Varcarolis Ch. 16 Trauma,
Stressor-Related, and Dissociative
Disorders
1. A nurse works with a patient diagnosed with posttraumatic stress disorder who has frequent
flashbacks as well as persistent symptoms of arousal. Which intervention should be included in
the plan of care?
a. Trigger flashbacks intentionally in order to help the patient learn to cope with them.
b. Explain that the physical symptoms are related to the psychological state.
c. Encourage repression of memories associated with the traumatic event.
d. Support numbing as a temporary way to manage intolerable feelings. - ANSb. Explain that
the physical symptoms are related to the psychological state.
Persons with posttraumatic stress disorder often experience somatic symptoms or sympathetic
nervous system arousal that can be confusing and distressing. Explaining that these are the
bodys responses to psychological trauma helps the patient understand how such symptoms are
part of the illness and something that will respond to treatment. This decreases powerlessness
over the symptoms and helps instill a sense of hope. It also helps the patient to understand how
relaxation, breathing exercises, and imagery can be helpful in symptom reduction. The goal of
treatment for posttraumatic stress disorder is to come to terms with the event so treatment
efforts would not include repression of memories or numbing. Triggering flashbacks would
increase patient distress.
2. Four teenagers died in an automobile accident. One week later, which behavior by the
parents of these teenagers most clearly demonstrates resilience? The parents who:
a. visit their teenagers grave daily.
b. return immediately to employment.
c. discuss the accident within the family only.
d. create a scholarship fund at their child's high school. - ANSd. create a scholarship fund at
their child's high school.
, Resilience refers to positive adaptation or the ability to maintain or regain mental health despite
adversity. Loss of a child is among the highest-risk situations for maladaptive grieving. The
parents who create a scholarship fund are openly expressing their feelings and memorializing
their child. The other parents in this question are isolating themselves and/or denying their
feelings. Visiting the grave daily shows active continued mourning but is not as strongly
indicative of resilience as the correct response.
3. After the sudden death of his wife, a man says, I cant live without her she was my whole life.
Select the nurses most therapeutic reply.
a. Each day will get a little better.
b. Her death is a terrible loss for you.
c. Its important to recognize that she is no longer suffering.
d. Your friends will help you cope with this change in your life. - ANSb. Her death is a terrible
loss for you.
Adjustment disorders may be associated with grief. A statement that validates a bereaved
persons loss is more helpful than false reassurances and clichs. It signifies understanding.
4. A woman just received notification that her husband died. She approaches the nurse who
cared for him during his last hours and says angrily, If you had given him your undivided
attention, he would still be alive. How should the nurse analyze this behavior?
a. The comment suggests potential allegations of malpractice.
b. In some cultures, grief is expressed solely through anger.
c. Anger is an expected emotion in an adjustment disorder.
d. The patient had ambivalent feelings about her husband. - ANSc. Anger is an expected
emotion in an adjustment disorder.
6. A child drowned while swimming in a local lake 2 years ago. Which behavior indicates the
childs parents have adapted to their loss? The parents:
a. visit their childs grave daily.
b. maintain their childs room as the child left it 2 years ago.
c. keep a place set for the dead child at the family dinner table.
Stressor-Related, and Dissociative
Disorders
1. A nurse works with a patient diagnosed with posttraumatic stress disorder who has frequent
flashbacks as well as persistent symptoms of arousal. Which intervention should be included in
the plan of care?
a. Trigger flashbacks intentionally in order to help the patient learn to cope with them.
b. Explain that the physical symptoms are related to the psychological state.
c. Encourage repression of memories associated with the traumatic event.
d. Support numbing as a temporary way to manage intolerable feelings. - ANSb. Explain that
the physical symptoms are related to the psychological state.
Persons with posttraumatic stress disorder often experience somatic symptoms or sympathetic
nervous system arousal that can be confusing and distressing. Explaining that these are the
bodys responses to psychological trauma helps the patient understand how such symptoms are
part of the illness and something that will respond to treatment. This decreases powerlessness
over the symptoms and helps instill a sense of hope. It also helps the patient to understand how
relaxation, breathing exercises, and imagery can be helpful in symptom reduction. The goal of
treatment for posttraumatic stress disorder is to come to terms with the event so treatment
efforts would not include repression of memories or numbing. Triggering flashbacks would
increase patient distress.
2. Four teenagers died in an automobile accident. One week later, which behavior by the
parents of these teenagers most clearly demonstrates resilience? The parents who:
a. visit their teenagers grave daily.
b. return immediately to employment.
c. discuss the accident within the family only.
d. create a scholarship fund at their child's high school. - ANSd. create a scholarship fund at
their child's high school.
, Resilience refers to positive adaptation or the ability to maintain or regain mental health despite
adversity. Loss of a child is among the highest-risk situations for maladaptive grieving. The
parents who create a scholarship fund are openly expressing their feelings and memorializing
their child. The other parents in this question are isolating themselves and/or denying their
feelings. Visiting the grave daily shows active continued mourning but is not as strongly
indicative of resilience as the correct response.
3. After the sudden death of his wife, a man says, I cant live without her she was my whole life.
Select the nurses most therapeutic reply.
a. Each day will get a little better.
b. Her death is a terrible loss for you.
c. Its important to recognize that she is no longer suffering.
d. Your friends will help you cope with this change in your life. - ANSb. Her death is a terrible
loss for you.
Adjustment disorders may be associated with grief. A statement that validates a bereaved
persons loss is more helpful than false reassurances and clichs. It signifies understanding.
4. A woman just received notification that her husband died. She approaches the nurse who
cared for him during his last hours and says angrily, If you had given him your undivided
attention, he would still be alive. How should the nurse analyze this behavior?
a. The comment suggests potential allegations of malpractice.
b. In some cultures, grief is expressed solely through anger.
c. Anger is an expected emotion in an adjustment disorder.
d. The patient had ambivalent feelings about her husband. - ANSc. Anger is an expected
emotion in an adjustment disorder.
6. A child drowned while swimming in a local lake 2 years ago. Which behavior indicates the
childs parents have adapted to their loss? The parents:
a. visit their childs grave daily.
b. maintain their childs room as the child left it 2 years ago.
c. keep a place set for the dead child at the family dinner table.
