C HAPTER 16: T RAUMA , S TRESSOR -R ELATED ,
AND D ISSOCIATIVE D ISORDERS
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. The gas pedal on a persons car stuck on a busy interstate highway, causing
the car to accelerate rapidl y. For 20 minutes, the car was very difficult to
control. Afterward, this persons cortisol regulation was compromised.
Which assessment finding would the nurse expect associated with the
dysregulation of cortisol?
a. Weight gain
b. Flashbacks
c. Headache
d. Diuresis
ANS: B
Cortisol is a hormone released in response to stress. Severe
dissociation or mindflight occurs for those who have suffered
significant trauma. The episodic failure of dissociation causes intrusive
s ymptoms such as flashbacks, th us dysregulating cortisol. The cortisol
level may go up or down, so diuresis and/or weight gain may or may
not occur. Answering this question correctl y requires that the student
appl y prior learning regarding the effects of cortisol.
, PTS: 1 DIF: Cognitiv e Level: Appl y (Application)
REF: 296 TOP: Nursing Process: Assessment MSC:
Client Needs: Physiological Integrit y
2. A soldier returns to the United States from active dut y in a combat zone in
Afghanistan. The soldier is diagnosed with posttraumatic stres s disorder
(PTSD). The nurses highest priorit y is to screen this soldier for:
a. bipolar disorder.
b. schizophrenia.
c. depression.
d. dementia.
ANS: C
Comorbidities for adults with PTSD include depression, anxiety
disorders, sleep disorders, and dissociative diso rders. Incidence of the
disorders identified in the distracters is similar to the general
population.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 300 TOP: Nursing Process: Assessment MSC:
Client Needs: Psychosocial Integrit y
3. Two weeks ago, a soldier returned to the U.S. from active duty in a
combat zone in Afghanistan. The soldier was diagnosed with posttraumatic
stress disorder (PTSD). Which comment by the soldier requires the nurses
immediate attention?
a. Its good to be home. I missed m y hom e, famil y, and friends.
b. I saw m y best friend get killed by a roadside bomb. I dont
understand why it wasnt me.
, c. Sometimes I think I hear bombs exploding, but its just the noise of
traffic in m y hometown.
d. I want to continue my education, but Im not sure how I will fit in
with other college students.
ANS: B
The correct response indicates the soldier is thinking about death and
feeling survivors guilt. These emotions may accompany suicidal
ideation, which warrants the nurses follow -up assessment. Suicide is a
high risk among military personnel diagnosed with posttraumatic stress
disorder. One distracter indicates flashbacks, common with persons
with PTSD, but not solel y indicative that further problems exist. The
other distracters are normal emotions associate d with returning home
and change.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF: 300
TOP: Nursing Process: Anal ysis/Diagnosis MSC: Client
Needs: Psychosocial Integrit y
4. A soldier returned home from active duty in a combat zone in Afghanistan
and was diagnosed with posttraumatic stress disorder (PTSD). The soldier
says, If theres a loud noise at night, I get under m y bed because I think
were getting bombed. What t ype of experience has the soldier described?
a. Illusion
b. Flashback
c. Nightmare
d. Auditory hallucination
ANS: B
AND D ISSOCIATIVE D ISORDERS
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. The gas pedal on a persons car stuck on a busy interstate highway, causing
the car to accelerate rapidl y. For 20 minutes, the car was very difficult to
control. Afterward, this persons cortisol regulation was compromised.
Which assessment finding would the nurse expect associated with the
dysregulation of cortisol?
a. Weight gain
b. Flashbacks
c. Headache
d. Diuresis
ANS: B
Cortisol is a hormone released in response to stress. Severe
dissociation or mindflight occurs for those who have suffered
significant trauma. The episodic failure of dissociation causes intrusive
s ymptoms such as flashbacks, th us dysregulating cortisol. The cortisol
level may go up or down, so diuresis and/or weight gain may or may
not occur. Answering this question correctl y requires that the student
appl y prior learning regarding the effects of cortisol.
, PTS: 1 DIF: Cognitiv e Level: Appl y (Application)
REF: 296 TOP: Nursing Process: Assessment MSC:
Client Needs: Physiological Integrit y
2. A soldier returns to the United States from active dut y in a combat zone in
Afghanistan. The soldier is diagnosed with posttraumatic stres s disorder
(PTSD). The nurses highest priorit y is to screen this soldier for:
a. bipolar disorder.
b. schizophrenia.
c. depression.
d. dementia.
ANS: C
Comorbidities for adults with PTSD include depression, anxiety
disorders, sleep disorders, and dissociative diso rders. Incidence of the
disorders identified in the distracters is similar to the general
population.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 300 TOP: Nursing Process: Assessment MSC:
Client Needs: Psychosocial Integrit y
3. Two weeks ago, a soldier returned to the U.S. from active duty in a
combat zone in Afghanistan. The soldier was diagnosed with posttraumatic
stress disorder (PTSD). Which comment by the soldier requires the nurses
immediate attention?
a. Its good to be home. I missed m y hom e, famil y, and friends.
b. I saw m y best friend get killed by a roadside bomb. I dont
understand why it wasnt me.
, c. Sometimes I think I hear bombs exploding, but its just the noise of
traffic in m y hometown.
d. I want to continue my education, but Im not sure how I will fit in
with other college students.
ANS: B
The correct response indicates the soldier is thinking about death and
feeling survivors guilt. These emotions may accompany suicidal
ideation, which warrants the nurses follow -up assessment. Suicide is a
high risk among military personnel diagnosed with posttraumatic stress
disorder. One distracter indicates flashbacks, common with persons
with PTSD, but not solel y indicative that further problems exist. The
other distracters are normal emotions associate d with returning home
and change.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF: 300
TOP: Nursing Process: Anal ysis/Diagnosis MSC: Client
Needs: Psychosocial Integrit y
4. A soldier returned home from active duty in a combat zone in Afghanistan
and was diagnosed with posttraumatic stress disorder (PTSD). The soldier
says, If theres a loud noise at night, I get under m y bed because I think
were getting bombed. What t ype of experience has the soldier described?
a. Illusion
b. Flashback
c. Nightmare
d. Auditory hallucination
ANS: B
