Submitted By: JESSICA TYRRELL
Date Submitted: February 3, 2022 at 11:51 am
Email: jtyrrell@mainebehavioralhealthcare.org, Degree: LSW
SCORE: 60%
1. According to Dr. Lazare, what are the four emotions of self-assessment?
Your Answer: b. Shame, humiliation, embarrassment, guilt
CORRECT ANSWER:
a. Embarrassment, shame, fear, pity
b. Shame, humiliation, embarrassment, guilt – Dr. Lazare describes these as “signal” emotions, since experiencing them usually indicates you are in distress in some way. In his essay on shame and humiliation, Dr. Lazare suggests that in order to work towards preventing these emotional responses in the medical encounter, providers “should assume that any disease (and treatment) can be a shame-inducing event which then interacts with a patient’s individual vulnerabilities.”
c. Shame, fear, guilt, envy
d. Humiliation, despair, embarrassment, rage
2. What percentage of kids will develop persistent traumatic stress reactions following a life-threatening illness, injury, or painful medical procedure?
Your Answer: c. 15 – 25%
CORRECT ANSWER:
a. 5 – 15%
b. 10 – 15%
c. 15 – 25% – While this number varies depending on type of traumatic event, it’s clear that a significant number of children develop lasting symptoms after a traumatic medical event. While less persistent and debilitating, up to 80% of patients and families will develop some level of stress reaction immediately following the event.
d. 30 – 35%
3. What symptoms did Nancy experience after her ICU stay, which are characteristic of posttraumatic stress disorder?
Your Answer: h. All of the above
CORRECT ANSWER:
a. Nightmares
b. Flashbacks
c. Paranoia
d. Interrupted sleep
e. a, b, c
f. b and c
g. a, b, d – These, in addition to other common symptoms such as hypervigilance, persistent avoidance of stimuli associated with the event, intrusive memories, exaggerated startle response, and negative emotional state and/or self view, are just some of the manifestations of PTSD. ICU experience is becoming increasingly acknowledged as a cause of PTSD. Recent studies have shown that 20-25% of individuals who survive a critical illness and ICU stay develop PTSD.
h. All of the above
4. In an attempt to reduce traumatic stress reactions in pediatric patients after medical intervention, Dr. Nancy Kassam-Adams encourages remembering the mnemonic DEF. What does the F stand for?
Your Answer: c. Family
CORRECT ANSWER:
a. Friends
b. Fears
c. Family – Just like providers assess the ABCs (Airway, Breathing, Circulation), psychosocial factors including DEF (Distress, Emotional Support, Family) should also be considered for every pediatric patient. From the Healthcare Toolbox Website: “Addressing Family needs includes assessing family stressors and resources, and recognizing that a child’s injury or illness impacts the entire family – parents, siblings, and other family members may also be distressed and may have traumatic stress reactions.” For specifics on how to practice trauma-informed care addressing family needs, click here.
d. Follow-up
5. What does Bob state are some of the common emotional responses to putting others into restraints?
Your Answer: c. Guilt and pity
CORRECT ANSWER:
a. Shame and anger
b. Fear and guilt – While the emotional responses to putting another person into restraints are certainly varied and complex, fear and guilt often play major roles. This may contribute to an experience of vicarious trauma, which is sometimes referred to as “emotional residue” or the “cost of caring” for struggling individuals.
c. Guilt and pity
d. Embarrassment and fear
