Chapter 16: Trauma, Stressor-Related, and
Dissociative Disorders
A nurse works with a patient diagnosed with posttraumatic stress disorder (PTSD) 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. - Answer- Explain that
the physical symptoms are related to the psychological state.
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 teenager's 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. - Answer- create a scholarship fund at their
child's high school.
After the sudden death of his wife, a man says, "I can't live without her ... she was my whole life."
Select the nurse's most therapeutic reply.
a. "Each day will get a little better."
b. "Her death is a terrible loss for you."
c. "It's important to recognize that she is no longer suffering."
d. "Your friends will help you cope with this change in your life." - Answer- "Her death is a terrible
loss for you."
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. - Answer- Anger is an expected
emotion in an adjustment disorder.
A wife received news that her husband died of heart failure and called her family to come to the
hospital. She angrily tells the nurse who cared for him, "He would still be alive if you had given him
your undivided attention." Select the nurse's best intervention.
a. Say to the wife, "I understand you are feeling upset. I will stay with you until your family comes."
b. Say to the wife, "Your husband's heart was so severely damaged that it could no longer pump."
c. Say to the wife, "I will call the health care provider to discuss this matter with you."
d. Hold the wife's hand in silence until the family arrives. - Answer- Say to the wife, "I understand
you are feeling upset. I will stay with you until your family comes."
, A child drowned while swimming in a local lake 2 years ago. Which behavior indicates the child's
parents have adapted to their loss? The parents
a. visit their child's grave daily.
b. maintain their child's room as the child left it 2 years ago.
c. keep a place set for the dead child at the family dinner table.
d. throw flowers on the lake at each anniversary date of the accident. - Answer- throw flowers on
the lake at each anniversary date of the accident
A store clerk was killed during a robbery 2 weeks ago. His widow, who has a long history of
schizoaffective disorder, cries spontaneously when talking about his death. Select the nurse's
most therapeutic response.
a. "Are you taking your medications the way they are prescribed?"
b. "This loss is harder to accept because of your mental illness. Do you think you should be
hospitalized?"
c. "I'm worried about how much you are crying. Your grief over your husband's death has gone on
too long."
d. "The unexpected death of your husband is very painful. I'm glad you are able to talk about your
feelings." - Answer- "The unexpected death of your husband is very painful. I'm glad you are able
to talk about your feelings."
Which scenario demonstrates a dissociative fugue?
a. After being caught in an extramarital affair, a man disappeared but then reappeared months
later with no memory of what occurred while he was missing.
b. A man is extremely anxious about his problems and sometimes experiences dazed periods of
several minutes passing without conscious awareness of them.
c. A woman finds unfamiliar clothes in her closet, is recognized when she goes to new restaurants,
and complains of "blackouts" despite not drinking.
d. A woman reports that when she feels tired or stressed, it seems like her body is not real and is
somehow growing smaller. - Answer- After being caught in an extramarital affair, a man
disappeared but then reappeared months later with no memory of what occurred while he was
missing.
The nurse who is counseling a patient with dissociative identity disorder should understand that
the assessment of highest priority is
a. risk for self-harm.
b. cognitive function.
c. memory impairment.
d. condition of self-esteem. - Answer- risk for self-harm
A patient states, "I feel detached and weird all the time. It is as though I am looking at life through
a cloudy window. Everything seems unreal. It really messes up things at work and school." This
scenario is most suggestive of which health problem?
a. Acute stress disorder
b. Dissociative amnesia
c. Depersonalization disorder
d. Disinhibited social engagement disorder - Answer- Depersonalization disorder
The unlicensed assistive personnel (UAP) says to the nurse, "That patient with amnesia looks fine,
but when I talk to her, she seems vague. What should I be doing for her?" Select the nurse's best
reply.
Dissociative Disorders
A nurse works with a patient diagnosed with posttraumatic stress disorder (PTSD) 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. - Answer- Explain that
the physical symptoms are related to the psychological state.
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 teenager's 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. - Answer- create a scholarship fund at their
child's high school.
After the sudden death of his wife, a man says, "I can't live without her ... she was my whole life."
Select the nurse's most therapeutic reply.
a. "Each day will get a little better."
b. "Her death is a terrible loss for you."
c. "It's important to recognize that she is no longer suffering."
d. "Your friends will help you cope with this change in your life." - Answer- "Her death is a terrible
loss for you."
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. - Answer- Anger is an expected
emotion in an adjustment disorder.
A wife received news that her husband died of heart failure and called her family to come to the
hospital. She angrily tells the nurse who cared for him, "He would still be alive if you had given him
your undivided attention." Select the nurse's best intervention.
a. Say to the wife, "I understand you are feeling upset. I will stay with you until your family comes."
b. Say to the wife, "Your husband's heart was so severely damaged that it could no longer pump."
c. Say to the wife, "I will call the health care provider to discuss this matter with you."
d. Hold the wife's hand in silence until the family arrives. - Answer- Say to the wife, "I understand
you are feeling upset. I will stay with you until your family comes."
, A child drowned while swimming in a local lake 2 years ago. Which behavior indicates the child's
parents have adapted to their loss? The parents
a. visit their child's grave daily.
b. maintain their child's room as the child left it 2 years ago.
c. keep a place set for the dead child at the family dinner table.
d. throw flowers on the lake at each anniversary date of the accident. - Answer- throw flowers on
the lake at each anniversary date of the accident
A store clerk was killed during a robbery 2 weeks ago. His widow, who has a long history of
schizoaffective disorder, cries spontaneously when talking about his death. Select the nurse's
most therapeutic response.
a. "Are you taking your medications the way they are prescribed?"
b. "This loss is harder to accept because of your mental illness. Do you think you should be
hospitalized?"
c. "I'm worried about how much you are crying. Your grief over your husband's death has gone on
too long."
d. "The unexpected death of your husband is very painful. I'm glad you are able to talk about your
feelings." - Answer- "The unexpected death of your husband is very painful. I'm glad you are able
to talk about your feelings."
Which scenario demonstrates a dissociative fugue?
a. After being caught in an extramarital affair, a man disappeared but then reappeared months
later with no memory of what occurred while he was missing.
b. A man is extremely anxious about his problems and sometimes experiences dazed periods of
several minutes passing without conscious awareness of them.
c. A woman finds unfamiliar clothes in her closet, is recognized when she goes to new restaurants,
and complains of "blackouts" despite not drinking.
d. A woman reports that when she feels tired or stressed, it seems like her body is not real and is
somehow growing smaller. - Answer- After being caught in an extramarital affair, a man
disappeared but then reappeared months later with no memory of what occurred while he was
missing.
The nurse who is counseling a patient with dissociative identity disorder should understand that
the assessment of highest priority is
a. risk for self-harm.
b. cognitive function.
c. memory impairment.
d. condition of self-esteem. - Answer- risk for self-harm
A patient states, "I feel detached and weird all the time. It is as though I am looking at life through
a cloudy window. Everything seems unreal. It really messes up things at work and school." This
scenario is most suggestive of which health problem?
a. Acute stress disorder
b. Dissociative amnesia
c. Depersonalization disorder
d. Disinhibited social engagement disorder - Answer- Depersonalization disorder
The unlicensed assistive personnel (UAP) says to the nurse, "That patient with amnesia looks fine,
but when I talk to her, she seems vague. What should I be doing for her?" Select the nurse's best
reply.
