MS QUIZ 12 Psychologic Responses to Illness and Psychiatric Disorder

How should a nurse describe a patient who has a functional interaction of the cognitive, affective, behavioral, and social dimensions of his personality?

a. Effectively organized

b. Personally satisfied

c. Well rounded

d. Mentally healthy

ANS: . Mentally healthy

Mental health depends on the functional integration of the four dimensions of the personality.

What is an example of a positive stressor?

a. Test anxiety

b. Loss of a job

c. Paying income tax

d. Single motherhood

ANS: A Test anxiety

Test anxiety can be beneficial to promote study and sharpen focus.

A wife of a critically injured husband has been at his bedside constantly for 2 days. As the nurse speaks to the wife, the wife sobs, "This is awful. I can't take it anymore." What is the wife experiencing?

a. Fear

b. Denial

c. Compensation

d. Stress

ANS: D. Stress

Long-term stress causes fatigue and an inability to solve problems.

How does fear differ from anxiety?

a. Fear is a useless emotion.

b. Fear is an ineffective coping strategy.

c. Fear is an irrational feeling.

d. Fear is a response to a specific threat.

ANS: D.Fear is a response to a specific threat.

Fear is a response to a specific threat (e.g., a rattlesnake in the garden); anxiety is a response to a nonspecific threat (e.g., first day on a new job).

A 5-year-old patient was in an accident in which his cousin was killed. The patient starts to wet the bed at night. What question should the nurse ask the mother when she confirms that it has been several years since the patient had any difficulty with bedwetting?

a. "Do you think this is related to the accident?"

b. "Do others in the family have this problem?"

c. "Does your child drink lots of fluids late at night?"

d. "Are there any stressful situations in your family?"

ANS: A "Do you think this is related to the accident?"

Anxiety is the root of such defense mechanisms as regression. This behavior is an example of regression, in which the 5-year-old child has gone back to behavior more suited to a younger developmental age.

Which patient diagnosis and behavior should lead a nurse to conclude the patient is using the defense mechanism of denial?

a. A patient with emphysema continues to smoke.

b. A patient with diabetes mellitus uses a sugar substitute.

c. A patient with a drug problem blames his mother for his habit.

d. A patient with osteoarthritis angrily kicks the steps that he cannot climb.

ANS: A.A patient with emphysema continues to smoke.

The patient with emphysema is an example of denial, the patient with diabetes is an example of an adaptive response, the patient with a drug problem is an example of projection, and the patient with osteoarthritis is an example of regression.

What is the goal of nursing care for the patient with a chronic illness?

a. Find the cause of the illness.

b. Tell the patient that he or she will learn to live with the illness.

c. Help the patient manage the illness.

d. Give the patient websites that have information about the illness.

ANS: C.Help the patient manage the illness.

The goal of caring for patients with a chronic illness is to help them manage the illness and to develop coping skills.

A patient is given anxiolytic medications for a mental disorder. What type of approach is this considered?

a. Analytical

b. Interpersonal

c. Biologic

d. Psychoanalytic

c. Biologic

A patient states that he feels angry at work for no reason and often yells at his coworkers. The therapist asks the patient to describe events and then tells the patient to try different strategies to cope with these angry outbursts. What type of approach is this considered?

a. Biologic

b. Analytical

c. Cognitive or behavioral

d. Interpersonal

d. Interpersonal

What is the best action for the nurse to implement to effectively listen therapeutically to a patient?

a. Concentrate on the patient and not think of responses to the patient while he or she is speaking.

b. Determine the cause of the patients problem while the patient is speaking.

c. Ask the patient why he thinks he feels the way he does.

d. Tell the patient that you have had similar experiences.

a. Concentrate on the patient and not think of responses to the patient while he or she is speaking.

A nurse speaking to a patient who is depressed says, So what you are saying is that you are feeling very sad today. What is this considered?

a. Listening

b. Sharing observations

c. Clarifying

d. Being available

c. Clarifying

A patient says, I just dont think I can keep going on. I just want it all to end. The nurse assesses that this patient has suicidal ideation. What is the nurses best response?

a. Do you have any thoughts of harming yourself?

b. Have you felt like this before?

c. You are just depressed. When you feel better, you wont think that way.

d. We will keep you safe here.

a. Do you have any thoughts of harming yourself?

What should a nurse suspect a patient diagnosis might be when the patient states, I often feel restless, have a tight sensation in my chest, and have an increased heart rate at times?

a. Anxiety disorder

b. Panic disorder

c. Agoraphobia

d. Obsessive-compulsive disorder

a. Anxiety disorder

A group of nursing students are taking their first major examination. What should the nursing instructor expect the students might experience?

a. Posttraumatic stress disorder

b. Panic disorder

c. Mild anxiety

d. Moderate anxiety

c. Mild anxiety

A patient is admitted with posttraumatic stress disorder (PTSD) says he had a very stressful experience when in high school and has never really recovered. What is the most appropriate nursing action?

a. Encourage the patient to talk about what caused the traumatic event.

b. Guide the patient in relaxation techniques to distract him when flashbacks occur.

c. Provide sleeping medication so that he can sleep at night.

d. Allow the patient to talk about his condition as often as he likes.

b. Guide the patient in relaxation techniques to distract him when flashbacks occur.

A patient who went away to college in September returns in October, thinking that he is a drummer in a popular rock band. What is this most likely a manifestation of?

a. Dissociative disorder

b. Conversion disorder

c. Schizophrenia

d. Amnesia

c. Schizophrenia

Which is not considered as a probable cause of mood disorders?

a. Loss of significant others

b. Learned helplessness

c. Neurotransmitter dysregulation

d. Traumatic event in childhood

d. Traumatic event in childhood

A patient with schizophrenia has undergone eight electroconvulsive therapy treatments (ECTs) in the past 2 weeks. The daughter is upset that her parent is lethargic, confused, and does not recognize her. What knowledge should the nurse consider when preparing to respond?

a. The combination of ECTs and neuroleptic medications can make a patient drowsy.

b. These reactions indicate a drug overdose.

c. Many patients with schizophrenia punish their families by pretending not to know them.

d. A temporary memory loss is common after several ECTs.

d. A temporary memory loss is common after several ECTs.

A patient is brought in from the emergency department after telling the physician that he is a relative of the president of the United States. He says that he should not be detained because he has important business to attend to that involves national security. He is dressed in a bright coat with plaid pants and gets very angry when you try to question him. What is this patient is experiencing?

a. Panic attack

b. Hyperactive episode

c. Extrapyramidal effect

d. Manic episode

d. Manic episode

While in the dayroom, one of the patients becomes very agitated and begins to threaten to harm the other patients and is directing violence at the other patients and staff. What is the most appropriate nursing implementation?

a. Decrease the stimuli and use restraints if all other measures fail.

b. Offer to call the physician and ask another staff member to call security.

c. Remove harmful objects and try to perform relaxation exercises with the patient.

d. Restrain the patient and do not allow him or her to eat or drink anything by mouth.

a. Decrease the stimuli and use restraints if all other measures fail.

A patient who has a history of episodes of road rage thinks that she is a very good driver and does not understand why she keeps being told she is a poor driver. She is losing her license now, and she tells the nurse that she is feeling very unhappy and abandoned. She feels like she might hurt herself. The nurse realizes that the patient is exhibiting which personality disorder?

a. Narcissistic

b. Paranoid

c. Schizoid

d. Borderline

d. Borderline

What is a common cause of delirium?

a. Overuse of steroids

b. Liver abnormalities

c. Parkinson disease

d. Neoplasms

d. Neoplasms