Two weeks ago, a soldier returned to the United States from active duty in a combat zone. The soldier was diagnosed with post-traumatic stress disorder (PTSD). Which comment by the soldier requires the nurse's immediate attention?
"I want to continue my education, but I'm not sure how I will fit in with other college students."
"It's good to be home. I missed my home, family, and friends."
"Sometimes I think I hear bombs exploding, but it's just the noise of traffic in my hometown."
"I saw my best friend get killed by a roadside bomb. I don't understand why it wasn't me."
The Correct Answer is D
A. Concerns about returning to school reflect normal adjustment issues and do not indicate immediate danger.
B. Expressing happiness about being home is a positive statement and does not require urgent intervention.
C. Hypervigilance and startle responses are common symptoms of PTSD and should be monitored but are not immediately life-threatening.
D. Expressions of survivor’s guilt or thoughts questioning why one survived while others did not can indicate severe emotional distress and possible risk for self-harm or suicidal ideation. This statement requires immediate assessment and intervention by the nurse.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Using silence allows the patient time to process thoughts and feelings, encourages introspection, and can facilitate deeper communication during interviews.
B. While prolonged silence can sometimes make patients uncomfortable, its intentional and therapeutic use is beneficial when appropriately timed.
C. Reflecting or paraphrasing communicates understanding; silence alone does not confirm comprehension.
D. In therapeutic communication, the nurse does not have to immediately fill silence; allowing moments of quiet can be purposeful.
Correct Answer is B
Explanation
A. Judging the patient can shut down communication and make the patient feel defensive rather than heard.
B. This technique, also called reflective listening, shows the patient that the nurse is actively listening and trying to understand their perspective, encouraging further expression.
C. Direct questions can be useful, but they may limit patient expression and can feel leading rather than supportive.
D. While intended to show empathy, this phrase can be perceived as dismissive if the nurse has not fully explored the patient’s feelings.
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