CBRN Patient Education & Psychosocial Support 5 — Questions and Answers
Question 1: A burn patient with a history of substance abuse is being discharged on opioid analgesics. Which psychosocial action is MOST important?
- Withhold opioids entirely due to addiction risk
- Coordinate with addiction medicine and establish a structured prescription monitoring plan (Correct answer)
- Discharge with a large supply to minimize return clinic visits
- Rely on the patient's self-report of pain to titrate all doses
Correct answer: Coordinate with addiction medicine and establish a structured prescription monitoring plan
Collaboration with addiction medicine and structured monitoring (e.g., prescription drug monitoring, frequent follow-up) balances pain management with relapse prevention.
Question 2: Which approach BEST supports culturally sensitive patient education for a burn patient from a non-English-speaking background?
- Ask a bilingual family member to translate all medical instructions
- Use a trained medical interpreter and provide materials in the patient's language (Correct answer)
- Speak slowly and use gestures to convey meaning
- Defer cultural considerations to the social worker
Correct answer: Use a trained medical interpreter and provide materials in the patient's language
Trained medical interpreters ensure accurate and confidential communication; family members may omit, alter, or be distressed by sensitive information.
Question 3: Acute stress disorder (ASD) differs from PTSD primarily in:
- The type of trauma required to trigger symptoms
- The duration of symptoms — ASD occurs within 4 weeks of trauma, PTSD persists beyond 1 month (Correct answer)
- ASD requiring pharmacotherapy while PTSD responds to psychotherapy
- The absence of re-experiencing symptoms in ASD
Correct answer: The duration of symptoms — ASD occurs within 4 weeks of trauma, PTSD persists beyond 1 month
ASD is diagnosed when trauma symptoms occur within 3 days to 4 weeks post-event; PTSD is diagnosed when symptoms persist beyond 1 month.
Question 4: A burn nurse notices a patient is not adhering to their home exercise program. Which motivational interviewing technique is MOST appropriate?
- Warn the patient about the consequences of non-adherence
- Ask open-ended questions to explore the patient's own reasons for and barriers to exercise (Correct answer)
- Remind the patient that the therapist's instructions must be followed
- Assign written homework about the benefits of exercise
Correct answer: Ask open-ended questions to explore the patient's own reasons for and barriers to exercise
Motivational interviewing uses open-ended questions to elicit the patient's intrinsic motivation, which is more effective than external pressure or information alone.
Question 5: When educating a burn patient about grief related to body image loss, the nurse should recognize that:
- Grief over appearance changes is a sign of poor coping and requires psychiatric referral
- Grief is a normal response to body image loss and follows a non-linear process (Correct answer)
- Patients who grieve openly have worse long-term outcomes
- Grief resolves completely once wounds are healed
Correct answer: Grief is a normal response to body image loss and follows a non-linear process
Grief over altered body image is a normal and expected response; recovery is non-linear, and nurses should normalize fluctuating emotions.
Question 6: Which factor should prompt a burn nurse to refer a patient to a financial counselor or social worker?
- Patient requests a private room during hospitalization
- Patient expresses concern about inability to pay for compression garments or follow-up care (Correct answer)
- Patient asks about the cost of cosmetic scar revision
- Patient's family requests information about the hospital cafeteria
Correct answer: Patient expresses concern about inability to pay for compression garments or follow-up care
Financial barriers to purchasing compression garments or attending follow-up care directly threaten scar management adherence and require social work intervention.
Question 7: A patient who sustained burns in a house fire is reluctant to return home after discharge. The nurse's BEST initial response is:
- Arrange an extended inpatient stay until the patient feels ready
- Explore the patient's specific fears about returning home and involve the interdisciplinary team (Correct answer)
- Remind the patient that the home is safe now and discharge is medically appropriate
- Refer to psychiatry for treatment-resistant anxiety
Correct answer: Explore the patient's specific fears about returning home and involve the interdisciplinary team
Exploring specific fears identifies whether safety concerns, PTSD triggers, or practical barriers are driving reluctance, allowing for targeted interdisciplinary intervention.
CBRN Patient Education & Psychosocial Support 5
A burn patient with a history of substance abuse is being discharged on opioid analgesics.
Which psychosocial action is MOST important?