which are essential compensatory strategies for those with hearing loss.
Choice B reason: Speaking face-to-face in a low-pitch voice is most effective because older adults often lose the ability to hear high-frequency sounds first. A lower pitch is easier to perceive, and face-to-face positioning allows the client to use visual cues such as lip movements and facial expressions. This method maximizes comprehension and reduces frustration.
Choice C reason: Speaking loudly into the left ear may distort sound and make communication harder. Excessive loudness can be uncomfortable and does not guarantee clarity. It also eliminates the benefit of visual cues, which are critical for older adults with hearing impairment.
Choice D reason: Speaking in a high-pitched voice is ineffective because high-frequency hearing loss is common in older adults. High-pitched sounds are often the most difficult for them to hear, so this approach would worsen communication rather than improve it.
Correct Answer is C
Explanation
Choice A reason: Antisocial traits involve behaviors such as disregard for others’ rights, deceitfulness, or aggression. Getting a tattoo in response to peer pressure does not necessarily indicate antisocial personality traits. It is more reflective of identity formation and family dynamics rather than pathology.
Choice B reason: Cutting self-off emotionally refers to distancing oneself completely from family relationships, often by avoiding contact or severing ties. The teenager’s action does not demonstrate emotional cutoff but rather an attempt to assert individuality while still remaining connected to the family system.
Choice C reason: Differentiation of self is a central concept in Bowen’s theory. It refers to the ability to establish one’s own identity and beliefs while remaining emotionally connected to the family. The teenager’s tattoo represents an effort to assert independence and individuality, even in defiance of parental wishes, which aligns with differentiation.
Choice D reason: Triangulation occurs when a third party is drawn into a conflict between two individuals to reduce tension. The teenager’s tattoo decision does not involve pulling another person into the parental-child conflict, so triangulation is not applicable.
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