Which of the following statements are true regarding post-traumatic stress disorder?
Critical incident stress management is the only method to deal with PTSD.
Individuals suffering from PTSD may display physical manifestations.
Professional burnout is rare secondary to PTSD.
Manifestations of PTSD are purely psychological.
The Correct Answer is B
Choice A rationale
Critical incident stress management is one approach used for crisis intervention, but it is not the only method available for managing this disorder. Comprehensive treatment often involves a combination of cognitive-behavioral therapy, eye movement desensitization and reprocessing, and pharmacological interventions like selective serotonin reuptake inhibitors. Suggesting it is the sole method ignores the complexity of trauma recovery and the necessity of individualized care plans that integrate various therapeutic modalities for long-term psychological health.
Choice B rationale
Individuals suffering from this condition frequently manifest physical symptoms alongside psychological ones. The chronic activation of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis leads to somatic complaints. These can include chronic pain, cardiovascular issues, gastrointestinal distress, and tension headaches. The body remains in a state of hyperarousal, meaning the physical manifestations are a direct biological consequence of the trauma-induced stress response, reflecting the intricate link between mental health and physical physiological stability.
Choice C rationale
Professional burnout is actually quite common among individuals experiencing this disorder, particularly for those in high-stress occupations like healthcare or emergency services. The emotional exhaustion and depersonalization associated with the condition significantly increase the risk of occupational burnout. The cognitive load required to manage intrusive thoughts and hypervigilance depletes the individual's professional efficacy and resilience, making the suggestion that burnout is rare in this context scientifically and statistically inaccurate for this population.
Choice D rationale
The manifestations of this disorder are not purely psychological; they involve significant neurobiological changes. Brain imaging often shows alterations in the hippocampus, amygdala, and prefrontal cortex. Furthermore, the autonomic nervous system remains dysregulated, leading to measurable physical changes in heart rate variability, sleep patterns, and cortisol levels. Classifying the disorder as purely psychological ignores the systemic physiological impact that traumatic stress has on the entire human body, including the immune and endocrine systems.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Ventricular escape rhythm occurs when higher pacemakers fail, resulting in a slow ventricular rate typically between 20 to 40 beats per minute. The ECG would show a consistent slow rhythm with wide QRS complexes rather than a brief burst of premature ventricular contractions interrupting a normal sinus rhythm. It serves as a safety mechanism to prevent cardiac standstill, which differs from the irritable ectopic activity seen in this specific clinical scenario.
Choice B rationale
Atrial flutter is characterized by a rapid, regular atrial rate usually between 250 to 350 beats per minute, creating a classic sawtooth pattern on the ECG. This rhythm originates from a macro-reentrant circuit within the atria rather than the ventricles. Since the client is in a normal sinus rhythm interrupted specifically by premature ventricular complexes, the pathophysiology of atrial flutter involving the atrioventricular node and atrial tissue does not match the observed ventricular ectopic activity.
Choice C rationale
Trigeminy is a specific pattern of ventricular irritability where every third beat is a premature ventricular contraction. In this pattern, the ECG displays two sinus beats followed by one ectopic beat in a repetitive cycle. The description provided involves a single run of three consecutive premature ventricular contractions rather than a recurring 2 to 1 ratio of sinus to ectopic beats, making trigeminy an incorrect interpretation of this specific short-lived ventricular burst.
Choice D rationale
Nonsustained ventricular tachycardia is defined as a run of three or more consecutive premature ventricular contractions lasting less than 30 seconds and ending spontaneously. This occurs due to increased ventricular irritability or reentry circuits within the His-Purkinje system. The client's ECG shows exactly three complexes, which meets the diagnostic criteria for this interpretation. It is a significant finding because it may precede sustained ventricular tachycardia, which can lead to hemodynamic instability or cardiac arrest.
Correct Answer is A
Explanation
Choice A rationale
An implantable cardioverter-defibrillator firing three times indicates recurrent, life-threatening ventricular arrhythmias that the device is struggling to suppress. This suggests myocardial instability or worsening electrophysiological status. Amiodarone is an class III antiarrhythmic used to stabilize the membrane and prolong the action potential. This patient is at the highest risk for sudden cardiac arrest and requires immediate assessment of hemodynamics, oxygenation, and electrolyte levels to prevent further lethal events.
Choice B rationale
Type 1 second-degree AV block, or Wenckebach, involves progressive PR interval prolongation until a QRS is dropped. While dizziness during ambulation indicates decreased cardiac output, a heart rate of 60 is relatively stable compared to repeated ICD discharges. Normal heart rate is 60 to 100 beats per minute. This patient needs monitoring and assistance with mobility to prevent falls, but they do not take precedence over a patient experiencing active ventricular instability.
Choice C rationale
A sinus rhythm with a rate of 98 indicates that the electrical cardioversion was successful in restoring a normal rhythm from a previous arrhythmia like atrial fibrillation. A rate of 98 is within the normal adult range of 60 to 100 beats per minute. While post-procedure monitoring for embolic events or rhythm recurrence is necessary, this patient is currently stable and showing the desired therapeutic outcome of the intervention performed two hours ago.
Choice D rationale
Atrial fibrillation with a controlled ventricular response of 88 indicates the patient is hemodynamically stable. The initiation of warfarin is a standard prophylactic measure to prevent thromboembolism and stroke associated with atrial stasis. While education on vitamin K intake and monitoring the International Normalized Ratio (normal range 0.8 to 1.1, therapeutic 2.0 to 3.0) is important, it is a routine pharmacological task that does not require immediate emergency intervention.
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