A nurse is caring for a client who has been diagnosed with acute stress disorder. Which of the following client statements aligns with this diagnosis?
“I was in a car crash two weeks ago and I have nightmares when I sleep.”.
“I was physically abused as a child and have frequent flashbacks since then.”.
“I was in a terrible car crash two years ago and I have been unable to drive since then.”.
“My parents fought a lot when I was a child.
The Correct Answer is A
Choice A rationale
Acute Stress Disorder (ASD) is a mental health condition that can occur in the immediate aftermath of a traumatic event, with symptoms starting within four weeks of the event and lasting for a minimum of three days and up to one month. This client’s statement about experiencing nightmares following a car crash two weeks ago aligns with the diagnosis of ASD.
Nightmares are a common symptom of ASD, often replaying the traumatic event, leading to disrupted sleep and increased distress.
Choice B rationale
This statement is more indicative of Post-Traumatic Stress Disorder (PTSD), a related but distinct condition from ASD. PTSD is characterized by persistent and intrusive memories of the traumatic event, which can include flashbacks, and symptoms must last for more than a month and cause significant distress or functional impairment. The chronic nature of the symptoms described by the client, including frequent flashbacks since childhood, is more consistent with PTSD than ASD.
Choice C rationale
This statement could suggest a condition known as Specific Phobia, Situational Type. This is a type of anxiety disorder characterized by an intense, persistent fear of certain situations. The individual will avoid the situation or endure it with intense fear or anxiety. In this case, the client’s inability to drive following a car crash two years ago could indicate a specific phobia related to driving.
Choice D rationale
The experience described by the client in this statement is indicative of a dissociative symptom, which can be a feature of several different mental health disorders, including but not limited to Dissociative Disorders and PTSD1. The feeling of leaving one’s body is referred to as depersonalization, a type of dissociation that can occur as a response to trauma. However, without more information, it is difficult to align this statement with a specific diag
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Correct Answer is D
Explanation
Choice A rationale
While it’s important to discuss the restraint and seclusion policy when a client becomes agitated, it’s not the ideal time. The client may not be in a state to fully understand the information due to their heightened emotional state.
Choice B rationale
Discussing the policy while administering chemical or physical restraints is not appropriate. The client may be distressed or resistant, making it difficult for them to comprehend the information.
Choice C rationale
Although debriefing after restraint removal is a crucial part of the process, it’s not the best time to first introduce the restraint and seclusion policy. The client may be physically and emotionally exhausted after the experience.
Choice D rationale
The restraint and seclusion policy should be discussed with the client upon admission. This ensures that the client is aware of the policy ahead of time, which can help reduce anxiety and fear if restraints or seclusion become necessary.
Correct Answer is A
Explanation
Choice A rationale
The symptoms described by the patient are indicative of Generalized Anxiety Disorder (GAD). GAD is characterized by excessive anxiety and worry about a number of events or activities.
The worry is out of proportion to the actual circumstance and is difficult to control.
Choice B rationale
Panic disorder is characterized by recurrent unexpected panic attacks, which are abrupt surges of intense fear or discomfort that reach a peak within minutes.
Choice C rationale
Agoraphobia involves fear and avoidance of situations where escape might be difficult or help might not be available in the event of developing panic-like symptoms.
Choice D rationale
Separation anxiety disorder is characterized by excessive fear or anxiety about separation from those to whom the individual is attached.
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