TCRN Psychosocial Aspects of Trauma Care 1 — Questions and Answers
Question 1: A patient arrives to the ED after a motor vehicle crash. Despite minor physical injuries, she is mute, staring blankly, and unresponsive to questions. This presentation is most consistent with:
- Malingering
- Acute stress reaction (Correct answer)
- Alcohol intoxication
- Conversion disorder
Correct answer: Acute stress reaction
Acute stress reaction is a normal immediate response to overwhelming trauma, often manifesting as dissociation, numbness, or mutism.
Question 2: Which intervention best supports a trauma patient experiencing acute psychological distress in the emergency department?
- Leave the patient alone in a quiet room to self-regulate
- Provide calm, brief explanations of procedures, maintain a therapeutic presence, and involve support persons when possible (Correct answer)
- Administer sedatives immediately to prevent further agitation
- Discourage the patient from talking about the traumatic event to avoid re-traumatization
Correct answer: Provide calm, brief explanations of procedures, maintain a therapeutic presence, and involve support persons when possible
Consistent presence, clear communication, and family support reduce anxiety and foster trust during acute trauma care.
Question 3: When informing a family of a patient's critical condition, which communication strategy is most appropriate?
- Provide information in a busy hallway to be efficient
- Use clear, jargon-free language in a private space, and allow time for questions and emotional responses (Correct answer)
- Deliver only positive information to prevent distress
- Delegate all family communication to the social worker exclusively
Correct answer: Use clear, jargon-free language in a private space, and allow time for questions and emotional responses
Private, honest, compassionate communication with time for questions is the standard for delivering difficult news to trauma families.
Question 4: Post-traumatic stress disorder (PTSD) differs from acute stress disorder (ASD) primarily in which way?
- PTSD involves physical symptoms while ASD involves only emotional symptoms
- ASD symptoms resolve within 4 weeks of trauma, while PTSD symptoms persist beyond 4 weeks (Correct answer)
- PTSD is diagnosed only in combat veterans
- ASD requires hospitalization while PTSD does not
Correct answer: ASD symptoms resolve within 4 weeks of trauma, while PTSD symptoms persist beyond 4 weeks
ASD occurs within the first month after trauma; PTSD is diagnosed when similar symptoms persist beyond one month.
Question 5: A trauma nurse who begins experiencing nightmares, emotional numbing, and avoidance of trauma cases is likely experiencing:
- Burnout only
- Compassion fatigue or secondary traumatic stress (Correct answer)
- Normal adjustment to a high-acuity environment
- Depression unrelated to work
Correct answer: Compassion fatigue or secondary traumatic stress
Compassion fatigue/secondary traumatic stress occurs when caregivers absorb the trauma of their patients, producing PTSD-like symptoms.
Question 6: Which statement best reflects the trauma-informed care principle of 'safety'?
- Restraining patients immediately when they display agitation
- Creating an environment where patients feel physically and emotionally safe and in control of their care (Correct answer)
- Ensuring the hospital is physically secure from external threats
- Administering anxiolytics prophylactically to all trauma patients
Correct answer: Creating an environment where patients feel physically and emotionally safe and in control of their care
Trauma-informed safety means minimizing re-traumatization by giving patients information, choices, and a sense of control in their environment.
TCRN Psychosocial Aspects of Trauma Care 1
A patient arrives to the ED after a motor vehicle crash.
Despite minor physical injuries, she is mute, staring blankly, and unresponsive to questions.
This presentation is most consistent with: