Review Post-traumatic stress disorder (PTSD)

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Post-traumatic stress disorder (PTSD)

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Total Questions : 15

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Question 1:

A nurse is assessing a client who has experienced a traumatic event. Which of the following is a re-experiencing symptom of post-traumatic stress disorder (PTSD)?

A. Avoiding thoughts, feelings, people, places, or activities associated with the trauma. B. Having persistent negative beliefs and emotions. C. Experiencing intrusive and distressing memories of the trauma. D. Feeling detached or estranged from others.

Answer and Explanation

Choice A:

Avoiding thoughts, feelings, people, places, or activities associated with the trauma is a symptom of post-traumatic stress disorder (PTSD), but it is not a re-experiencing symptom. This behavior is part of the avoidance and numbing cluster of symptoms in PTSD.

Choice B:

Having persistent negative beliefs and emotions is another symptom of PTSD, but it is not a re-experiencing symptom. This is related to the negative alterations in cognitions and mood that individuals with PTSD may experience.

Choice C:

Experiencing intrusive and distressing memories of the trauma is a re-experiencing symptom of PTSD. Individuals with PTSD may have flashbacks, nightmares, or intrusive thoughts about the traumatic event, causing distress and emotional turmoil.

Choice D:

Feeling detached or estranged from others is a symptom of PTSD but is not considered a re-experiencing symptom. It falls under the category of alterations in arousal and reactivity, affecting the individual's ability to connect with others emotionally.

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Question 2:

A nurse is providing education to a group of clients about post-traumatic stress disorder (PTSD) Which of the following statements should the nurse include in the teaching? (Select all that apply.)

A. "PTSD can occur after experiencing or witnessing a traumatic event.". B. "PTSD is characterized by four types of symptoms: re-experiencing, avoidance, negative alterations in cognition and mood, and alterations in arousal and reactivity.". C. "Cognitive-behavioral therapy (CBT) is a treatment option for PTSD.". D. "PTSD is only diagnosed if symptoms last for more than one year.". E. "People with a history of mental illness are at a higher risk for developing PTSD.".

Answer and Explanation

Choice A:

PTSD can indeed occur after experiencing or witnessing a traumatic event. Trauma can lead to a range of psychological and physiological responses that characterize PTSD.

Choice B:

PTSD is characterized by four main types of symptoms: re-experiencing, avoidance, negative alterations in cognition and mood, and alterations in arousal and reactivity. Re-experiencing symptoms involve intrusive memories or flashbacks, avoidance symptoms involve efforts to avoid reminders of the trauma, negative alterations in cognition and mood encompass feelings of guilt, blame, and distorted thoughts, while alterations in arousal and reactivity can include irritability and exaggerated startle response.

Choice C:

Cognitive-behavioral therapy (CBT) is indeed a recognized and effective treatment option for PTSD. CBT helps individuals identify and change negative thought patterns and behaviors associated with their trauma, aiming to reduce distress and improve coping mechanisms.

Choice D:

PTSD is not limited to a specific duration for diagnosis. Symptoms must persist for more than a month and cause significant impairment in functioning, but there is no requirement for symptoms to last for more than one year.

Choice E:

While it is true that individuals with a history of mental illness are generally more susceptible to developing various mental health conditions, this statement is not wholly accurate. PTSD can affect anyone exposed to traumatic events, regardless of their mental health history.

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Question 3:

A nurse is caring for a client with post-traumatic stress disorder (PTSD) Which statement by the client indicates the presence of avoidance symptoms?

A. "I can't stop thinking about what happened.". B. "I try to avoid going to places that remind me of the trauma.". C. "I feel detached from my family and friends.". D. "I often feel irritable and have angry outbursts.".

Answer and Explanation

Choice B:

The statement "I try to avoid going to places that remind me of the trauma." indicates the presence of avoidance symptoms, which are a hallmark of PTSD. Avoidance symptoms involve efforts to stay away from situations, places, or people that trigger memories of the traumatic event.

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Question 4:

A nurse is assessing a client with post-traumatic stress disorder (PTSD) Which statement by the client indicates the presence of negative alterations in cognition and mood symptoms?

A. "I can't remember anything about the traumatic event.". B. "I always feel on edge and easily startled.". C. "I have intense nightmares about the trauma.". D. "I believe that the world is completely dangerous.".

Answer and Explanation

Choice D:

The statement "I believe that the world is completely dangerous." indicates the presence of negative alterations in cognition and mood symptoms, which are another facet of PTSD. These symptoms often involve a distorted perception of the world, including beliefs about danger and an inability to trust others.

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Question 5:

A nurse is providing care for a client with post-traumatic stress disorder (PTSD) Which nursing intervention should the nurse implement?

A. Encouraging the client to avoid talking about the traumatic event. B. Assisting the client in identifying and challenging negative thoughts. C. Encouraging the client to engage in risky behaviors to cope with stress. D. Referring the client to a support group for individuals with anxiety disorders.

Answer and Explanation

Choice A:

Encouraging the client to avoid talking about the traumatic event would not be a suitable intervention for a client with post-traumatic stress disorder (PTSD) Avoidance can exacerbate symptoms and hinder the healing process. Discussing the traumatic event in a safe and therapeutic environment is an essential part of PTSD treatment.

Choice B:

Assisting the client in identifying and challenging negative thoughts is a crucial intervention for individuals with PTSD. Cognitive Behavioral Therapy (CBT) is a recommended approach for treating PTSD, and it involves addressing distorted or negative thought patterns that contribute to the distressing symptoms. By challenging and reframing these thoughts, clients can learn to manage their symptoms and regain a sense of control.

Choice C:

Encouraging the client to engage in risky behaviors to cope with stress is not appropriate and can potentially worsen the client's condition. Engaging in risky behaviors could lead to harm and complicate the treatment process. Instead, promoting healthy coping mechanisms and stress-reduction strategies would be more beneficial.

Choice D:

Referring the client to a support group for individuals with anxiety disorders might not be the most suitable intervention for PTSD. While anxiety disorders and PTSD share some similarities, they are distinct conditions with different treatment approaches. A support group specifically focused on PTSD would provide more tailored and effective assistance.

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Question 6:

Which of the following is a risk factor for developing post-traumatic stress disorder (PTSD)?

A. Being male. B. Having a family history of PTSD. C. Having exposure to media coverage of trauma. D. Having good social support.

Answer and Explanation

Choice A:

Being male is not a risk factor for developing PTSD. PTSD can affect individuals of any gender. While there may be differences in the prevalence and expression of symptoms between genders, being male alone is not a risk factor for developing the disorder.

Choice B:

Having a family history of PTSD is a recognized risk factor for developing the disorder. Genetics and family environment can play a role in the predisposition to PTSD. Individuals with a family history of trauma-related disorders might have a higher vulnerability to developing PTSD after exposure to a traumatic event.

Choice C:

Having exposure to media coverage of trauma can contribute to distress, anxiety, and even trigger symptoms in individuals with PTSD. However, it is not considered a primary risk factor for developing the disorder. Other factors, such as personal trauma history and individual vulnerability, play a more significant role.

Choice D:

Having good social support is actually a protective factor against developing PTSD. Adequate social support can buffer the impact of trauma and contribute to better resilience and recovery. It is not a risk factor but rather a positive factor that can help mitigate the effects of trauma.

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Question 7:

A nurse is caring for a client with post-traumatic stress disorder (PTSD) Which of the following assessments should the nurse prioritize?

A. Assessing the client's physical health. B. Assessing the client's coping skills. C. Assessing the client's social support. D. Assessing the client's past trauma history.

Answer and Explanation

Choice A:

Assessing the client's physical health is a priority because physical health issues can significantly impact the overall well-being of an individual with PTSD. Trauma and chronic stress can lead to physical health problems, including sleep disturbances, cardiovascular issues, and gastrointestinal problems. Addressing these physical concerns is essential for a holistic approach to care.

Choice B:

Assessing the client's coping skills is important, but it may not be the top priority. Coping skills assessment is essential for treatment planning, but addressing immediate physical health needs and safety concerns takes precedence, especially if the client is experiencing acute distress.

Choice C:

Assessing the client's social support is important for long-term recovery, but it may not be the primary assessment in the initial stages of care. Social support can contribute to resilience, but addressing physical health and acute distress is more critical initially.

Choice D:

Assessing the client's past trauma history is relevant for understanding the context of the disorder, but it might not be the priority in the moment. Trauma history can be explored in therapy sessions, but addressing immediate physical and emotional needs comes first.

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Question 8:

A nurse is caring for a client with post-traumatic stress disorder (PTSD) Which of the following nursing interventions should the nurse implement? (Select all that apply.)

A. Promoting self-care and healthy lifestyle habits. B. Teaching the client relaxation techniques. C. Assisting the client in avoiding triggers and symptoms. D. Facilitating exposure therapy.

Answer and Explanation

Choice A:

Promoting self-care and healthy lifestyle habits is an essential nursing intervention for clients with post-traumatic stress disorder (PTSD) This involves assisting the client in maintaining a balanced and healthy lifestyle, which can positively impact their overall well-being. Engaging in regular exercise, maintaining a balanced diet, getting adequate sleep, and practicing relaxation techniques can help reduce stress and improve the client's mental health.

Choice B:

Teaching the client relaxation techniques (Choice B) is another appropriate nursing intervention for clients with PTSD. Relaxation techniques such as deep breathing, progressive muscle relaxation, and guided imagery can help the client manage anxiety and stress-related symptoms.

Choice C:

Assisting the client in avoiding triggers and symptoms (Choice C) is a common strategy in managing PTSD. By identifying triggers and learning strategies to avoid or cope with them, the client can minimize the recurrence of traumatic memories and associated distress.

Choice D:

Facilitating exposure therapy (Choice D) is not typically recommended as a primary nursing intervention for PTSD. Exposure therapy involves gradually exposing the client to traumatic memories or triggers in a controlled environment to reduce their sensitivity over time. This technique is often led by mental health professionals such as psychologists or psychiatrists.

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Question 9:

A nurse is educating a client about the pharmacological treatments for PTSD. Which of the following medications is an atypical antipsychotic commonly used in the management of PTSD?

A. Sertraline. B. Risperidone. C. Venlafaxine. D. Lamotrigine.

Answer and Explanation

Choice A:

Sertraline (Choice A) is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat conditions such as depression and anxiety disorders. While it may be beneficial in managing certain symptoms of PTSD, it is not classified as an atypical antipsychotic.

Choice B:

Risperidone (Choice B) is an atypical antipsychotic that can be used in the management of PTSD, particularly for reducing hyperarousal symptoms, aggression, and irritability. It helps regulate neurotransmitter activity and has shown efficacy in controlling certain PTSD-related symptoms.

Choice C:

Venlafaxine (Choice C) is a serotonin-norepinephrine reuptake inhibitor (SNRI) used to treat various mood disorders. While it may have some benefits in treating anxiety symptoms associated with PTSD, it is not categorized as an atypical antipsychotic.

Choice D:

Lamotrigine (Choice D) is an anticonvulsant primarily used in the treatment of epilepsy and bipolar disorder. It is not a typical medication for managing PTSD symptoms.

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Question 10:

A nurse is providing teaching to a group of clients with PTSD. Which of the following non-pharmacological therapies is considered a trauma-focused psychotherapy?

A. Acupuncture. B. Yoga. C. Cognitive processing therapy. D. Biofeedback.

Answer and Explanation

Choice A:

Acupuncture (Choice A) is an alternative therapy that involves inserting thin needles into specific points on the body. While it may have benefits for pain management and relaxation, it is not considered a trauma-focused psychotherapy for PTSD.

Choice B:

Yoga (Choice B) is a mind-body practice that can promote relaxation and stress reduction. While it can be a helpful component of a holistic approach to managing PTSD, it is not specifically classified as trauma-focused psychotherapy.

Choice C:

Cognitive processing therapy (Choice C) is a well-established trauma-focused psychotherapy for PTSD. It involves helping clients process and reframe their traumatic experiences by challenging and modifying negative beliefs and thoughts associated with the trauma.

Choice D:

Biofeedback (Choice D) is a technique that teaches individuals to control physiological functions, such as heart rate and muscle tension, through relaxation techniques. While it can aid in stress management, it is not a trauma-focused psychotherapy.

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Question 11:

A nurse is assessing a client with PTSD. Which of the following statements made by the client indicates a positive outcome of PTSD management?

A. "I am experiencing a reduction in PTSD symptoms.". B. "I have improved coping skills and resilience.". C. "I have restored self-esteem and identity.". D. "I have reintegration into society and relationships.".

Answer and Explanation

Choice A:

If the client states, "I am experiencing a reduction in PTSD symptoms," it reflects a positive change but not necessarily a comprehensive improvement. Reduction in symptoms could be due to various factors, and it might not indicate overall progress in managing PTSD.

Choice B:

This choice indicates a positive outcome because improved coping skills and resilience are fundamental aspects of successful PTSD management. This suggests that the client has learned to deal with triggers and stressors more effectively, leading to better emotional regulation and adaptation.

Choice C:

"I have restored self-esteem and identity" is important for psychological well-being, but it specifically focuses on self-esteem and identity rather than the broader range of symptoms associated with PTSD. While this could be a part of the recovery process, it's not as comprehensive as improved coping skills and resilience.

Choice D:

"I have reintegration into society and relationships" also reflects progress, but it pertains to the social aspects of recovery rather than the individual's internal coping mechanisms. Social reintegration is crucial, but it may not directly correlate with better management of PTSD symptoms.

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Question 12:

A nurse is discussing the effectiveness of PTSD management with a client. Which of the following factors can influence the effectiveness of treatment?

A. Severity of the trauma. B. Availability of treatment options. C. Adherence and compliance of the client. D. All of the above. E. None of the above.

Answer and Explanation

Choice A:

The severity of the trauma can influence the effectiveness of treatment since more severe traumas might require more intensive interventions. Higher severity could also lead to increased resistance to treatment.

Choice B:

The availability of treatment options is significant because limited options might restrict the client's access to suitable interventions, potentially affecting the treatment's success.

Choice C:

Adherence and compliance of the client play a vital role. If the client does not follow the treatment plan consistently, the effectiveness of any intervention can be compromised.

Choice D:

This is the correct answer as all of the mentioned factors can impact the effectiveness of PTSD management. The severity of trauma, treatment availability, and client adherence are interrelated aspects that collectively influence the outcome.

Choice E:

"None of the above" is not the correct answer since each of the factors mentioned can indeed impact the effectiveness of treatment in various ways.

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Question 13:

A nurse is assessing a client with PTSD who is interested in trying complementary and alternative therapies. Which of the following therapies has some evidence of effectiveness for PTSD?

A. Acupuncture. B. Yoga. C. Meditation. D. Hypnosis.

Answer and Explanation

Choice A:

Acupuncture is not one of the therapies that have substantial evidence for effectiveness in treating PTSD. While acupuncture has been explored for various conditions, including pain and anxiety, its evidence for treating PTSD specifically is limited and inconsistent.

Choice B:

Yoga can be beneficial for individuals with PTSD as it combines physical postures, breathing exercises, and meditation, which can help manage stress and anxiety. However, the evidence for its effectiveness is not as strong as for meditation, which has shown more consistent results in reducing PTSD symptoms.

Choice C:

Meditation, particularly mindfulness meditation, has demonstrated some evidence of effectiveness for PTSD. Mindfulness meditation involves focusing on the present moment and accepting thoughts and feelings without judgment. Studies have shown that it can reduce symptoms of hyperarousal, intrusive thoughts, and avoidance behaviors commonly associated with PTSD.

Choice D:

Hypnosis is not considered a first-line therapy for PTSD. While some limited studies have explored its potential benefits, it lacks the robust evidence that other therapies like meditation and cognitive-behavioral therapies possess.

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Question 14:

A nurse is educating a client with PTSD about the first-line pharmacological treatments. According to the National Institute for Health and Care Excellence (NICE), which of the following medications is recommended as a first-line treatment for PTSD?

A. Sertraline. B. Venlafaxine. C. Amitriptyline. D. Mirtazapine.

Answer and Explanation

Choice A:

Sertraline is recommended as a first-line pharmacological treatment for PTSD by the National Institute for Health and Care Excellence (NICE) It is a selective serotonin reuptake inhibitor (SSRI) that has shown effectiveness in reducing PTSD symptoms, particularly in terms of intrusive thoughts and avoidance behaviors.

Choice B:

Venlafaxine is also an antidepressant, but it is generally considered a second-line treatment option for PTSD. It might be considered if SSRIs are ineffective or not tolerated due to its different mechanism of action as a serotonin-norepinephrine reuptake inhibitor (SNRI)

Choice C:

Amitriptyline is a tricyclic antidepressant that is not commonly recommended for the first-line treatment of PTSD. SSRIs like sertraline are preferred due to their generally more favorable side effect profiles.

Choice D:

Mirtazapine is another antidepressant with different pharmacological properties compared to SSRIs. However, like venlafaxine, it is typically considered a second-line option for treating PTSD.

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Question 15:

A nurse is providing teaching to a group of clients with PTSD. Which of the following non-pharmacological therapies has been shown to reduce PTSD symptoms by 50% to 80% in most clients after 8 to 16 sessions?

A. Prolonged exposure (PE) B. Cognitive processing therapy (CPT) C. Eye movement desensitization and reprocessing (EMDR) D. Acceptance and commitment therapy (ACT)

Answer and Explanation

Choice A:

Prolonged exposure (PE) is a type of cognitive-behavioral therapy that involves confronting and processing traumatic memories. While it is effective for many individuals with PTSD, its effectiveness in reducing symptoms by 50% to 80% in most clients after 8 to 16 sessions is not as consistently reported as with EMDR.

Choice B:

Cognitive processing therapy (CPT) focuses on addressing maladaptive beliefs related to the traumatic event. While it can be effective, its reported symptom reduction rates may vary, and it might not consistently achieve the 50% to 80% reduction mentioned.

Choice C:

Eye movement desensitization and reprocessing (EMDR) is a well-established therapy specifically designed for trauma-related disorders like PTSD. Research indicates that many individuals experience significant symptom reduction within 8 to 16 sessions, with reported rates often falling within the 50% to 80% range.

Choice D:

Acceptance and commitment therapy (ACT) and dialectical behavior therapy (DBT) are therapies often used for conditions like depression and anxiety but may not have as robust a body of evidence for PTSD treatment as EMDR or certain cognitive-behavioral therapies.

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Post-traumatic stress disorder (PTSD)

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