Question 1

A member of the military shares that he has been a victim of sexual trauma during his enlistment.Which question will the nurse ask to best assess the individual's degree of self-blame?

Accepted Answer

Military sexual trauma (MST) survivors may experience self-blame and doubt,and even have feelings of guilt that they somehow brought on the assault.This situation can result in an emotional invalidation of their traumatic experience when they report these incidents to superiors,only to be discouraged from following up on their claim or told that the abuse never happened.Having their report taken seriously and resulting in appropriate actions has a positive bearing on the victim's sense of validation.The remaining options lack the opportunity to open up discussion on that topic.

Question 2

Several nurses are newly assigned to a hospital unit that focuses on the care of military personnel who have sustained severe brain injuries and their families.The nurse manager would initially suggest that they:

Accepted Answer

It is critical that providers working with survivors of trauma be aware of their personal feelings and vulnerabilities to provide quality clinical care.The remaining options are needs that can be addressed in the near future.

Question 3

A military veteran is diagnosed with heart disease.With this medical history and a military background that included two tours of duty in a combat zone abroad,the nurse assesses for related psychiatric disorders by asking: (Select all that apply.)

Accepted Answer

Returning veterans may experience cognitive difficulties such as concentration problems and memory loss.Other complications can include sleep deprivation,migraine headaches,or insomnia.Poor concentration can also result in an increase in trauma from accidents.Constipation and diarrhea are not commonly associated with this population.

Question 4

Which assessment question is particularly important to ask of a veteran of the Iraq conflict?

Accepted Answer

It has been estimated that as many as 20% of all suicides in this country are documented among veterans.In the first half of 2009,more American soldiers committed suicide than died in combat with continued high rates for veterans of Iraq and Afghanistan deployments.

Question 5

A combat experienced military veteran with a diagnosis of depression is concerned about adjusting to civilian life and reconnecting with family and friends.In assisting the individual's long-term readjustment,the mental health nurse would suggest a referral to:

Accepted Answer

Upon returning home the combat veteran finds that he no longer has the psychological and emotional support of his comrades in arms.He finds little solace from family and friends who cannot share his experiences and often has difficulty assimilating to his previous life.A support group comprised of fellow military personnel would be the most positive form of assistance to provide long-term positive readjustment to civilian life.

Question 6

The nurse is about to assess the possible incidence of sexual abuse.Based on an understanding of how males and females experience and internalize sexual trauma differently,the nurse would ask the male soldier:

Accepted Answer

Males and females may experience sexual trauma in different ways.Males typically do not view themselves as being potential victims of sexual abuse and are not likely to admit to being a victim of sexual abuse.They may therefore experience it as a narcissistic insult,causing confusion and even questioning their masculinity or sexual preference.Asking the question in this context is a more effective questioning technique.

Question 7

Which intervention will best establish a military personnel's mental health fitness for deployment to a war zone?

Accepted Answer

The use of a predeployment mental health screening can reduce mental health problems,medical evacuations from war zones for mental health problems,and suicidal ideation.

Question 8

Female military personnel who have recently returned from deployment in a war zone are being assessed for potential physical and sexual assault as well as for an increased risk for developing posttraumatic stress disorder (PTSD).During the assessment,the nurse would ask: (Select all that apply.)

Accepted Answer

The role of female soldiers has expanded into the realm of hostile environments.In the current military arena,nearly everyone is vulnerable to attack at any given time and female soldiers may even be singled out and targeted by enemy combatants.
Women are more likely to suffer childhood abuse or other types of trauma compared to men.Survivors of multiple traumas may experience cumulative effects from re-victimization.These individuals may be less resilient and more vulnerable to develop psychiatric disorders including depression,PTSD,and other anxiety disorders.Questions related to their perception of military support or their safety in general is not related to assessing for the conditions mentioned.

Question 9

A military veteran is being evaluated for traumatic brain injury (TBI).Which nursing assessment data supports such a diagnosis? (Select all that apply.)

Accepted Answer

Physiological problems related to TBI can include headache,seizures,as well as appetite and weight changes.The remaining options,hypertension and respiratory infections,are not generally occasioned with TBI.

Question 10

Which information noted on a psychosocial assessment is of greatest concern when identifying risk factors for the possible development of posttraumatic stress disorder (PTSD) for a soldier about to be deployed to a war zone?

Accepted Answer

There is evidence that the potential to develop PTSD may be influenced by earlier life experience such as the exposure to a traumatic experience as a child.While the other options suggest stressors,they are not as personally impactful or as traumatic as the correct option.

Question 11

Which interventions address the most commonly identified sources of risk to the mental health of military personnel and their dependents? (Select all that apply.)

Accepted Answer

These five areas challenge the ability to provide mental health care to military personnel and their families: psychological health,access to services and support,communication challenges,deployment,and frequent relocation.While a stressor,financial aid is not a recognized mental health-related service the military provides.

Question 12

When educating an individual diagnosed with posttraumatic stress disorder (PTSD) regarding prescribed medication therapy,the nurse should include that:

Accepted Answer

Pharmacological interventions have been found to be useful in the treatment of the positive symptoms of PTSD including hyperarousal and reexperiencing phenomenon,and to a lesser extent the negative symptoms of PTSD,including avoidance symptoms.Selective serotonin reuptake inhibitors (SSRIs) are generally considered the first line of pharmacological treatment for individuals diagnosed with PTSD.These medications help with symptoms including depression,irritability,anxiety,and intrusive thoughts.The SNRI venlafaxine also has been found to be helpful in the management of this disorder.Benzodiazepines may be helpful in managing anxiety,insomnia,and hyperarousal,but they should be used cautiously due to the high degree of comorbid substance abuse in veterans.Mood stabilizers have not been demonstrated to be effective in the management of PTSD symptoms.

Question 13

Which statement made by a female military personnel currently deployed in a war zone provides the best evidence that the soldier is not feeling any unhealthy guilt over being separated from family?

Accepted Answer

Women traditionally serve in the role of family matriarch.Following deployment,they may have a particularly difficult time adjusting to a new role including being separated from home,family,and children.This may cause feelings of guilt and inadequacy that can lead to depression and anxiety.The correct option demonstrates a healthy balance of concern and acceptance for and by the individual and her family.The remaining options lack that sense of balance.

Question 14

A military veteran being treated for substance abuse shares that the family is experiencing financial problems since being discharged.In order to assess the individual's coping skills,the nurse asks:

Accepted Answer

The nurse must be mindful that substance abuse is a disease and individuals may return to previous ways when coping with stressful and unplanned events.Assessing previous coping skills will provide insight into the way current stresses will be managed.The remaining options provide opportunities to assess the financial problem itself.

Question 15

Six months after returning from a combat zone,a discharged Marine reports having both memory and concentration problems that resulted in earning failing grades in two college courses.An understanding of the pathophysiology of traumatic brain injury would prompt the nurse to initially ask:

Accepted Answer

Many cases of traumatic brain injury (TBI) may be overlooked as the symptoms are diffuse and may not initially suggest any specific brain injury as the primary cause.Often symptoms do not surface until well after the initial injury,which can further complicate accurate diagnosis of TBI.Also,mild TBI may not be the primary or most urgent injury that occurs in the field,and it may be missed during triage.The question of whether the individual has ever experienced a blow to the head that resulted in unconsciousness lasting 20 minutes or more would be the most probative question to ask.

Question 16

A military veteran is diagnosed with tinnitus.The educational material provided by the nurse related to the condition should include: (Select all that apply.)

Accepted Answer

Hearing problems may develop as the result of traumatic injury or repeated exposure to noise hazards including gunfire,explosions,and loud equipment.Examples of hearing problems include partial or total hearing loss and tinnitus or ringing of the ears.Each of these may be temporary or permanent.The remaining options are not generally applied to tinnitus.

Question 17

Which statement by a military veteran being treated for posttraumatic stress disorder (PTSD) is the strongest evidence that the condition is being managed?

Accepted Answer

A hyperactive startle reflex is a common characteristic of PTSD.Being able enjoy a noisy,explosive display of fireworks would be the best indicator of the disorder presented by the options.The other options demonstrate hope and confidence in treatment but not actual behavioral changes.

Quiz 39: The Military and Their Families