A soldier returns to the United States from active duty in a combat zone in Afghanistan. The soldier is diagnosed with post-traumatic stress disorder (PTSD). Which comment by the soldier requires the nurse's immediate attention?
a. "It's good to be home. I missed my family and friends."
b. "I saw my best friend get killed by a roadside bomb. It should have been me instead."
c. "Sometimes I think I hear bombs exploding, but it's just the noise of traffic in my hometown."
d. "I want to continue my education but I'm not sure how I will fit in with other college students."
ANS: B
The correct response indicates the soldier is thinking about death and feeling survivor's guilt. These emotions may accompany suicidal ideation, which warrants the nurse's follow-up assessment. Suicide is a high risk among military personnel diagnosed with PTSD. One distracter indicates flashbacks, which is common with individuals with PTSD but is not solely indicative of further problems. The other distracters are normal emotions associated with returning home and change.
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