NUR 114 Exam 1 Practice Questions and
Correct Answers
Post traumatic stress disorder ✅A disorder that develops in some people who have
experienced a frightening, unexpected, or dangerous event.
Continues to feel stressed or frightened even when no longer in danger.
Evidenced by patterns of behavior:
Re-experiences trauma via dreams, recurrent or intrusive thoughts.
Shows emotional numbing such as feeling detached from others.
Irritable, remains on guard, and experiences hyperarousal
A disorder that develops due to an event. Not based on personal characteristics but
rather something that had happened or was witnessed by the patient. They have lost
their coping mechanism and usually shows up within 3 months of the event
Trauma takes many forms and it depends a lot on the person themselves
Life Events that can lead to PTSD ✅PTSD is a disorder associated w/ event exposure,
rather than a personal characteristic such as being anxious or shy.
There usually is a causative trauma or event that occurs prior to development of
symptoms.
Trauma can take many forms.
What other life events could we add to this list?
Natural disasters
Combat & military experiences
Terrorist attacks
Vehicle accident
Physical or sexual assault
Unexpected death of another
Serious bodily injury
Harassment or stalking
Child Abuse
Traumatic events disrupt life if experienced.
Some people have difficulty:
Coping, managing stress and emotions related to the event.
Resuming their daily life
Symptoms of PTSD ✅Usually begins within 3 months of event
Types of Symptoms
Re-experiencing
Includes flashbacks, nightmares, Ect.
,Avoidance
They try to avoid thoughts and feelings or triggers
Arousal & Reactivity
Reckless or self destructive behavior, being easily startled, difficulty sleeping, angry
outbursts
Cognition & Mood
Trouble remembering key features of the traumatic event, distorted guilt like blame
Symptoms can start early or they can start many years later (usually due to a trigger)
Can be chronic, has to last at least a month (otherwise it is called acute stress disorder)
PTSD is 3 months and longer
Videbeck p. 218 DSM-5 PTSD Diagnostic criteria ✅DSM-5 DIAGNOSTIC CRITERIA:
Posttraumatic Stress Disorder 309.81 (F43.10)
Note: The following criteria apply to adults, adolescents, and children older than 6
years. For children 6 years and younger, see corresponding criteria below.
Exposure to actual or threatened death, serious injury, or sexual violence in one (or
more) of the following ways:
Directly experiencing the traumatic event(s).
Witnessing, in person, the event(s) as it (they) occurred to others.
Learning that the traumatic event(s) occurred to a close family member or a close
friend. In cases of actual or threatened death of a family member or friend, the event(s)
must have been violent or accidental.
Experiencing repeated or extreme exposure to aversive details of the traumatic event(s)
(e.g., first responders collecting human remains; police officers repeatedly exposed to
details of child abuse).
Note: Criterion A4 does not apply to exposure through electronic media, television,
movies, or pictures, unless this exposure is work related.
Presence of one (or more) of the following intrusion symptoms associated with the
traumatic event(s), beginning after the traumatic event(s) occurred:
Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s).
Note: In children older than 6 years, repetitive play may occur in which themes or
aspects of the traumatic event(s) are expressed.
Recurrent distressing dreams in which the content and/or affect of the dream are related
to the traumatic event(s).
Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as though
the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with
the most extreme expression being a complete loss of awareness of present
surroundings.)
Note: In children, trauma-specific reenactment may occur in play.
Intense or prolon
Diagnosis of PTSD ✅Exposure to traumatic event directly: witnessed; or experiencing
repeated or extreme exposure to event; or learning about an event that occurred to
close or loved one.
Presence of symptoms.
,Duration greater than 1 month.
Disturbance causes clinically significant distress/impairment in social, occupational, or
other areas of functioning.
Disturbance is not attributable to medical condition or effects of substances.
Other Facts about PTSD ✅Can occur at any age and to anyone
Onset can be delayed for months or years
Is chronic in nature and may become worse during stressful times.
Other life events can exacerbate symptoms.
May develop other psychiatric disorders such as depression or anxiety.
PTSD in adolescents ✅More likely to develop PTSD
Age, gender, type of trauma, and repeated trauma are related to PTSD rates.
Increased risk for suicide, substance abuse, poor social support, poor physical health,
academic problems.
More likely to engage in traumatic reenactment in daily life.
Ex. Fighting in school
As children age every year there is more opportunity for exposure (to trauma or
anything traumatic) and lifetime issues due to gaining responsibilities, testing limits of
independence, hormonal changes, less inhibitions, more interaction with more people
PTSD and children ✅More likely to develop if:
Parents have major depression
Experienced child abuse
Sometimes reenact trauma in play
Ex. Reenactment in play with toys
If parents have major depression and abuse their child there is a 6 fold increase in the
risk of PTSD in the child. May also cause other disorders in children like ADD
Symptoms of PTSD in children/adolescents ✅Worry about dying at an early age
Losing interest in activities
Head and stomach aches
Persistent negative emotional state; inability to experience positive emotions
Having problems falling or staying asleep
Irritability or angry outbursts
Having problems concentrating
Showing increased alertness to the environment
Repeating behavior associated with trauma
Treatments of PTSD ✅Cognitive behavioral therapy
Eye movement desensitization and reprocessing
Play therapy
Psychological first aid
Cognitive behavioral therapy ✅Prolonged Exposure Therapy
, Goes back over the thoughts, feelings and situations of the trauma and records it and
then plays it back for the patient so they can hear it
May also physically take them to the place of the trauma to help them work through their
trauma
Cognitive Processing Therapy
Helps the person change their thoughts about the trauma itself and about how they
think of the trauma
Helps the person challenge the thoughts and have the trauma be less upsetting
Cognitive behavioral therapy is a type of therapy that includes exposure and anxiety
management to change the relationship of the trauma to help them deal with it better
and to create some coping mechanisms
Prolonged exposure therapy ✅Goes back over the thoughts, feelings and situations of
the trauma and records it and then plays it back for the patient so they can hear it
May also physically take them to the place of the trauma to help them work through their
trauma
Cognitive processing therapy ✅Helps the person change their thoughts about the
trauma itself and about how they think of the trauma
Helps the person challenge the thoughts and have the trauma be less upsetting
Eye movement desensitization and reprocessing ✅This is where the brain processes
thoughts and when something traumatic happens the brain goes to a snapshot and then
the patient relives it and so this therapy uses electrodes or sensors that vibrate and
sends and electrical signal to the brain and so as they talk about the event the brain is
able to reprocess the event in a way that is less traumatic
Play therapy ✅Used often with kids and they are able to play or draw out the trauma
because they do not have the words to use and it puts it in a way that an adult is able to
understand it and help them process it more effectively
Psychological first aid ✅Used when there is a large trauma at schools such as a death,
and they teach people how to help the group process appropriately and they teach
calming and coping mechanisms
Medications to treat PTSD ✅Not used forever, usually used to help them get through
the worst of it
Usually takes about 6 months for them to get through the worst of it with medication but
it depends on the patient and the situation
Antidepressants
SSRI: Most effective
Sertraline (Zoloft)
Paroxetine (Paxil)
