Brandy is an 18-year-old being treated in the Community Mental ...

[sam.t96]

Brandy is an 18-year-old being treated in the Community Mental Health Clinic for an adjustment disorder after receiving news of her parents' impending divorce. While talking about her feelings she becomes angry and starts shouting and crying.
 
  She screams, I wish they would both die Which of these is the most appropriate response by the nurse at this point? A. Contact the parents and the police to report that Brandy is expressing homicidal ideation.
  B. Encourage Brandy to talk more about her anger.
  C. Instruct Brandy that it's okay to cry but that it is not acceptable to talk that way about her parents.
  D. Assess Brandy for suicidal ideation.

Question 2

Major Smith, who is being treated for PTSD symptoms following a course of military duty, reports, I think I was in denial about even having PTSD. I thought I was just having trouble sleeping.
 
  Which of these is an accurate evaluation of the patient's comments? A. The patient is still in denial and unable to recognize that he is having flashbacks rather than insomnia.
  B. The patient is beginning to recognize stages of grieving and reevaluating his symptoms.
  C. The patient is beginning to recognize that he may be at risk for suicide.
  D. The patient is trying to avoid discussing symptoms of PTSD.

[ghepp]

Answer to Question 1

B
It is important in treating patients with adjustment disorders to allow them to express anger. Item C discourages the patient from expressing anger. Items A and D would be premature, since there is inadequate evidence to warrant those responses.

Answer to Question 2

B
The patient is expressing recognition that he was in denial, which is a stage of grieving. It is not uncommon for people to recognize that they are having troubling symptoms but not immediately recognize this as PTSD.