Mental Health Exam #1
D. Assess the facts of the situation
A first-time mother is crying and asks the nurse, "How can I go to work if I can't afford child care?" Which is the nurse's initial action to assist the client with problem- solving? A. Determine the risks and benefits for each alternative B. Formulate goals for resolution of the prob- lem C. Evaluate the outcome of the implemented alternative D. Assess the facts of the situation
C. Reaction formation
A fourth-grade boy teases and makes jokes about a cute girl in his class. This behavior should be identified by a nurse as indicative of which defense mechanism? A. Displacement B. Projection C. Reaction formation D. Sublimation
2, 4, 1, 3
Place the selected steps of the problem-solving process in the correct order. 1. Determine risks and benefits of each option. 2. Formulate goals to resolve the stressful situation. 3. Implement a second alternative. 4. Study the alternatives for dealing with the situation.
D. The client is susceptible to illness due to effects of stress on the immune system.
A client's spouse of 34 years dies unexpectedly. The client cries often and becomes socially isolated. The client's therapist stresses the importance of proper sleep, nutrition, and exercise. What is the best rationale for the therapist's advice? A. An interpersonal approach is indicated for depressed clients. B. Sleep, nutrition, and exercise affect imbalances in neurotransmitters. C. Sleep, nutrition, and exercise will alleviate symptoms of depression. D. The client is susceptible to illness due to effects of stress on the immune system.
B. Reuptake
An instructor is teaching nursing students about neurotransmitters. Which term best explains the process by which neurotransmitters released into the synaptic cleft return to the presynaptic neuron? A. Regeneration B. Reuptake C. Recycling D. Retransmission
A. Reactions to stress are relative rather than absolute. Individual responses to stress vary.
A mental health nurse is speaking with parents who are concerned about their 15-year-old identical twins' responses to stress. One twin becomes anxious and irritable, while the other withdraws and cries. Which is the nurse's best response? A. Reactions to stress are relative rather than absolute. Individual responses to stress vary. B. It is abnormal for identical twins to react differently to similar stressors. C. Identical twins should share the same temperament and respond similarly to stress. D. Environmental influences to stress weigh more heavily than genetic influences.
A. "Psychiatrists use criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders."
A mental health technician asks the nurse, "How do psychiatrists determine which diagnosis to give a patient?" Which is the nurse's best response? A. "Psychiatrists use criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders." B. "Psychiatrists are required to follow hospital policy to diagnose mental disorders." C. "Psychiatrists make diagnoses based on the patient's behavior and other factors." D. "Psychiatrists use on of the 10 diagnostic labels from the American Medical Association."
C. Assist her with the problem-solving process.
An unemployed college graduate confides in the clinic nurse that she is experiencing severe anxiety over not finding a teaching position and that she is having difficulty with independent problem-solving. Which nursing intervention is best? A. Encourage her to use other coping mecha- nisms. B. Complete the problem-solving process for her. C. Assist her with the problem-solving process. D. Encourage her to keep a daily journal of feelings.
A. Defense mechanisms are self-protective responses to stress and do not need to be eliminated
A new psychiatric nurse states, "This client's use of defense mechanisms should be eliminated." Which is a correct evaluation of the nurse's statement? A. Defense mechanisms are self-protective responses to stress and do not need to be eliminated B. Defense mechanisms are maladaptive attempts of the ego to manage anxiety and should always be eliminated C. Defense mechanisms are used by individuals with weak ego integrity and should not be eliminated D. Defense mechanisms cause disintegration of the ego and should be fostered and encouraged
D. Norepinephrine
A nurse concludes that a restless, agitated client is manifesting a fight-or-flight response. The nurse understands the client's response is associated with which neurotransmitter? A. Acetylcholine B. Dopamine C. Serotonin D. Norepinephrine
A. Fidgeting B. Laughing inappropriately D. Nail biting
A nurse is assessing a client who appears to be experiencing moderate anxiety during questioning. Which symptoms might the client demonstrate? Select all that apply. A. Fidgeting B. Laughing inappropriately C. Palpitations D. Nail biting E. Extremely limited attention span
D. The client's behaviors demonstrate no functional impairment, indicating no mental illness.
A nurse is assessing a client who is experiencing occasional feelings of sadness because of the recent death of a beloved pet. The client's appetite, sleep patterns, and daily routine have not changed. How should the nurse interpret the client's behaviors? A. The client's behaviors demonstrate mental illness in the form of depression. B. The client's behaviors are extensive, which indicates the presence of mental illness. C. The client's behaviors are not congruent with cultural norms. D. The client's behaviors demonstrate no functional impairment, indicating no mental illness.
C. Resources are available.
A nurse is assessing a client's response to stress. The nurse concludes that the client is performing a secondary appraisal of a stressful event when the client determines: A. The event is benign. B. The event is irrelevant. C. Resources are available. D. The event is pleasurable.
B. Mental health is successful adaptation to stressors in the internal and external environment.
A nurse is educating a patient about the difference between mental health and mental illness. Which statement indicates teaching was effective? A. Mental health is the absence of any stressors. B. Mental health is successful adaptation to stressors in the internal and external environment. C. Mental health is incongruence between thoughts, feelings, and behavior D. Mental health is a diagnostic category in the DSM-5.
A. "Medications are one way to address chemical imbalances. Environmental and interpersonal factors can also have an impact on biological factors."
A depressed client states, "I have a chemical imbalance in my brain. I have no control over my behavior. Medications are my only hope to feel normal again." Which response by the nurse is best? A. "Medications are one way to address chemical imbalances. Environmental and interpersonal factors can also have an impact on biological factors." B. "Biological factors are the sole cause of depression, so medications will improve your mood." C. "Environmental factors have been shown to exert the most influence in the development of depression." D. "Researchers have been unable to demonstrate a link between biology and genetics."
B. Maladaptive coping
A 32-year-old woman is speaking to the office nurse at an initial visit. The nurse asked, "What brings you in today?" The woman replied, "I have been having headaches three to four times a week for the past month or so. I'm not sleeping well and feel tired most of the time. I work 60 hours per week and am going through a divorce." The nurse determines the client's symptoms represent which of the following? A. Adaptive coping B. Maladaptive coping C. Problem-solving D. Self-awareness
D. "The limbic system is largely responsible for one's emotional state."
A client diagnosed with major depressive disorder asks, "What part of my brain controls my emotions?" Which nursing response is best? A. "The occipital lobe judges perceptions as positive or negative." B. "The parietal lobe has been linked to depression." C. "The medulla regulates key biological and psychological activities." D. "The limbic system is largely responsible for one's emotional state."
C. Neurotransmitters
A client diagnosed with schizophrenia expresses little emotion and refuses to attend group therapy. The nurse recognizes the client's behavior is influenced by which component of the nervous system? A. Dendrites B. Axons C. Neurotransmitters D. Synapses
C. Needs further assessment of the client's coping skills to determine susceptibility to stress-related illness.
A client has experienced the death of a close family member and at the same time becomes unemployed. The client's 6-month score on the Recent Life Changes Questionnaire is 110. The nurse: A. Understands the client is at risk for significant stress-related illness. B. Determines the client is not at risk for significant stress-related illness. C. Needs further assessment of the client's coping skills to determine susceptibility to stress-related illness. D. Recognizes the client may view the losses as challenges and perceive them as opportunities.
B. Dopamine
A client is admitted to a psychiatric unit with the diagnosis of catatonic schizophrenia. Which of the client's neurotransmitters should the nurse expect to be elevated? A. Serotonin B. Dopamine C. Gamma-aminobutyric acid (GABA) D. Histamine
D. Decreased levels of acetylcholine
A client is admitted to the emergency department experiencing memory deficits and decreased motor function. What alteration in brain chemistry should the nurse correlate with the presentation of these symptoms? A. Abnormal levels of serotonin B. Decreased levels of dopamine C. Increased levels of norepinephrine D. Decreased levels of acetylcholine
B. "Your reactions to past experiences influence your current feelings."
A client tells the nurse, "I experience stress on a regular basis. Why do I feel this way?" Which is the nurse's most appropriate response? A. "Genetics has nothing to do with your tem- perament or feelings." B. "Your reactions to past experiences influence your current feelings." C. "Your stress level is lower when you are in good physical health." D. "You'll experience less stress if you use appropriate coping skills."
A. "What resources have you used previously in stressful situations?" B. "Have you ever experienced a similar stressful situation?" E. "What skills do you possess that might lead to gainful employment?"
A nurse is interviewing a distressed client who reports being fired after 15 years of loyal employment. Which of the following questions best assists the nurse to determine the client's appraisal of the situation? Select all that apply. A. "What resources have you used previously in stressful situations?" B. "Have you ever experienced a similar stressful situation?" C. "Who do you think is to blame for this situa- tion?" D. "Why do you think you were fired from your job?" E. "What skills do you possess that might lead to gainful employment?"
C. Possessing a feeling of self-fulfillment and realizing full potential
A nurse is performing a mental health assessment on an adult client. According to Maslow's hierarchy of needs, which client action would demonstrate the highest achievement in terms of mental health? A. Maintaining a long-term, faithful, intimate relationship B. Achieving a sense of self-confidence C. Possessing a feeling of self-fulfillment and realizing full potential D. Developing a sense of purpose and the ability to direct activities
B. Awareness of factors creating stress
A nurse is providing education on anxiety and stress management. Which of the following should be identified as the most important initial step in learning how to manage anxiety? A. Diagnostic blood tests B. Awareness of factors creating stress C. Relaxation exercises D. Identification of support systems
A. "Enjoy a pet." B. "Spend time with a loved one." C. "Listen to music." D. "Focus on the stressors."
A nurse is working with a client who has recently been under a great deal of stress. Which nursing recommendations would be most helpful to assist the client to cope with stress? Select all that apply. A. "Enjoy a pet." B. "Spend time with a loved one." C. "Listen to music." D. "Focus on the stressors." E. "Journal your feelings."
D. "When an individual's physiological and psychological resources are depleted."
A nursing instructor asks students when diseases of adaptation are likely to occur. Which student response indicates that teaching is effective? A. "When an individual has limited experience dealing with stress." B. "When an individual inherits maladaptive genes." C. "When an individual experiences existing conditions that exacerbate stress." D. "When an individual's physiological and psychological resources are depleted."
C. Exhaustion
A nursing student comes down with a sinus infection toward the end of every semester. Which stage of stress is the student most likely experiencing when this occurs? A. Alarm reaction B. Resistance C. Exhaustion D. Fight or flight
B. Watery eyes D. Increased heart rate E. Increased respirations
A patient presents in the emergency department immediately following a shooting incident in a school where she has been teaching. There is no evidence of physical injury, but she appears very hyperactive and talkative. Which are common initial biological responses to stress? Select all that apply. A. Constricted pupils B. Watery eyes C. Unusual food cravings D. Increased heart rate E. Increased respirations
D. A challenge.
A physically and emotionally healthy client has just been fired. During a routine office visit, he tells the nurse, "Perhaps this was the best thing to happen. Maybe I'll consider pursuing an art degree." The nurse determines the client perceives the stressor of his job loss as: A. Irrelevant. B. Harm/loss. C. A threat. D. A challenge.
D. "A threat to self-esteem can result in psy- chological stress."
A school nurse is assessing a female high-school student who is overly concerned about her appearance. The client's mother states, "That's not something to be stressed about!" Which response by the nurse is best? A. "Teenagers! They don't know a thing about real stress." B. "Psychological or physical stress occur only when there is a loss." C. "Poor physical condition can interfere with psychological well-being." D. "A threat to self-esteem can result in psy- chological stress."
B. Problem-solving training
A student confides in the school nurse that he is "stressed out" about deciding whether to go to college or work to provide income the family needs. Which coping strategy is the nurse's best recommendation? A. Meditation B. Problem-solving training C. Relaxation D. Journaling
C. Angrily criticizes a coworker
A supervisor openly disagrees with an employee's suggestions during a staff meeting. The employee's behavior represents the defense mechanism of displacement when he does which of the following actions? A. Assertively confronts the supervisor B. Abruptly leaves the staff meeting C. Angrily criticizes a coworker D. Takes the supervisor to lunch
B. Projection
A teenage boy is attracted to a female teacher. Without objective evidence, a school nurse overhears the boy state, "I know she wants me." This statement reflects which defense mechanism? A. Displacement B. Projection C. Rationalization D. Sublimation
B. A client exhibiting aggressive behavior toward another client
According to Maslow's hierarchy of needs, which situation on an inpatient psychiatric unit would require priority intervention by a nurse? A. A client rudely complaining about limited visiting hours B. A client exhibiting aggressive behavior toward another client C. A client stating that no one cares D. A client verbalizing feelings of failure
A. Incomprehensibility and cultural relativity
Most cultures label behavior as mental illness on the basis of which of the following criteria? A. Incomprehensibility and cultural relativity B. Strength of character and ethics C. Goal directedness and high energy D. Creativity and good coping skills
C. "Yes, it was a difficult relationship, but I think I have learned from the experience."
Devastated by a divorce from an abusive husband, a wife completes grief counseling. Which statement by the wife should indicate to a nurse that the client is in the acceptance stage of grief? A. "If only we could have tried again, things might have worked out." B. "I am so mad that the children and I had to put up with him as long as we did." C. "Yes, it was a difficult relationship, but I think I have learned from the experience." D. "I still don't have any appetite and continue to lose weight."
C. "Psychological factors, like excessive stress, have been found to affect medical conditions."
During an intake assessment, a nurse asks both physiological and psychosocial questions. The client angrily responds, "I'm here for my heart, not my head problems." Which is the nurse's best response? A. "It's just a routine part of our assessment. All clients are asked these same questions." B. "Why are you concerned about these types of questions?" C. "Psychological factors, like excessive stress, have been found to affect medical conditions." D. "We can skip these questions, if you like. It isn't imperative that we complete this section."
A. It informs the nurse of accurate and reliable medical diagnosis. B. It represents progress toward a more holistic view of mind-body. C. It provides a framework for interdisciplinary communication.
How is the DSM-5 useful in the practice of psychiatric nursing? Select all that apply. A. It informs the nurse of accurate and reliable medical diagnosis. B. It represents progress toward a more holistic view of mind-body. C. It provides a framework for interdisciplinary communication. D. It provides a template for nursing care plans. E. It provides a framework for communication with the client.
A. An achieved state of relaxation
Meditation has been shown to be an effective stress management technique. Which nursing assessment indicates meditation has been effective? A. An achieved state of relaxation B. An achieved insight into one's feelings C. A demonstration of appropriate role behav- iors D. An enhanced ability to problem-solve
D. An individual's personal perception of the event is excluded.
Miller and Rahe (1997) identified a correlation between the effects of life change and illness. This research led to the development of the Recent Life Changes Question- naire (RLCQ). Which principle most limits the effectiveness of this tool? A. Specific physical and psychological illnesses are not identified. B. Numerical values associated with specific life events are randomly assigned. C. Stress is viewed as a solely physiological response. D. An individual's personal perception of the event is excluded.
3, 1, 2, 4, 5
Place Kubler-Ross' stages of feelings related to loss in the correct order. 1. Anger 2. Bargaining 3. Denial 4. Depression 5. Acceptance
B. Psychoneuroimmunology
Six months after her husband and children were killed in a car accident, a client is diagnosed with ulcerative colitis. The nurse should recognize that this situation validates which study perspective? A. Neuroendocrinology B. Psychoneuroimmunology C. Diagnostic technology D. Neurophysiology
B. "The concepts are multidimensional and culturally defined"
Teaching regarding the concepts of mental health and mental illness is effective when the student nurse states which of the following? A. "The concepts are rigid and based in religious beliefs" B. "The concepts are multidimensional and culturally defined" C. "The concepts are universal and unchanging" D. "The concepts are fixed and unidimensional"
D. "Your body responded to the stress of knowing the car was going to hit you."
The emergency department nurse is providing discharge instructions to a 23- year-old man who was injured in a motor vehicle crash. The client stated, "My heart was racing when I saw the car coming through the red light was going to hit me. I didn't know my heart could go that fast!" Which is the nurse's best response? A. "Don't worry, your heart is strong because you are young and in good health." B. "Everyone gets scared when they realize another car is going to hit them." C. "You had a panic attack when you saw the car that hit you was not going to stop." D. "Your body responded to the stress of knowing the car was going to hit you."
C. Accuses his wife of infidelity and betrayal
The mental health nurse is conducting an intake interview with a couple seeking marital counseling. The nurse recognizes the husband is using the ego defense mechanism of projection when he exhibits which of the following? A. Stamps his feet and demands his wife honor her vows B. Ignores his wife's continues absence from the home C. Accuses his wife of infidelity and betrayal D. Takes out his frustration by verbally abusing his coworkers
B. Increased peristalsis
The nurse identifies which symptom as typical of the fight-or-flight response? A. Decreased heart rate B. Increased peristalsis C. Increased salivation D. Pupil constriction
B. Existing conditions
The nurse in the intensive care unit (ICU) is giving report to the nurse on the cardiac step-down unit. The nurse states, "The patient is a 48-year-old woman admitted 3 days ago for chest pain and a stent placement. Vital signs are stable, but I am worried about her stress level. She said she just moved here due to a job transfer and her husband stayed behind to sell the house. She told me they have a high insurance deductible and she is worried about the hospital bill." Which factor has the most significant influence on the client's health? A. Coping skills B. Existing conditions C. Individual vulnerability D. Perceived threat
A. Anticipatory grief
The nurse is caring for a client admitted to the palliative care unit. The client's spouse has been at the client's bedside since the client was admitted. One week ago, the spouse began to visit 2 or 3 hours a day. The nurse understands the spouse is experiencing which of the following? A. Anticipatory grief B. Bereavement C. Depression D. Resolution
B. Rationalization
The nurse is interviewing a client with a history of excessive drinking and multiple arrests for impaired driving. The client states, "I work hard to provide for my family. I don't see why I can't drink to relax." The nurse recognizes the client is using which defense mechanism? A. Projection B. Rationalization C. Regression D. Sublimation
D. Major depressive disorder
The nurse recognizes that a decrease in norepinephrine levels plays a significant role in which disorder? A. Mania B. Schizophrenia C. Anxiety D. Major depressive disorder
B. Mild anxiety enhances patient learning
The nurse recognizes which principle underlies effective patient teaching? A. Moderate to severe anxiety increases patient learning B. Mild anxiety enhances patient learning C. Panic-level anxiety improves nurses' teaching D. Severe anxiety intensifies concentration and enhances attention
C. Anorexia nervosa
The nurse understands that abnormal levels of growth hormone may play a role in which disorder? A. Acute mania B. Schizophrenia C. Anorexia nervosa D. Alzheimer's disease
B. Limbic system
The nursing instructor described cerebral structures and the "emotional brain" to students. Teaching is effective if the students identify which brain structure? A. Cerebellum B. Limbic system C. Cortex D. Left temporal lobe
B. Personally relevant.
The school nurse is assessing a female high school student who is distraught because her parents can't afford horseback riding lessons. The nurse recognizes the student's perception is that the problem is: A. Endangering her well-being. B. Personally relevant. C. Based on immaturity. D. Exceeds her capacity to cope.
A. Decreased resistance to disease
When an individual's stress response is sustained over a long period, the nurse anticipates which physiological effect? A. Decreased resistance to disease B. Increased libido C. Decreased blood pressure D. Increased inflammatory response
D. Saying to the spouse, "I don't drink too much!"
When under stress, a client routinely uses an excessive amount of alcohol. Finding her drunk, her husband yells at her about the chronic alcohol abuse. Which reaction should the nurse recognize as the use of the defense mechanism of denial? A. Hiding liquor bottles in a closet B. Yelling at their son for slouching in his chair C. Burning dinner on purpose D. Saying to the spouse, "I don't drink too much!"
C. Panic disorder
Which client diagnosis should the nurse associate with a decrease in GABA? A. Alzheimer's disease B. Schizophrenia C. Panic disorder D. Depression
A. "Avoiding contact with others helps me cope."
Which client statement alerts the nurse that the client may be responding maladaptively to stress? A. "Avoiding contact with others helps me cope." B. "I really enjoy journaling; it's my private time." C. "I signed up for a yoga class this week." D. "I made an appointment to meet with a therapist."
C. "I'm a morning person, so I get my best work done in the a.m."
Which client statement indicates the nurse's teaching about the effect of circadian rhythms is effective? A. "When I dream about my mother's horrible train accident, I become hysterical." B. "I get really irritable during my menstrual cycle." C. "I'm a morning person, so I get my best work done in the a.m." D. "Every February, I tend to experience periods of sadness."
A. Availability of resources C. Genetics D. Past experiences
Which concepts are included in Hobfoll's Conservation of Resources theory? Select all that apply. A. Availability of resources B. Disequilibrium C. Genetics D. Past experiences E. Resilience
B. Generalized anxiety disorder
Which disorder does the nurse recognize as a disorder in the DSM-5? A. Morbid obesity B. Generalized anxiety disorder C. Essential hypertension D. Bereavement
B. Demonstrates impaired daily functioning and maladaptive responses to stress
Which indicates to the nurse a client is at risk for developing a mental disorder? A. Expresses thoughts, feelings, and behaviors included amond Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria B. Demonstrates impaired daily functioning and maladaptive responses to stress C. Communicates significant distress that has not interfered with important activities D. Employs various defense mechanisms to protect the ego from anxiety
D. An adult throws a temper tantrum when he does not get his own way.
Which is an example of the ego defense mechanism of regression? A. A mother blames the teacher for her child's failure in school. B. A teenager becomes hysterical after seeing a friend killed in a car accident. C. A woman wants to marry a man exactly like her beloved father. D. An adult throws a temper tantrum when he does not get his own way.
D. Problem-solving will be limited.
Which is the most significant consequence of the excessive use of defense mechanisms? A. The superego will be suppressed. B. Emotions will be experienced intensely. C. Learning and the ability to grow will be enhanced. D. Problem-solving will be limited.
B. Schizophrenia
Which mental illness should a nurse identify as being associated with a decrease in prolactin hormone level? A. Major depressive disorder B. Schizophrenia C. Anorexia nervosa D. Alzheimer's disease
B. "An individual experiencing neurosis feels helpless to change his or her situation."
Which nursing statement about the concept of neuroses is most accurate? A. "An individual experiencing neurosis is unaware that he or she is experiencing distress." B. "An individual experiencing neurosis feels helpless to change his or her situation." C. "An individual experiencing neurosis is aware of psychological causes of his or her behavior." D. "An individual experiencing neurosis has a loss of contact with reality."
A. Local or cultural norms define pathological behavior. B. The higher the social class the greater the recognition of mental illness behaviors. C. Psychiatrists typically see patients when the family can no longer deny the illness.
Which of the following are cultural aspects of mental illness? Select all that apply. A. Local or cultural norms define pathological behavior. B. The higher the social class the greater the recognition of mental illness behaviors. C. Psychiatrists typically see patients when the family can no longer deny the illness. D. The greater the cultural distance from the mainstream of society, the greater the likelihood that the illness will be treated with sensitivity and compassion.
C. Environmental mastery E. Integration
Which of the following are included in Jaboda's indicators of mental health? Select all that apply. A. Acceptance B. Creativity C. Environmental mastery D. Fulfillment E. Integration
B. Dorothea Dix
Which of the following believed mental illness was curable? A. Benjamin Rush B. Dorothea Dix C. Florence Nightingale D. Linda Richards
D. Adaptation
Which of the following is determined by the degree to which thoughts, feelings, and behaviors interfere with an individual's functioning? A. Anxiety B. Defense mechanisms C. Mental health D. Adaptation
A, C, E
Which of the following statements should a nurse recognize as true about defense mechanisms? Select all that apply. A. They are employed when there is a threat to biological or psychological integrity. B. They are controlled by the id and deal with primal urges. C. They are used in an effort to relieve mild to moderate anxiety. D. They are protective devices for the superego. E. They are mechanisms that are characteristically self-deceptive.
A, C, E
Which of the following were attributed to mental illness prior to the influence of Middle Eastern countries? Select all that apply. A. Supernatural Forces B. Medical conditions C. Disequilibrium of humors D. Personality E. Demons
C. Sympathetic nervous system
Which part of the nervous system should the nurse identify as playing a major role during stressful situations? A. Peripheral nervous system B. Somatic nervous system C. Sympathetic nervous system D. Parasympathetic nervous system
A. Somatic symptom disorders
Which psychoneurotic responses to severe anxiety are identified in the DSM-5? A. Somatic symptom disorders B. Grief reactions C. Psychosis D. Bipolar disorder
D. A woman was raped when she was 12 and no longer remembers the incident.
Which should the nurse recognize as an example of the defense mechanism of repression? A. A student aware of the need to study for tomorrow's test goes to a movie instead. B. A woman whose son was killed in Iraq does not believe the military report. C. A man who is unhappily married goes to school to become a marriage counselor. D. A woman was raped when she was 12 and no longer remembers the incident.