NUR 329 Exam 3 Review Fall 2023/2024 Questions and Answers.

NUR 329 Exam 3 Review Fall 2023/2024 Questions and Answers. On the topic of the Military and Military Families – (Chapter 38) 1. Be able to identify symptomatology that one might expect from a military person who has been deployed  Symptomology o Migraine headaches o Memory impairment o Hypervigilance o Insomnia o Jitteriness o Aggressive behaviors o Substance abuse  What priority assessment/s and interventions would be appropriate o Counseling and therapy o Medications o CBT and specialized therapy o Exposure therapy o Relaxation techniques o Adaptive disclosure o Cognitive processing therapy o Community-based care o Mental health promotion  1. John is being treated for PTSD symptoms, which began shortly after his retirement from the military. He has had nightmares, flashbacks of traumatic events from combat, and episodes of acute anxiety. His wife is asking the nurse how he could be developing PTSD at this time when he hasn’t been in a combat situation for over 10 years. Which of these teaching points are evidence-based pieces of information to share with John’s wife? Select all that apply. A. Retirement has been identified as a common precipitating factor for PTSD. B. PTSD symptoms may develop at any time after a trauma. C. PTSD is not the appropriate diagnosis, according to DSM-5, unless the trauma occurred greater than 5 years ago. D. This is probably not PTSD but rather a brief adjustment reaction to retirement.  2. Les has been referred to the VA clinic because he was recently fired from his job. His former employer reported that he was drinking on the job and had become physically aggressive with one of his coworkers. Which of the following statements during the intake assessment are consistent with common symptoms of PTSD? Select all that apply. A. “I’ve been drinking and smoking pot more frequently in the past few months.” B. “I’ve always thought I was too good for that job anyway.” C. “Sometimes I get so angry I just want to punch someone’s lights out.” D. “I haven’t been getting enough sleep because the nightmares keep waking me up.” E. “I don’t like authority figures.”  3. Jane has begun treatment for PTSD with symptoms of depression. The nurse is reviewing the physician’s orders. Which of these are evidence-based modalities for initial treatment of Jane’s illnesses? Select all that apply. A. Acupuncture B. Electroconvulsive therapy (ECT) C. Sertraline (Zoloft) D. Cognitive behavior therapy (CBT) E. Propranolol (Inderal) 2. Think about what life might be like for the family of military personnel  How military life affects everyone in the household o A pattern of rigidity, regimentation, and conformity in family life o Military spouses live with concept of “mission first” o Escalated misbehavior of the children  Infants: Decreased appetite, weight loss, irritability, apathy  Toddlers: may be sullen, tearful, throw temper tantrums, or develop sleep problems  Preschoolers: may exhibit regressive behaviors; may assume blame for parent’s departure  School-age: irritability, aggression, whininess, express fears about parent’s safety  Adolescents: rebellion, irritability, challenging authority, sexual acting out, drug or alcohol abuse. o Spousal loneliness o Spouses live in constant fear and anxiety associated with the life-threatening conditions facing his/her service member partner  4. Paula’s husband returned from active duty 1 month ago, and Paula is now seeing a counselor for relational conflict in her marriage. She tells the counselor she thinks her husband “can’t love anything as much as he loves the military” and that “he acts like he can’t wait to be redeployed.” Which of these common aspects about military culture might be contributing to her husband’s behavior? A. Military mission is advanced as the highest priority. B. Marriage is discouraged in the military. C. Redeployment is considered the highest honor. D. People who choose a military lifestyle often have asocial personality traits.  5. Bill is an only child whose parents are both career military personnel. He is being seen by the school nurse for complaints of fever and wants to be sent home. On examination he is afebrile. He tells the nurse he doesn’t like this school anyway and the nurse notes that this is his third school transition in four years. Which of these understandings about the experience of military family members is important to providing compassionate care for this child? A. Military children are more often exposed to unusual viruses, so he should be sent for a complete evaluation and bloodwork. B. Military children are generally healthier than their nonmilitary peers, so he should be given strict consequences for pretending to be ill. C. Children of military personnel are often victims of physical abuse, so he should be asked direct questions about whether or not his parents have been physically aggressive with him. D. Isolation and alienation are common experiences of military family members, so it is important to assess further his adjustment in the current school setting. 3. Consider the differences between the male and female military experience.  Female o Special concerns  Sexual harassment  Sexual assault  Differential treatment and conditions  Parenting issues  6. Susan returned from active duty and is being treated for PTSD. She tells the nurse that she was never in a combat zone during her deployment, and her commanding officer told her that you can’t have PTSD unless you were in active combat. Which of these responses by the nurse is an accurate reflection about PTSD in military personnel? A. Women may experience other anxiety disorders but rarely experience PTSD as a result of being in the military. B. PTSD after serving in the military is almost always related to trauma associated with active combat. C. Women in the military more often experience PTSD secondary to sexual assault. D. All of the above. On the topic of Trauma and Stressor-Related Disorders- (Chapter 28&38) 4. Understand that both military and non-military people are subject to developing PTSD; discuss the signs and symptoms of PTSD and be able to recognize them.  S/S o Reliving the trauma through flashbacks, nightmares, and intrusive thoughts o Intensive efforts to avoid activities, people places, situations, or objects that arouse recollection of trauma o Chronic negative emotional state and diminished interest or participation in significant activities o Aggressive, reckless, or self-destructive behavior o Hypervigilance and exaggerated startle response o Angry outburst, problems with concertation, and sleep disturbances.