Which actions should a nurse take to support a client exhibiting survivor guilt after a traumatic event? (Select all that apply)
Encourage suppression of feelings
Advise self-isolation until feelings pass
Facilitate peer support groups
Ignore irrational thoughts
Promote open discussions about the traumatic event
Provide information on PTSD
Isolate client from others involved in the event
Correct Answer : C,E,F
Choice A reason: Encouraging the suppression of emotions is counterproductive and medically contraindicated in the treatment of trauma-related psychological distress. Internalizing guilt and grief can lead to the development of complex post-traumatic stress disorder, chronic depression, and maladaptive coping mechanisms such as substance abuse or self-harm behaviors.
Choice B reason: Advising self-isolation is detrimental as it prevents the patient from receiving necessary social validation and emotional support. Social withdrawal is a hallmark symptom of trauma that should be actively countered by clinicians to prevent the patient from spiraling into further despair, loneliness, and clinical depression.
Choice C reason: Facilitating peer support groups allows the individual to interact with others who have undergone similar traumatic experiences. This shared experience helps universalize their feelings of guilt, reducing the sense of isolation and providing a safe environment for the collective processing of complex emotions and recovery.
Choice D reason: Ignoring irrational thoughts is an ineffective nursing intervention because these cognitive distortions are central to survivor guilt. Instead of ignoring them, the nurse should utilize cognitive-behavioral techniques to help the client identify, challenge, and eventually restructure these irrational beliefs into more balanced and realistic perspectives.
Choice E reason: Promoting open discussions creates a therapeutic environment where the client can externalize their trauma. Verbally articulating the events and the subsequent feelings of guilt helps the brain process the memory, moving it from an acute, fragmented state toward a more integrated and manageable narrative.
Choice F reason: Providing education on post-traumatic stress disorder (PTSD) empowers the client by framing their distressing symptoms as a predictable physiological and psychological response to abnormal events. Understanding the neurobiology of trauma helps demystify their experience and reduces the self-stigma often associated with survivor guilt.
Choice G reason: Isolating the client from other survivors or involved parties can increase the burden of guilt and prevent the collective healing process. Interaction with other survivors often provides the necessary evidence that the individual was not uniquely responsible for the outcome, which is crucial for emotional recovery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Administering 5 mL would result in a total dosage of 50 mg per administration, which significantly exceeds the prescribed 20 mg. This calculation error could lead to severe medication toxicity or increased side effects, violating the basic safety protocols of medication administration and pharmacological standards.
Choice B reason: A 3 mL dose provides 30 mg of the medication. This is a 50% overdose compared to the ordered 20 mg. In clinical practice, precision in liquid measurements is vital to maintain therapeutic windows and prevent adverse drug reactions associated with incorrect dosing of antidepressants.
Choice C reason: To calculate the dose, the formula is Dose Ordered / Dose on Hand x Volume = Amount to Administer. Therefore, 20 mg / 10 mg x 1 mL = 2 mL. This ensures the patient receives the exact 20 mg required every 6 hours to maintain steady-state plasma concentrations.
Choice D reason: A 1 mL dose provides only 10 mg, which is half of the therapeutic amount ordered by the provider. Sub-therapeutic dosing can lead to treatment failure, prolongation of depressive symptoms, and potential exacerbation of the underlying psychiatric condition due to inadequate neurotransmitter modulation.
Correct Answer is B
Explanation
Choice A reason: Social anxiety disorder focuses specifically on the fear of being scrutinized, judged, or embarrassed by others in social or performance-related situations. While it may lead to staying at home, the core fear is social evaluation rather than the logistical inability to escape a specific physical environment or situation.
Choice B reason: Agoraphobia is characterized by marked fear or anxiety about being in situations where escape might be difficult or help might not be available in the event of developing panic-like symptoms. This often leads to "homebound" behavior, where the individual feels safe only within their own residence and avoids public spaces or transportation.
Choice C reason: Generalized anxiety disorder (GAD) involves excessive, uncontrollable worry about various aspects of daily life, such as health, finances, or work. While GAD is pervasive and distressing, it is not characterized by the specific situational avoidance or the localized fear of being unable to escape that defines agoraphobia.
Choice D reason: Panic disorder is defined by recurrent, unexpected panic attacks and the persistent worry about having more attacks. While agoraphobia often develops as a complication of panic disorder (as the patient fears having an attack in public), the specific fear of being unable to escape situations is the defining feature of agoraphobia itself.
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