Mental Health Chapter 10
A nurse is distraught while caring for a long-term seriously ill client. Which condition is this nurse experiencing? 1 Posttraumatic stress disorder (PTSD) 2 Mental illness 3 Compassion stress 4 Flight or fight
Answer:3
A veteran is suffering from posttraumatic stress disorder (PTSD) after serving two tours in Afghanistan. What additional co-occurring conditions are associated with PTSD? Select all that apply. 1 Lung cancer 2 Heart attacks 3 Depression 4 Osteoarthritis 5 Reduced lipid levels
Answer 2,3,4
The client is learning to relax during a stress reduction series. Which system is activated? 1 HPA axis 2 Sympathetic nervous system 3 Parasympathetic nervous system 4 Limbic system
Answer 3
A client with a diagnosis of obesity has been participating in a new program of exercise for 60 minutes a day, five times a week to facilitate a weight loss. What type of stress is the client experiencing? 1 Eustress 2 Distress 3 Stress response 4 Chronic stress
Answer: 1
What information should the nurse give to the family of a client who has experienced a dissociative episode? 1 Dissociation is a method for coping with severe stress. 2 Dissociation suggests the possibility of early dementia. 3 Brief periods of psychotic behavior may occur. 4 There are a number of interventions to prevent self-mutilation and suicide attempts
Answer: 1
A nurse on a busy medical-surgical unit is complaining of fatigue. What is the most likely cause of fatigue in a nurse who is otherwise healthy? 1 Secondary stress trauma 2 Acute stress disorder 3 Posttraumatic stress disorder 4 Traumatic brain injury
Answer: 1
A young parent is experiencing posttraumatic stress disorder (PTSD) after the death of two children in a motor vehicle accident. How would the cardinal signs of PTSD show up in this client? Select all that apply. 1 Flashbacks and distressing memories 2 Avoidance of friends with young children 3 Persistent fear and guilt 4 Ability to relax but not fall asleep 5 Meaningful relationships at work and home 6 Tolerating an exercise program
Answer: 1,2,3
A client who survived a bomb blast has symptoms of chronic depression, irritation, and insomnia. Which statement of the nurse is appropriate to be included in the client teaching regarding management guidelines? Select all that apply. 1 "Don't consume alcohol." 2 "Coffee should be avoided." 3 "Keep practicing deep breathing and aerobic exercises." 4 "Dreaming about the traumatic event is a normal response to your trauma." 5 "Smoking will cause your symptoms to worsen.
Answer: 1,2,3,4
Which client statements support the existence of a comorbid condition characteristically associated with posttraumatic stress disorder (PTSD)? Select all that apply. 1 "I don't have any really good friends, just acquaintances." 2 "Marriage doesn't work for me; I've been divorced three times." 3 "My partner is always upset because I can't seem to keep a job." 4 "Controlling my anger is a big problem for me." 5 "I wish my parents were still alive; they loved and cared about me.
Answer: 1,2,3,4
A retired football player is having problems keeping a job and recently got a divorce. Which questions does the nurse include in the assessment? Select all that apply. 1 Do you have a safe place to live? 2 Are you having troubles concentrating? 3 How long is your attention span? 4 Are you using any drugs or alcohol? 5 Do you remember a head injury event? 6 Why are you having troubles at work and home?
Answer: 1,2,3,4,5
Which are the most likely causes of stress? Select all that apply. 1 Low social status 2 Threats to self-esteem 3 Loud noises 4 Defense mechanisms 5 Poverty
Answer: 1,2,3,5
A group of veterans is having difficulties living in a community shelter. Which factors are predictive of positive outcomes for a veteran to be independent? Select all that apply. 1 Ability to get and keep a job 2 A solid supportive family 3 History of diabetes and heart disease 4 Alcohol and tobacco use 5 Lack of a criminal record 6 History of spousal abuse
Answer: 1,2,5
An employee is working to manage several similar projects to meet a deadline. Which type of stress is this employee experiencing? 1 Acute 2 Autonomic 3 Chronic 4 Eustress
Answer: 4
When a client complains of being "stressed out," the nurse understands that this label may include what experiences? Select all that apply. 1 Sleeping through the night 2 Excessive appetite 3 Loss of interest in favorite activities 4 Headaches and back pain 5 Difficulty concentrating
Answer: 2,3,4,5
A client is expressing difficulty with social relationships. What signs of posttraumatic stress disorder (PTSD) does the nurse identify? Select all that apply. 1 Ability to clearly remember all aspects of the trauma 2 Persistent negative emotions of guilt and shame 3 Long criminal history of abuse and crime 4 Participation in the group activities 5 Unable to sleep throughout the night without nightmares 6 Able to complete a skills task list with good concentration
Answer: 2,3,5
A nurse has been caring for a client diagnosed with posttraumatic stress disorder. Which client behaviors indicate an improved ability to cope? Select all that apply. 1 Improved eye contact 2 Fewer physical complaints 3 Asks for help when required 4 Improved grooming skills 5 More restful sleep periods
Answer: 2,3,5
A 4-year-old client, who survived a severe car accident that resulted in the mother's death, is withdrawn, not sleeping, having nightmares, and acting out the car accident over and over again when playing. The father reports the client says repeatedly, "It's my fault because I'm bad." These behaviors support which diagnosis? 1 Adjustment disorder 2 Dissociative identity disorder 3 Posttraumatic stress disorder (PTSD) 4 Acute stress disorder (ASD)
Answer: 3
A client may experience which short-term reaction in response to a traffic accident involving death on the scene? 1 Heart attack 2 Diabetes 3 Psychological stress 4 Gastric ulcers
Answer: 3
A client with posttraumatic stress disorder (PTSD) is finishing outpatient therapy. What behavior most clearly suggests the client is recovering? 1 Living alone 2 Regularly attending church 3 Having breakfast with a friend weekly 4 Sleeping restlessly at night
Answer: 3
A nurse is caring for an adult client who has been diagnosed with a trauma-related disorder. The client reports to the nurse that he has started using relaxation techniques and is sleeping better. As what should the nurse interpret this? 1 The client is feeling uneasy. 2 The client is feeling less confident. 3 The client is able to manage anxiety. 4 The client has improved self-esteem
Answer: 3
A group of teenagers was exposed to a violent shooting of two of their friends after being held captive for several hours. What physiological changes may occur within their brains? Select at all that apply. 1 Reduced amygdala size 2 Reversible brain damage 3 Increased metabolic activity in the limbic regions 4 Altered release of neurotransmitters 5 Reduced hippocampal volume
Answer: 3,4,5
Which symptoms would lead a health care provider to suspect posttraumatic stress disorder (PTSD) in an adult client? Select all that apply. 1 Visiting the scene of the accident over and over 2 Talking with strangers about the events of the accident 3 Flashbacks of the accident 4 Hypervigilance 5 Irritability 6 Difficulty concentrating
Answer: 3,4,5,6
A client is experiencing stress at work. What is an example of a physical stressor in the workplace? 1 Staff cliques 2 Guilt 3 Low pay 4 Loud noises
Answer: 4
A community is experiencing a high degree of illness after a devastating earthquake. What percentage of diseases are related to stress? 1 60% 2 70% 3 80% 4 90%
Answer: 4
A war veteran comes to the clinic demonstrating signs of posttraumatic stress disorder (PTSD). What method of treatment does the nurse use when treating this client? 1 Low-carbohydrate diet 2 Herbal supplements 3 Manipulative practices 4 Cognitive behavioral therapy
Answer: 4
An elderly client suffered from a head injury after a fall several months ago. During a transfer to the chair, the client suddenly becomes alert and combative. What does the nurse identify as the most likely cause of this behavior? 1 The client is concerned with the nurse's ability to transfer safely. 2 The client has a sleep disturbance causing irritability. 3 The client was socially withdrawn and now has recovered. 4 The client is recalling the original trauma from falling
Answer: 4
A nurse has worked on a mental health unit for an extended period of time. Which statement is best associated with behaviors demonstrated as a result of burnout? 1 "These clients are like living with my mother and aunt." 2 "I'm really looking forward to the day I can retire and travel." 3 "I'm so tired; having a four-day stretch off will be so wonderful." 4 "The clients often behave in a manner that makes them unlikable."
Answer:1
The nurse manager is working on a unit support process to prevent compassion fatigue for a busy oncology unit. Which characteristics should be included in the program goals? Select all that apply. 1 Reduce medication errors 2 Develop self-care skills. 3 Add more sick days off. 4 Identify signs of depression. 5 Discuss healthy work relationships. 6 Develop a professional support team
Answer:1,2,4,5,6
A nurse is struggling with balancing family and work and has missed several days this quarter. What strategies does the nurse manager offer for support? Select all that apply. 1 Offer the Employee Assistance Program (EAP). 2 Place the nurse in the disciplinary tract for attendance. 3 Identify self-care aspects to add joy, pleasure, and diversion. 4 Inform the staff to help this nurse with busy tasks. 5 Help the nurse reframe struggles and challenges to find meaning. 6 Encourage the nurse to visit a primary care physician for sleep medication.
Answer:1,3,5
Emergency department staff were overwhelmed with a massive motor vehicle accident that left several dead. What support should the nursing manager provide to reduce acute stress disorders? Select all that apply. 1 Provide a lunch-and-learn on critical debriefing strategies. 2 Provide individual and group debriefing sessions to work out feelings and concerns. 3 Identify staff not coping well and offer the Employee Assistance Program (EAP). 4 Help the staff reframe negative events to provide new positive images. 5 Complete a depression screening on all employees involved. 6 Have the emergency department physician write prescriptions for benzodiazepines.
Answer:2
Which question is the most appropriate to ask when assessing a patient for supportive signs and symptoms for a potential diagnosis of posttraumatic stress disorder (PTSD) related to a sexual assault? 1 "Are you hearing voices?" 2 "Do you experience flashbacks of the rape?" 3 "What are you doing to cope with your anxiety?" 4 "Have you developed any compulsive behaviors since being assaulted?
Answer:2
A veteran who has come for treatment for depression also has diabetes and heart disease. The veteran states he recently got a divorce. What factor will most support a positive outcome for treatment? 1 Self-medicates with alcohol 2 Takes prescription drugs for chronic pain 3 Has reliable family support 4 Is employed at a local factory
Answer:3
The nurse is creating a plan of care for a client who is reporting increased stress related to a new position at work. What nursing intervention can address the short-term effects that the stress has on the hypothalamus-pituitary-adrenal cortex? 1 Maintain adequate fluid intake 2 Monitor blood pressure 3 Implement an exercise routine 4 Screen the client for depression
Answer: 1
A nurse conducts an initial interview with a combat veteran. The veteran says, "The war was years ago, but I still remember my friends who were killed. I don't know why I lived and they died." What is the nurse's priority response? 1 "Are you having any thoughts of harming yourself?" 2 "It's important to think about how good your life is now." 3 "Are you saying you have some guilt about being a survivor?" 4 "The outcomes of war are tragic and stay with us for many years."
Answer: 1
A veteran of the war in Afghanistan tells the nurse, "Everyday, something happens that makes me feel like I'm still there. My family has grown impatient with me. They say it's time for me to move on from that time in my life but I can't." What is the nurse's priority action? 1 Assess the veteran for suicide risk. 2 Refer the veteran for specialized mental health services. 3 Assess the veteran for evidence of traumatic brain injury (TBI). 4 Refer the veteran's family to a posttraumatic stress disorder (PTSD) group
Answer: 1
An adult client received a heart transplant five years ago. Multiple medical complications followed, resulting in persistent irritability, depression, and insomnia. The client's spouse says, "I've walked on eggshells for five years, never knowing when something else will go wrong." What is the nurse's first step regarding the spouse? 1 Explore the spouse's feelings, showing care and compassion. 2 Encourage the spouse to attend a community support group. 3 Teach stress reduction and relaxation techniques to the spouse. 4 Refer the spouse to the primary care provider for health assessment.
Answer: 1
An individual is running to escape a tornado. Which chemical is working to help this person? 1 Epinephrine 2 Amino acids 3 Fatty acids 4 Cortisol
Answer: 1
The client is being admitted for short-term effects of a stress event. What is the nurse likely to find during the assessment? 1 Tachycardia 2 High blood lipid levels 3 Depression 4 Heart disease
Answer: 1
What clients are at risk for posttraumatic stress disorder (PTSD)? Select all that apply. 1 A child after the violent death of his mother from spousal abuse 2 A young man who just completed his first marathon 3 An older woman after the death of her daughter after a long illness 4 A football player after winning a championship game 5 A woman who has just lost her child to cancer 6 A teenage victim of sexual abuse
Answer: 1,3,5,6
A client reports feeling anxious while at work due to an overwhelming assignment. Which type of stressor is this client exhibiting? 1 Physical 2 Psychological 3 Existential 4 Psychosocial
Answer: 2
A couple is planning a large wedding in a city 100 miles from their home. When the couple tells the nurse this information, which response does the nurse expect to be associated with this experience? 1 Distress 2 Eustress 3 Acute stress 4 Depersonalization
Answer: 2
An individual lives in a community adjacent to a military base. Loud jets fly overhead multiple times daily. The client tells the nurse, "They're so loud I can't hear myself think." What is the nurse's first action? 1 Direct the client to report the jet noise to local authorities. 2 Teach relaxation and stress reduction techniques to the client. 3 Assess the client for sensory impairments, particularly auditory. 4 Encourage the client to form a community action group to oppose noise pollution.
Answer: 2
What is the defining characteristic of acute stress disorder that distinguishes it from posttraumatic stress disorder (PTSD)? 1 Occurs after a traumatic event 2 Symptoms resolve within 1 month 3 Sleep is restless with nightmares 4 Irritability caused by basic work and family issues
Answer: 2
What is a short-term effect of stress controlled by the hypothalamus-pituitary-adrenal cortex (HYPAC)? 1 Fluid gain 2 Hypoglycemia 3 Reduced inflammation 4 Muscular tension
Answer: 3