Chapter 40: Care of Veterans with Mental Health Needs

Format: Multiple choice

Client Needs: Psychosocial Integrity

Cognitive Level: Apply

Integrated Process: Nursing Process

Objectives: 2, 5

Page and Header: 787, U.S. Military Organizations

1. The mental health needs of military service members and veterans differ according to their branch and terms of service. This is best explained by which observation?

A) Service members who do not deploy overseas are not impacted.

B) Some military service branches are disproportionately affected.

C) Each branch is equally trained and skilled to defend our country.

D) Reserve and National Guard service members can earn immunity.

Page and Header: 787, U.S. Military Organizations

2. The unique needs of military service members and veterans can be explained by which concept?

A) Assimilation of females into military and combat roles

B) Transition from compulsory enlistment to all-volunteer force

C) Representation of less than one-half of 1% of the U.S. population

D) A highly structured, traditional, and hierarchal military culture

Page and Header: 788, Military Culture/The Changing Role of Women in the Military Throughout History

3. The role of women in the military can best be described by which reference?

A) Women service members have been acknowledged since the 19th century.

B) Women’s military service has been limited to support roles during wartime.

C) Acceptance into military academies has increased the number female officers in service.

D) Female service members are restricted to nursing and office support roles.

Page and Header: 789, Inclusion of Underrepresented Groups in the Military; 789, Recommendations to Improve Racial and Ethnic Diversity and Inclusion in the U.S. Military, Box 40.2

4. Historically minority groups such as women, blacks, immigrants, or religious groups were allowed to serve in homogenous groups yet discriminated against upon return home. Which statement remains valid today?

A) Some cultures and religions still struggle to recognize female leaders.

B) Female military squad leaders are seen as homosexual or transgender.

C) Racial issues are less prevalent than sexually or religiously based issues.

D) Legislation prevents discrimination against immigrant service members.

Page and Header: 789, Veterans of the U.S. Military

5. Recruitment advertisements include statements such as “see the world” and “we do more each morning before the world wakes up.” Which statement do Military veterans find most offensive?

A) “You served in the Grunt Army?”

B) “Did you get to kill anybody?”

C) “Couldn’t get in the Air Force?”

D) “Why weren’t you an officer?”

Page and Header: 790, Veteran Identity

6. Twenty-first century conflict missions are best identified by which statement?

A) Protect American culture

B) Preserve American history

C) Maintain global superiority

D) Exemplify democratic republic

Page and Header: 790, Female Veterans

7. Multiple factors contribute to the mental health of a female serving in the military. Which statement best reflects recent trends?

A) The number of females serving in the military is increasing but they are of a younger age group.

B) Multiple deployments increase resilience to military pressure.

C) The VA provides adequate supplies to female veteran clients.

D) Females must adjust to the pervasive macho sense of humor.

Page and Header: 790, Health Care for Veterans

8. Despite its extensive history and continued growth in the number of VA Health Care System facilities, it has become necessary to expand beyond their 1600 facilities in the 21st century. Which statement supports this development?

A) Many VA Medical Centers are expensive and obsolete.

B) 2011 Joining Forces initiative supports military families.

C) In 2007 the VANAP integrated with civilian schools.

D) Soldier’s Homes are reserved for homeless veterans.

Page and Header: 791, Mental Health Needs of Veterans, Risks for Mental Health Issues

9. Many social, geographical, family, economic, and societal factors can increase the risk for a service member or veteran to develop mental health issues. Which factor best supports this statement?

A) Frequent moving and changing schools during childhood

B) Being female with a history of trauma and low social capital

C) Extensive athletic participation in low-contact sports

D) Infrequent contact with family, friend, church network

Page and Header: 792, Posttraumatic Stress Disorder

10. Which statement accurately reflects post-traumatic stress disorder as experienced by service members and veterans?

A) They must have been directly involved in gunfire exchange.

B) They must report that they were directly with a peer who died.

C) They perceive a threat as imminent and take direct action on it.

D) Drinking and taking pills will help one to sleep despite nightmares.

Page and Header: 793, Combat Versus Non-Combat-Related Trauma

11. Which statement differentiates combat-related trauma from non-combat-related trauma?

A) One may have been deployed to a war zone or combat area.

B) One must have had one’s life at risk to protect combat peers.

C) One may have been directly involved in a combat scenario.

D) One perceives that one is guilty or responsible for the event.

Page and Header: 793, Moral Injury

12. Moral injury is one of several complex traumas to which military veterans are exposed. Which statement accurately reflects this occurrence?

A) Disagreeing when a peer is singled out for additional disciplinary exercise

B) Feeling that the drill sergeant treats someone in an unnecessarily harsh and mean way

C) Hearing that someone in basic training died by suicide in the barracks

D) Witnessing the death or killing of children during a deployment

Page and Header: 793, Violent Combat and Caring for the Wounded

13. Those who participate in violent combat and provide care for the wounded can experience which symptoms of PTSD? Select all that apply.

A) Re-experiencing a cognitive-sensory experience to current stimuli

B) Sudden onset of feeling sad and tearful with no explanation

C) Numbing symptoms such as feeling emotionally and physically flat

D) Intrusive memories, nightmares, distress, and physiological reactivity

E) Experiencing anxious-arousal cognitive impairment with autonomic symptoms

Page and Header: 795, Depression

14. Which statement is the most accurate regarding depression in the military and veteran population?

A) Depression resolves once a service member returns to the United States.

B) Depression improves when service members rejoin their family.

C) Depression dissipates upon return to civilian employment.

D) Depression lingers for variable and sometimes lengthy intervals.

Page and Header: 796, Suicide; 792, Epidemiology; 791, Protective Factors; 797, Evidence-Based Nursing Care for Veterans with Suicide Ideation

15. What is an accurate statement about suicide in the military and veteran populations in contrast to the U.S. civilian population?

A) Childhood sexual abuse does not impact veteran suicide risks.

B) U.S. military and veteran suicide is an established growing trend.

C) Suicides are reduced upon surrendering weapons as a civilian.

D) Service members maintain honor by setting up “suicide by cop.”

Page and Header: 800, Pain

16. It is challenging to understand the mission, culture, and requirements, and demands placed on our military service members and veterans. Which statement acknowledges a truth about this population?

A) Women are especially suited for physical and temperature burdens.

B) Service members are young, healthy, and fit with high pain tolerance.

C) Ongoing physical tasks and strength bearing demands pain endurance.

D) Service members who require analgesic are discharged.

Page and Header: 800, Traumatic Brain Injury

17. Traumatic Brain Injury (TBI) is often referred to as the signature injury of the post-9/11 conflict. Which statements are true of TBI in military service members and veterans? Select all that apply.

A) Attention disorders and cognitive disorders are associated with TBI.

B) TBIs are complex and must be accurately triaged, assessed, and treated.

C) Hearing disturbances and headaches are most frequent with TBI (blast).

D) TBIs experienced in combat related to IED mandate military separation.

E) Service members who are athletes have protective factors against TBI.

F) Frequent comorbidities of TBI are PTSD, depression, anxiety, sleep disorders.

G) A high percentage of service members and veterans use pain medication to help relieve TBI symptoms.

Page and Header: 800, Homelessness

18. Homelessness within the veteran population is complex and multifaceted. Which statement reflects current trends?

A) A high number of underrepresented homeless veterans screen positive for PTSD.

B) The VHA does not discharge those with serious mental illness to shelters.

C) The government provides for female service members, veterans, and children.

D) Veterans suffering with substance use do not live in community shelters.

Page and Header: 788, Box 40.1 Names of Operational Phases of Wars in Iraq and Afghanistan

19. The Military and VA systems at times seem to be built on countless acronyms. This shared language allows enhanced communication across military service branches and periods of conflict. Which acronyms reflect 21st-century periods of military conflict? Select all that apply.

A) OIF

B) PGW1

C) GWOT

D) OEF

E) WWII

F) OND

G) OIR

Page and Header: 798, Risks and Protective Factors; 798, Opioid Use in the Military; 799, Opioid Use by Veterans; 799, Polysubstance Use, Comorbidity, and Overdose; 799, Other Issues Impacting Veteran Mental Health; 800, Traumatic Brain Injury; 801, Summary of Key Points

20. The uniquely aggressive and consistent physical demands on those who serve in the military contribute to well-documented chronic pain issues. Which statements reflect accurate information on chronic pain in this population? Select all that apply.

A) Chronic groin pain in veterans in the most frequently reported pain.

B) Jaw pain, severe headaches, migraines, and neck pain are common.

C) Substance use, depression, and suicide can be associated with pain issues.

D) Musculoskeletal pain (MSP) can result from service injuries or disorders.

E) Combat injuries include polytrauma, blast, and Traumatic Brain Injuries (TBI).

F) Non-combat injuries include muscle strain, overuse, and chronic pain.

G) MSP and orthopedic problems include inflammation and pain from overuse.

H) Endocrine dysfunction and sleep disturbance are common symptoms.