Intrusion symptoms include flashbacks, nightmares, and distressing memories of the trauma.
Before you read
Test yourself first: 5 questions
Question 1 of 5
A client with post-traumatic stress disorder (PTSD) suddenly becomes startled, tense, and reports feeling as though a past traumatic event is happening again. The nurse recognizes this as which manifestation?
Answer: B. Reliving a traumatic event as though it is recurring in the present is a flashback, a hallmark intrusive symptom of PTSD. Confabulation, derealization, and delusion are distinct phenomena and do not describe re-experiencing trauma.
Question 2 of 5
A combat veteran has nightmares and flashbacks and avoids reminders of trauma. These are features of:
Answer: B. Re-experiencing (flashbacks/nightmares), avoidance, hyperarousal, and negative mood are hallmarks of post-traumatic stress disorder (PTSD).
Question 3 of 5
A client recovering from substance use disorder asks about preventing relapse. The nurse teaches:
Answer: B. Identify and avoid triggers, build a support network (e.g., support groups), use coping skills and stress management, and have a plan for high-risk situations. Isolating and relying on willpower alone increase relapse risk.
Question 4 of 5
When communicating with a child who has autism spectrum disorder, the nurse should:
Answer: B. Use clear, concrete language, maintain routine and minimize sensory overload, allow extra processing time, and use visual supports. Sudden changes, abstract idioms, and overstimulation increase distress.
Question 5 of 5
A preschooler whose younger sibling was just born begins wetting the bed and using baby talk after being toilet trained for a year. How should the nurse interpret this behavior?
Answer: A. Returning to earlier behaviors such as bedwetting and baby talk after the birth of a sibling is regression, a common and usually temporary coping response to stress in preschoolers. It is not necessarily a sign of abuse, a urinary tract infection, or developmental delay, though persistent or unexplained changes warrant further assessment.
Keep the streak going with more questions like these, each with a full rationale.
What is post-traumatic stress disorder?
Symptoms persist more than one month and cause significant distress or impairment. SSRIs are first-line, with trauma-focused psychotherapy as the cornerstone of treatment.
Key points to remember
- Intrusion symptoms include flashbacks, nightmares, and distressing memories of the trauma.
- Avoidance of reminders, people, places, or thoughts related to the event is characteristic.
- Negative changes in mood and cognition include guilt, detachment, and emotional numbing.
- Hyperarousal includes hypervigilance, exaggerated startle, irritability, and sleep disturbance.
- Symptoms last longer than one month and impair daily functioning.
- Substance use and depression commonly co-occur, raising suicide risk.
Signs & symptoms
- Flashbacks, nightmares, intrusion
- Avoidance of triggers/reminders
- Hypervigilance, exaggerated startle
Nursing priorities
- Assess for suicide risk and substance use given high comorbidity.
- Provide a safe, predictable environment and avoid sudden stimuli that may trigger startle.
- Use grounding techniques to help the client return to the present during flashbacks.
- Encourage gradual expression of feelings at the client's pace without forcing recall.
- Administer prescribed SSRIs and support engagement in trauma-focused therapy.
Patient teaching
- Healing takes time; trauma-focused therapy is highly effective, take SSRIs consistently.
- Use learned grounding and relaxation skills when triggered, and limit alcohol and caffeine.
- Build a support network and report worsening mood or suicidal thoughts.
Red flags: report now
- Active suicidal or homicidal ideation requires immediate safety intervention.
- Dissociative flashbacks where the client loses awareness of surroundings pose injury risk.
- Escalating substance use to self-medicate trauma must be addressed promptly.
References
Clinical references for this topic
