Adaptive Quizzing #4

Which statement demonstrates an expression of anxiety rather than fear?

"I really dislike knowing that we have a 50-point test tomorrow."

What statement about panic attacks by the patient indicates a need for further teaching?

"I will control my panic attacks by avoiding stress"

Buspirone is prescribed for a patient with anxiety. Which instruction should the nurse provide to this patient?

"It will take two to four weeks for you to feel the full benefit."

A man was killed during a robbery 10 days ago. His widow, who has a long history of mental illness, cries spontaneously when talking to the nurse about her loss. What is the nurse's most therapeutic response?

"The sudden death of your husband is hard to accept. I am glad you are able to tell me about how you are feeling."

When discussing the symptoms of posttraumatic stress disorder (PTSD), the nurse correctly states:

"The symptoms can occur almost immediately or can take years to manifest."

The nurse is teaching a patient with dissociative disorder about risk factors. Which statement made by the patient indicates teaching was effective?

"Traumatic events are the most basic cause of dissociative disorder."

A nurse conducts an initial interview with a veteran of two tours in the war with Afghanistan. The veteran says, "Sometimes I still hear explosions but I know I am safe in my home." What is the nurse's best response?

"You are describing flashbacks. These often happen after traumatic events such as war. I'd like to arrange for you to talk more about your feelings and reactions."

Which child should be assessed for possible posttraumatic stress disorder (PTSD) as a result of exposure to major trauma in his or her life? Select all that apply.

A 4-year-old who was hospitalized for two months after being injured in an automobile accident An 8-year-old child who has a medical history that includes several broken bones and a dislocated shoulder. A 12-year-old who has been in cancer remission for three years since finishing both chemotherapy and radiation treatments.

What statement is true regarding normal anxiety? Select all that apply.

A degree of anxiety is necessary and healthy; It is a factor in the achievement of personal goals; it motivates people to make and survive change in their lives; It provides the energy needed to achieve tasks related to living

Which symptom can the nurse expect a patient with depersonalization disorder to demonstrate?

A feeling of detachment from one's body or mental processes.

The difference between moderate and severe anxiety is that

A person experiencing moderate anxiety can be redirected when instructed to do so

An obsession is defined as

A recurrent, persistent thought or impulse

What can be said about the comorbidity of anxiety disorders?

A second anxiety disorder may coexist with the first

The nurse caring for a patient experiencing a panic attack anticipates that the psychiatrist would prescribe a stat dose of

A short-acting benzodiazepine medication

What question would assist a nurse in determining whether a patient diagnosed with obsessive-compulsive disorder has achieved treatment outcomes? Select all that apply.

Can the patient meet his or her own self-care needs effectively Is the patient able to maintain satisfying interpersonal relationships? Does the patient understand that anxiety is the cause of the ritual behavior? Has the patient learned to use newly acquired methods to manage anxiety?

The nurse is providing teaching to a preoperative patient just before surgery. The patient is becoming more and more anxious as the information is presented. Soon the patient begins to report dizziness and heart pounding. The nurse observes obvious trembling and that the patient appears confused. What is the nurse's immediate intervention?

Ceasing any further attempt at preoperative teaching at this time

Which statement regarding dissociative disorder is true? Select all that apply.

Cortisol regulation is dysregulated as a result of episodic dissociative events. Dissociation is associated with a disconnection of thoughts, emotions, and behaviors. A feature of severe dissociation referred to as "mindflight" occurs in response to significant trauma. Some dissociative behavior is considered normal and observed in otherwise mentally healthy individuals.

Which statement is true regarding psychopharmacological therapy for posttraumatic stress disorder (PTSD)? Select all that apply.

Initial therapy may include fluoxetine.; Clonidine is prescribed to help manage intrusive symptoms.; Panic attacks are addressed through the prescription of propranolol.; Mirtazapine may be prescribed if the original prescription is not effective.

After considering the following information, which nursing intervention would have priority when a patient is experiencing an "attack of the nerves" (ataque de nervios)?

Moving the person away from stairs and furniture so as to minimize injury from a fall

Which nursing intervention would be helpful when caring for a patient diagnosed with an anxiety disorder?

Reinforce use of positive self-talk to change negative assumptions.

An adult invites 14 guests for Thanksgiving dinner. Just before the guests arrive, the adult notices the turkey is burned and inedible. Which behavior by this adult indicates adaptive coping? The adult

Says to the guests, "We are having a vegetarian Thanksgiving dinner this year."

Which statement concerning developmental assessment of a 5-year-old child is true? Select all that apply.

Stress-related behaviors that are identified may be managed by the nurse; The Denver II Developmental Screening tool is appropriate for this age group; A concern is whether the child is functioning at his or her current chronological age

A 3-year-old child is admitted for an extensive stay in an acute care hospital. The parents will be able to visit only on weekends. The nurse bases emotional care of the child on the understanding that

The child is at risk for physical illnesses resulting from the separation

Parents express concern when their 5-year-old child, who is receiving treatment for cancer, keeps referring to an imaginary friend, Candy. The nurse explains that:

The imaginary friend is a coping mechanism the child is using

The nurse is caring for a patient with dissociative amnesia disorder. The patient gets extremely aggressive due to anxiety and causes physical harm to him or herself and to others. Which nursing intervention does the nurse follow to reduce anxiety and aggression in the patient?

The nurse frequently observes the patient by visiting the patient's room.

A student nurse observes that a patient often looks at her reflection in the mirror. What is the most appropriate diagnosis the student nurse could make from the patient's behavior?

The patient has body dysmorphic disorder

What statement about panic attacks is true? Select all that apply.

They are characterized by a sudden onset of extreme apprehension.; The fear is so intense that it interferes with a person's ability to function normally. People with a history of panic attacks develop a deep-seated fear of having an attack.

Which statement concerning syndromes seen in other cultures, such as piblokto, Navajo frenzy witchcraft, and amok, is true?

They are culture-bound syndromes that are not dissociative disorders.

A 72-year-old patient is diagnosed with Parkinson's disease and anxiety. The health care provider prescribes a benzodiazepine. The nurse questions this prescription based on what fact related to this classification of medications?

This medication would increase the patient's risk for falls.

Which child is at greatest risk for developing attachment problems as a result of a neurobiological development?

a 4-year-old female

The nurse anticipates that the nursing history of a patient diagnosed with obsessive compulsive disorder (OCD) will reveal

a sibling with the disorder

Which intervention is focused on addressing the goals of stage 1 of the model for trauma treatment of a child? Select all that apply.

a staff member is assigned a 1:1 monitoring situation with the child; the child is oriented to and frequently re familiarized with his or her daily schedule.

A nurse is caring for a child diagnosed with posttraumatic stress disorder as a result of violence at home. What trauma interventions should the nurse plan for this child?

allow the child to draw and play

A patient is diagnosed with disturbed personal identity. What signs and symptoms do the nurse expect to find in the patient? Select all that apply.

amnesia; feelings of unreality

Which category of medication used to treat anxiety has a potential for dependence?

benzodiazepines

What information will the nurse include in medication education for a patient prescribed an antianxiety medication for obsessive-compulsive behavior? Select all that apply.

caffeine beverages should be avoided; antacid use can affect medication absorption; benzodiazepines have a quick onset of action

According to attachment theory, relationship disorders are related to trauma associated with:

caregivers or parents

A patient who is a victim of sexual assault has insomnia, reduced concentration, anxiety, and recurring thoughts of the event. Which medication does the nurse anticipate being prescribed for the patient?

clonidine

A man continues to speak of his wife as though she were still alive, three years after her death. This behavior suggests the use of....

denial

A patient says to the nurse, "Sometimes I feel like I'm floating above my body, watching it from the outside." When documenting this observation, which term applies?

depersonalization

What assessment finding can the nurse expect in a patient experiencing a panic level of anxiety?

depersonalization

A patient is experiencing a panic attack. The nurse can be most therapeutic by

encouraging the patient to take slow, deep breaths

An appropriate intervention for stage 2 of the staged model of trauma treatment is:

engaging in memory work

A patient approaches the nurse's station, begins tapping a finger on the desk, and tells the nurse, "I am feeling pretty anxious." What is the nurse's best action?

escort the patient to an exercise class

A symptom commonly associated with panic attacks is

fear of impending doom

A patient is diagnosed with depersonalization disorder. Which symptom should the nurse expect the patient to report during the interview?

feeling of being an observer of one's own body

What symptoms are included in adjustment disorder? Select all that apply.

guilt; anger; depression; social withdrawal

Which anxiety disorder is related to overattention or obsessive thoughts? Select all that apply.

hoarding disorder; hair pulling disorder; body dysmorphic disorder

Which behavior best supports the diagnosis of posttraumatic stress disorder (PTSD) in a 4-year-old child?

hypervigilance

If the record mentions that the patient habitually relies on rationalization, the nurse might expect the patient to

justify illogical ideas and feelings

A nurse is assessing an adult patient with posttraumatic stress disorder (PTSD). Which symptom should the nurse expect to find?

mood alterations

When a toddler's mother is hospitalized for several months, the nursing diagnosis risk for impaired parent/child attachment is related to prolonged separation, which has been included in the child's plan of care. The most appropriate outcome would be that:

mother and child show signs of healthy bonding

The nurse is assessing a young child for posttraumatic stress disorder (PTSD). What does the nurse include in the assessment? Select all that apply.

motor function; speech patterns; general appearance; characteristics of play

A patient diagnosed with panic disorder begins a new prescription for lorazepam. The nurse should provide instructions to discontinue which of this patient's usual daily activities?

moving the lawn

A young adult applying for a position is mildly tense but eager to begin the interview. This can be assessed as showing

normal anxiety

What mental health disorder can be a direct physiological result of hyperthyroidism?

panic attack

The inability to leave one's home because of avoidance of severe anxiety suggests the anxiety disorder of

panic attacks with agoraphobia

A possible outcome criterion for a patient diagnosed with anxiety disorder is

patient demonstrates effective coping strategies

A primary health care provider instructed a nurse to give cognitive-behavioral therapy to a patient with social phobia. What intervention is appropriate for the patient during the cognitive-behavior therapy?

re-evaluate the patient's situation

A person who recently gave up smoking and now talks constantly about how smoking fouls the air, causes cancer, and "burns" money that could be better spent to feed the poor is demonstrating

reaction formation

A nurse is assessing a child who has witnessed violence at home. What should the nurse document when completing an admission genogram of the child? Select all that apply.

relationships; family history; family composition

A 20-year-old was sexually molested at age 10, but can no longer remember the incident. The ego defense mechanism in use is

repression

A child who is able to regain mental stability after a traumatic event is said to be:

resilient

An adult states, "My mother lives with me since my dad died 6 months ago. For the past couple of months, every time I need to leave the house for work or anything else, Mom becomes extremely anxious and cries that something terrible is going to happen to me. She seems okay except for these times, but it's affecting my ability to go to work." This information supports which psychiatric diagnosis?

separation anxiety disorder

After a year of diarrhea, a patient has a colonoscopy. As the health care provider explains the findings, the patient rapidly says, "You're talking too fast. I can't understand you. All I can hear is a buzz from the fluorescent lights." The patient is wet with perspiration. Which level of anxiety is evident?

severe

A potential problem for a patient diagnosed with severe obsessive-compulsive disorder is

sleep disturbance

Which defense mechanisms do not have adaptive uses?

splitting

A patient attempted suicide three days ago. When the nurse asks about the related events, the patient says, "I don't want to think about that now, but maybe we could talk about it later." Which defense mechanism has the patient used?

suppression

A nurse is planning care management for a traumatized child. Which soothing strategies should the nurse include to help in the recovery of the child? Select all that apply.

talk in a low, calming voice; provide distraction through books; provide the child with his or her favorite music

The nurse is assessing a child who has moved to a boarding school. On assessment, the nurse concludes that the child is suffering from separation anxiety disorder. Which signs would lead the nurse to that assessment? Select all that apply.

the child is extremely shy; the child is confused most of the time; the child demonstrates a lack of self-direction

A nurse has been caring for a patient with posttraumatic stress disorder. Which patient behaviors indicate an improved ability to cope? Select all that apply.

the patient asks for help when required; the patient has fewer physical complaints; the patient tries to find information about treatment

The nurse is teaching deep breathing exercises to a patient with severe anxiety. Which sign after performing this exercise would indicate that the patient's anxiety has decreased?

the patient demonstrates selective inattention

A nurse is evaluating the effects of treatment for a patient with dissociative identity disorder. Which factor would indicate success of the treatment?

the patient has integrated past events

A patient who has to undergo cataract surgery next week complains of chest pain, feelings of choking, and hot flashes. What appropriate diagnosis does the nurse make from the patient's symptoms?

the patient has panic disorder

A patient diagnosed with posttraumatic stress disorder shows little symptom improvement after being prescribed a selective serotonin reuptake inhibitor (SSRI). The nurse expects that the next medication to be prescribed will be a

tricyclic antidepressant (TCA)

When does the nurse ideally conduct the initial debriefing for a patient who is admitted for severe injuries due to an accident?

within two days of the accident