Exam 38: Military Families

John is being treated for PTSD symptoms,which began shortly after his retirement from the military.He has had nightmares,flashbacks of traumatic events from combat,and episodes of acute anxiety.His wife is asking the nurse how he could be developing PTSD at this time when he hasn't been in a combat situation for over 10 years.Which of these teaching points are evidence-based pieces of information to share with John's wife? Select all that apply.

Susan returned from active duty and is being treated for PTSD.She tells the nurse that she was never in a combat zone during her deployment,and her commanding officer told her that you can't have PTSD unless you were in active combat.Which of these responses by the nurse is an accurate reflection about PTSD in military personnel?

Brian is seeking treatment for PTSD following his tour of duty in a combat zone.He reports to the assessment nurse that he has been smoking pot and drinking alcohol daily for the past 4 days because he just can't stand feeling depressed all the time.Which of these assessments is the highest priority considering Brian's symptoms?

Paula's husband returned from active duty 1 month ago,and Paula is now seeing a counselor for relational conflict in her marriage.She tells the counselor she thinks her husband "can't love anything as much as he loves the military" and that "he acts like he can't wait to be redeployed." Which of these common aspects about military culture might be contributing to her husband's behavior?

Mary is seeing her family physician for a routine checkup and mentions to the nurse that her husband just returned from active duty in the military.He was deployed to Iraq for the last 18 months,and Mary says she is very excited that they will finally be able to "pick up" where they left off.The nurse decides to ask more questions about their marital relationship in this post-deployment period.What is the best rationale for including these assessment questions?

Les has been referred to the VA clinic because he was recently fired from his job.His former employer reported that he was drinking on the job and had become physically aggressive with one of his coworkers.Which of the following statements during the intake assessment are consistent with common symptoms of PTSD? Select all that apply.

Bill is an only child whose parents are both career military personnel.He is being seen by the school nurse for complaints of fever and wants to be sent home.On examination he is afebrile.He tells the nurse he doesn't like this school anyway and the nurse notes that this is his third school transition in four years.Which of these understandings about the experience of military family members is important to providing compassionate care for this child?

Joshua,a 15-year-old whose father has been suffering from PTSD since returning from combat,is now seeing a counselor himself with reports of "flashbacks" that are similar to his father's symptoms.Which of the following interpretations of Joshua's behavior is supported by evidence?

The nurse is conducting an assessment for Don,a 5-year veteran with a traumatic brain injury (TBI).He was referred to the clinic for evaluation of movement disorders.He reports taking alprazolam (Xanax)for the last 3 months and wonders if that is contributing to his tremors and shuffling gait.Which of these understandings is most important in guiding the nurse's further assessment and response to Don?

Carl is being treated for PTSD after return from military combat.He also sustained a mild traumatic brain injury secondary to an explosive device while in combat.The nurse decides to conduct additional screening assessments on the basis of common comorbidities that occur with these conditions.Which of these screening assessments would be relevant?

Jane has begun treatment for PTSD with symptoms of depression.The nurse is reviewing the physician's orders.Which of these are evidence-based modalities for initial treatment of Jane's illnesses? Select all that apply.

Sam,a 50-year-old veteran with a traumatic brain injury (TBI),was recently diagnosed with Alzheimer's disease.His sister asks the nurse,"How can this be an accurate diagnosis? There is no incidence of this in our family." Which of these teaching points is accurate for the nurse to share with Sam's sister?