Psych Exam 3 Study Guide
What is the medical term for chronic nail biting?
Onychophagia
Name the "Big Five" Personality Traits:
Openness to experience Conscientiousness Extroversion Agreeableness Neuroticism
Cognitive therapy works with and treats cognitive ______________________?
Distortions
Name the term: Dimension of personality characterized by emotional instability and being prone to emotional distress.
Neuroticism
Venlafaxine and Duloxetine are what class of medications and used for the treatment of Anxiety disorders?
SNRI Antidepressants
Name the stage: "The adaptation stage is when the body attempts to adapt to the stressor." 1. Exhaustion 2. Alarm 3. Resistance
3. Resistance
What are the 3 stages of General Adaptation Syndrome (GAS)?
Alarm Resistance Exhaustion
Diazepam and Lorazepam are what class of medication?
Benzodiazepines
Sertraline and paroxetine are what class of medications and the first line of treatment for Anxiety and OCD?
SSRI Antidepressants
The human physiological response caused by a stressor is known as a ______________________________________________________ response, which was originally investigated by Walter Cannon (Frothingham, 2021, p. 2). This term illustrates an individual's involuntary response when faced with a life-threatening situation.
"fight or flight"
A nurse is caring for a client who has emphysema and recently reduced their level of activity because they fear developing dyspnea. When teaching the client to use guided imagery, which of the following should the nurse encourage the client to visualize? a. Walking on a beach without using supplemental oxygen b. Sleeping comfortably and soundly, without respiratory distress c. Placing their hand to feel the rise and fall of their chest d. Dangling feet in a pool and taking regular deep breaths
d. Dangling feet in a pool and taking regular deep breaths
A nurse is assisting in the care of a client who states, "When I am stressed at work, I can't help coming home and arguing with my partner." The nurse should recognize that the client is exhibiting which of the following defense mechanisms? a. Intellectualization b. Projection c. Sublimation d. Displacement
d. Displacement
High temperature, increased respirations, irritability and confusion are all signs of withdrawal from what substance?
Alcohol
Within the '"fight or flight" response, was are the 5 individual responses?
Fight - facing the stressor or situation ready to confront or fight Faint - limiting exposure to stress by physically fainting, or experiencing syncope Flight - running away from or fleeing the stressor or situation Freeze - unable to respond or react against the stressor or situation Fawn - attempting to please or give in to the stressor or situation
Name the different levels of anxiety:
Mild Moderate Severe Panic
After the traumatic event has occurred, at what time does or can PTSD manifestations start?
after 1 month
Name the stage: "The body has depleted its resources in an attempt to overcome the stress but has been unsuccessful." 1. Exhaustion 2. Alarm 3. Resistance
1. Exhaustion
This tool is used to determine severity of alcohol withdrawal and needed medication to manage the withdrawal safely?
CIWA-Ar
What are the main optimal pharmacological treatment for OCD?
SSRI antidepressants (ex: Fluvoxamine or Sertraline- 1st line followed by Venlafaxine) Second- generation Antipsychotics (ex: Risperidone, Quetiapine, Olanzapine)
Identify the term: The ability to successfully adapt to difficult or challenging life experiences that are mentally and emotionally challenging, requiring flexibility in behaviors to adapt to external and internal demands. 1. Stress 2. Maladaptive 3. Resilience 4. Distress
3. Resilience
Identify the term: Negative stress response which has a detrimental effect both physically and psychologically on an individual. 1. Stress 2. Maladaptive 3. Resilience 4. Distress
4. Distress
Name the stage: "The intense acute stress stage is where the body provides an adaptive response to the stressor." 1. Exhaustion 2. Alarm 3. Resistance
2. Alarm
Nurse Vicky is assessing a newly admitted client for symptoms of post-traumatic stress disorder (PTSD). Which symptoms are typically seen with this diagnosis? Select all that apply. A. Anger with numbing of other emotions. B. Exaggerated startle response. C. Feeling that one is having a heart attack. D. Frequent thoughts about contamination. E. Frequent nightmares. F. Survivor's guilt.
(A,B,E,F) A. Anger with numbing of other emotions. B. Exaggerated startle response. E. Frequent nightmares. F. Survivor's guilt.
Naltrexone is what class of medication and blocks the effects of opioids?
opioid antagonist
Name the term: The body's response to destroy antigens including inflammation or microbes including leukocytes.
Immune Response
Match the type of stress: ACUTE CHRONIC TOXIC A. Prolonged internal and external exposure to stressful events, situations, or experiences (stressors). B. Response to a stressor which activates the body's stress response for a short period of time in response to a temporary stressor. C. Prolonged activation of the physiologic stress response system due to chronic exposure to neglect, interpersonal violence, community violence, or bullying.
A. = CHRONIC B. = ACUTE C:. = TOXIC
A nurse is meeting with a new client at a substance use disorder clinic. During the meeting, the nurse observes that the patient is anxious, fidgeting in their chair, and sweating profusely. Which of the following types of data describes the client's actions? A. Objective B. Historical C. Secondary D. Subjective
A. Objective
Name the term: The use of strategies, both cognitive and behavioral, to recognize and manage during the stress response and reduce the negative effects of stress.
Coping
When a person is exposed to stress, what hormone and protein, is released in the body?
Cortisol (Hormone) Cytokines (Protein)
A nurse at Nurseslabs Medical Center is developing a care plan for a female client with post-traumatic stress disorder. Which of the following would she do initially? A. Instruct the client to use distraction techniques to cope with flashbacks. B. Encourage the client to put the past in proper perspective. C. Encourage the client to verbalize thoughts and feelings about the trauma. D. Avoid discussing the traumatic event with the client.
C. Encourage the client to verbalize thoughts and feelings about the trauma.
A client is experiencing an anxiety attack. The most appropriate nursing intervention should include? A. Turning on the television. B. Leaving the client alone. C. Staying with the client and speaking in short sentences. D. Ask the client to play with other clients.
C. Staying with the client and speaking in short sentences.
A nurse is caring for a 78-year-old client who is being seen for hypertension. The client has type 2 diabetes mellitus with neuropathy and high cholesterol. At their routine provider's visit, the client reports to the intake nurse that they have been drinking alcohol more heavily lately ever since their partner passed away. One of their friends told them they should cut down on the alcohol use. What are risk factors for alcohol or substance use in the older adult population? A. Belonging to community clubs or other social groups where drinking and drug use occurs B. Female gender, high socio-economic status, college graduate C. Experiencing emotional instability such as anger issues and mood fluctuations D. Chronic medical conditions, pain, emotional losses, male gender
D. Chronic medical conditions, pain, emotional losses, male gender
A nurse is caring for a client who is experiencing chronic stress. Which of the following does the nurse anticipate that the client will report? (Select all that apply.) Increased anxiety Recurring sinus infections Feelings of depression Sudden bursts of energy Daily overeating Heart palpitations
Increased anxiety Recurring sinus infections Feelings of depression
A nurse is facilitating a group session on adaptive defense mechanisms. The nurse should identify which of the following client statements as examples of adaptive defense mechanisms? (Select all that apply.) a. "When I get stressed out, I like to go to the gym." b. "I volunteer at a local substance use help group." c. "When I get home from school, it's hard to hear things for hours after." d. "When people are mean to me, I am mean right back to them." e. "I was so upset after I failed my exam that I broke my laptop."
a. "When I get stressed out, I like to go to the gym." b. "I volunteer at a local substance use help group."
A nurse is caring for a client who has a history of anxiety and hypertension. The nurse should recommend which of the following relaxation techniques for the client? a. Biofeedback b. Prayer c. Reading a book d. Drawing
a. Biofeedback
A nurse is caring for a client who is exhibiting manifestations of anxiety. Which of the following manifestations would the nurse expect to see increase during the client's flight or flight response? (Select all that apply.) a. Blood pressure b. Heart rate c. Respiratory rate d. Bowel sounds e. Pupillary response
a. Blood pressure b. Heart rate c. Respiratory rate e. Pupillary response
A nurse is caring for a client undergoing a procedure and encourages the client to imagine themselves lying on the beach. Which of the following coping styles is the nurse suggesting? a. Guided imagery b. Deep breathing c. Fantasy d. Adjusting expectations
a. Guided imagery
A nurse is caring for a client who is exhibiting hypervigilance and restlessness. The client states, "I need to figure a way out of this mess." The nurse should recognize that the client is most likely in which of the following stages of anxiety? a. Mild b. Moderate c. Severe d. Panic
a. Mild
A nurse is assisting in planning education for a group of teachers on personality traits. Which of the following traits describes a student who is eager to learn? a. Openness b. Extraversion c. Conscientiousness d. Agreeableness
a. Openness
A nurse is discussing individual and environmental factors of stress response with a group of newly licensed nurses. The nurse should include which of the following as individual factors? (Select all that apply.) a. Perception b. Temperament c. Lifestyle d. Culture e. Religion
a. Perception b. Temperament c. Lifestyle
A nurse is caring for a client in a clinic. The client states, "I am overwhelmed by stress." Which of the following should the nurse identify as the highest priority question to ask the client? a. "Do you have any relatives who have problems with stress?" b. "How much physical activity do you typically get in a day?" c. "What kinds of things do you find helpful for coping with your stress?" d. "How much sleep do you get each night?"
c. "What kinds of things do you find helpful for coping with your stress?"
A nurse is assisting in the care of a client whose partner recently died. The client asks, "Do you think meditation helps with stress?" Which of the following responses should the nurse make? a. "I will give you some meditation techniques that I use to help with stress." b. "There is no clinical evidence that meditation helps, but it wouldn't hurt." c. "You may find meditation gives comfort and lowers your stress." d. "Using meditation along with another effective coping strategy may help you."
c. "You may find meditation gives comfort and lowers your stress."
A nurse is leading a group of clients who are using the Holmes-Rahe Life Stress Inventory Scale to self-assess stressors in their life. Which of the following findings indicates the highest degree of stress? a. A client who has reported being assigned more responsibility at work b. A client with children who will be relocating to a new city for work. c. A client who is returning to college following the loss of their job d. A client who is recently separated from their spouse
c. A client who is returning to college following the loss of their job
A nurse is assisting in the care of a client who states, "My cardiologist told me that I need to reduce stress. What is the best way for me to do that?" Which of the following responses should the nurse make first? a. "Physical exercise has been shown to be beneficial in reducing stress." b. "Self-help books are a good way to learn strategies to reduce stress." c. "It might be a good idea for you to try painting to help reduce your stress." d. "Tell me more about the stressors that you are facing in your life."
d. "Tell me more about the stressors that you are facing in your life."
Olanzapine is what medication class and used as treatment for Bipolar disorder, manic disorder and schizophrenia?
atypical antipsychotics
Name the medical term for compulsive buying often felt as a reward-seeking behavior?
Oniomania
________________________ is characterized as a response to an unpleasant or threatening event or situation
Stress
A nurse is providing care to a client who was recently involved in a motor-vehicle crash. The nurse should identify that the client is in the moderate stage of anxiety based on which of the following behaviors? a. Answering questions with the response, "I am glad to be alive." b. Becoming unconscious after seeing a video of the accident c. Jumping off the bed and running out the door d. Practicing deep breathing with the nurse
d. Practicing deep breathing with the nurse
The psychiatric nurse uses cognitive-behavioral techniques when working with a client who experiences panic attacks. Which of the following techniques are common to this theoretical framework? Select all that apply. A. Administering anti-anxiety medication as prescribed. B. Encouraging the client to restructure thoughts. C. Helping the client to use controlled relaxation breathing. D. Helping the client examine evidence of stressors. E. Questioning the client about early childhood relationships. F. Teaching the client about anxiety and panic.
(B,C,D,F) B. Encouraging the client to restructure thoughts. C. Helping the client to use controlled relaxation breathing. D. Helping the client examine evidence of stressors. F. Teaching the client about anxiety and panic.
A nurse is providing teaching about stress with a client. The nurse should identify that which of the following client statements indicates an understanding of the teaching? a. "My stressor will all go away when I retire." b. "My stress could be related to my culture." c. "My attitude about my stressor can influence my coping." d. "I can decrease my stress by getting a new job."
c. "My attitude about my stressor can influence my coping."
Genevieve only attends social events when a family member is also present. She exhibits behavior typical of which anxiety disorder? A. Agoraphobia B. Generalized anxiety disorder C. Obsessive-compulsive disorder D. Post-traumatic stress disorder
A. Agoraphobia Correct Answer: A. Agoraphobia Agoraphobia is a disorder characterized by avoidance of situations in which escape may not be possible or help may be unavailable. Agoraphobia is the anxiety that occurs when one is in a public or crowded place, from which a potential escape is difficult, or help may not be readily available. It is characterized by the fear that a panic attack or panic-like symptoms may occur in these situations. Individuals with agoraphobia, therefore, strive to avoid such situations or locations.
A nurse is providing education to a group of clients about neurotransmitters. Which of the following neurotransmitters should the nurse include that is implicated in the reward pathway of the brain and addiction? A. Dopamine B. Serotonin C. Norepinephrine D. Y-aminobutyric acid
A. Dopamine
A nurse is reviewing a client's risk for substance use disorder. Which of the following information about ingestion routes accurately describes substance addiction potential? A. Smoking or injecting a substance increases the potential for addiction. B. Taking pills orally increases risk for addiction because pills are easy to access and use. C. Some routes of substance use give the addict slower, more drawn-out pleasure from the drug. D. The route does not make a difference, but the specific drug consumed is the factor.
A. Smoking or injecting a substance increases the potential for addiction.
Nurse Martha is teaching her students about anxiety medications; she explains that benzodiazepines affect which brain chemical? A. Acetylcholine B. Gamma-aminobutyric acid (GABA) C. Norepinephrine D. Serotonin
B. Gamma-aminobutyric acid (GABA) Correct Answer: B. Gamma-aminobutyric acid (GABA) Anti Anxiety medications stimulate the neurotransmitter GABA, which is a chemical associated with relaxation. The other options are not affected by benzodiazepines. Benzodiazepines are a class of drugs that act upon benzodiazepine receptors (BZ-R) in the central nervous system (CNS). The receptor is a protein composed of five transmembrane subunits that form a chloride channel in the center, i.e., GABA-A receptor. The five subunits consist of two alpha, two beta, and one gamma subunit. The extracellular portions of the alpha and beta subunit proteins form a receptor site for gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter.
Mandy, a nurse who works at Nurseslabs Rehabilitation Center is assessing a client for recent stressful life events. She recognizes that stressful life events are both: A. Desirable and growth-promoting B. Positive and negative C. Undesirable and harmful D. Predictable and controllable
B. Positive and negative Correct Answer: B. Positive and negative The concept of stressful life events is based on the research of Holmes and Rahe, who found that both positive and negative changes result in stress. Stressful life events, or life event stressors, are undesirable, unscheduled, nonnormative, and/or uncontrollable discrete, observable events with a generally clear onset and offset that usually signify major life changes. Stressful life events have significant negative consequences for both physical and psychological well-being.
A nurse is caring for a client who was hospitalized with a high blood alcohol content level. The provider fears the client may go into withdrawal and require medical supervision. The client's manifestations now include anxiety, tremors, BP 166/100 mm Hg, and tachypnea. The nurse should recognize that the client is experiencing which of the following stages of withdrawal from alcohol? A. Stage 1- MILD B. Stage 2- MODERATE C. Stage 0- Pre-Withdrawal D. Stage 3- SEVERE
B. Stage 2- MODERATE
Marty is pacing and complains of racing thoughts. Nurse Lally asks the client if something upsetting happened, and Marty's response is vague and not focused on the question. Nurse Lally assess Marty's level of anxiety as: A. Mild B. Moderate C. Severe D. Panic
C. Severe Correct Answer: C. Severe When the client has difficulty focusing and exhibits excessive motor activity, the level of anxiety is severe. Severe anxiety is intensely debilitating, and symptoms of severe anxiety meet key diagnostic criteria for clinically-significant anxiety disorder. People with severe anxiety typically score higher on scales of distress and lower on functioning. Severe anxiety symptoms also frequently co-occur with major depression, which can contribute to greater disability.
Name the term: A positive stress response to a challenging but beneficial task that results in development growth, mastery, or a sense of fulfillment.
Eustress
What is the medical term for "skin picking" which is common with patient's suffering from OCD as a soothing behavior?
Excoriation disorder a.k.a Dermatillomania
What body systems are affected during the Physiological Effects of Fight-Flight-Freeze-Fawn Response?
Heart Lungs Skin Pancreas Endocrine system
A nurse is discussing risk factors of negative stress responses with a group of clients. The nurse should include which of the following risk factors in the discussion? (Select all that apply.) Birth order Temperament Interpersonal violence Health behaviors Financial stability Sex
Temperament Interpersonal violence Health behaviors
A nurse is reinforcing teaching about physiological responses to stress with a group of clients. The nurse should include which of the following short-term physiological changes in the teaching? (Select all that apply.) a. Increase in muscular tension, blood pressure, and triglycerides b. Increase in heart rate and respiratory rate c. Corticosteroid release increases stamina and impedes digestion d. Cortisol release increases glucogenesis and reduces fluid loss e. Increased immune system function f. Increased risk of depression, autoimmune disorders, and heart disease
a. Increase in muscular tension, blood pressure, and triglycerides b. Increase in heart rate and respiratory rate c. Corticosteroid release increases stamina and impedes digestion d. Cortisol release increases glucogenesis and reduces fluid loss
A nurse is caring for a client who was in a motor-vehicle crash. The client states, "I had to get home before 6pm so I had to drive really fast." Which of the following defense mechanisms is the client exhibiting? a. Rationalization b. Displacement c. Identification d. Altruism
a. Rationalization
A nurse is assisting in the care of a client who attempted to die by suicide. The client is currently undergoing cognitive behavioral therapy. Which of the following statements by the client indicates that the therapy has been effective? a. "I have removed all of the mirrors from my house." b. "I guess I am fortunate to have survived my suicide attempt." c. "It is hard to go out when you know that everyone is laughing at you." d. "At least now when people stare at me, I have enough courage to tell them off."
b. "I guess I am fortunate to have survived my suicide attempt."
A nurse is leading a group of clients in an outpatient setting. The nurse should recognize which of the following client statements as an example of a maladaptive defense mechanism? a. "When I get overly stressed at work, I need to just get out of there and go for a walk at lunch." b. "When my partner yells at the dog I run and hide, but I don't know why I do that." c. "When I am overly stressed, I will just sit and watch a movie to help me relax." d. "Losing my child to cancer is so painful that I decided to raise money for cancer research so nobody else has to go through this."
b. "When my partner yells at the dog I run and hide, but I don't know why I do that."
A nurse is teaching a client about potential risks of chronic stress. Which of the following conditions should the nurse include as a potential risk? a. Peripheral vascular disease b. Diabetes c. Seizures d. Meningitis
b. Diabetes
A nurse is reinforcing education to a client who is afraid of heights and is planning to drive across a high bridge. The nurse should identify that which of the following structures stimulates the automatic nervous system? a. Thalamus b. Hypothalamus c. Parietal lobe d. Pituitary gland
b. Hypothalamus
A nurse in a mental health clinic is observing a client in the day room. The nurse should identify which of the following actions by the client as a maladaptive defense mechanism? a. The client is sitting down and is painting a picture. b. he client tells another client that all of the therapists are mean. c. The client crumbles up their paper and throws it across the room. d. The client is talking about starting a fundraiser for other people who lost everything in a fire.
b. he client tells another client that all of the therapists are mean.
A nurse is caring for a client who states, "I am so stressed over my upcoming reunion because I am not as successful as most of my classmates." Which of the following therapies for stress related disorders may benefit this client? a. Aversion therapy b. Biofeedback c. Cognitive reframing d. Desensitization therapy
c. Cognitive reframing
A nurse is educating a group of clients on the concept of hardiness. Which of the following statements should the nurse include in the teaching? a. "The foundation of hardiness is the ability to fixate on a stressor in an effort to suppress negative thinking." b. "Hardiness is a personality trait that refers to how a person reacts to the world around them." c. "Hardiness is a genetic predisposition that is non-modifiable." d. "The foundation of hardiness is a positive self-perception and attitudes of hopefulness."
d. "The foundation of hardiness is a positive self-perception and attitudes of hopefulness."
Identify the term: A type of stress that includes characteristics both biological and behavioral that are detrimental and interfere with optimal functioning and coping with life. 1. Stress 2. Maladaptive 3. Resilience 4. Distress
2. Maladaptive
During a community visit, volunteer nurses teach stress management to the participants. The nurses will most likely advocate which belief as a method of coping with stressful life events? A. Avoidance of stress is an important goal for living. B. Control over one's response to stress is possible. C. Most people have no control over their level of stress. D. Significant others are important to provide care and concern.
B. Control over one's response to stress is possible.
Which of the following are specific risk of factors for healthcare professionals to become addicted to alcohol or drugs? A. Higher divorce rate, legal problems, disciplinary actions at work B. Work stress and burnout, work injuries, access to drugs C. Mandatory continuing education, license renewal, financial issues D. Higher incidence of risk-taking behaviors, reckless health practices, work parties with alcohol and drugs present
B. Work stress and burnout, work injuries, access to drugs
A group of community nurses sees and plans care for various clients with different types of problems. Which of the following clients would they consider the most vulnerable to post-traumatic stress disorder? A. An eight (8)-year-old boy with asthma who has recently failed a grade in school. B. A 20-year-old college student with DM who experienced date rape. C. A 40-year-old widower who has recently lost his wife to cancer. D. A wife of an individual with a severe substance abuse problem.
B. A 20-year-old college student with DM who experienced date rape. Correct Answer: B. A 20-year-old college student with DM who experienced date rape Post-traumatic stress disorder is caused by the experience of severe, specific trauma. Rape is a severely traumatic event. Posttraumatic stress disorder (PTSD) is a syndrome that results from exposure to real or threatened death, serious injury, or sexual assault. Following the traumatic event, PTSD is common and is one of the serious health concerns that is associated with comorbidity, functional impairment, and increased mortality with suicidal ideations and attempts
Mr. Johnson was recently admitted to a psychiatric unit because of severe obsessive-compulsive behavior. Which initial response by the nurse would be most therapeutic for him? A. Accepting the client's ritualistic behaviors. B. Challenging the client's need for rituals. C. Expressing concern about the harmfulness of the client's rituals. D. Limiting the client's rituals that are excessive.
A. Accepting the client's ritualistic behaviors. Correct Answer: A. Accepting the client's ritualistic behaviors It is important to accept the client's need to perform ritualistic behaviors in this situation; admission to a psychiatric unit is stressful, and this client will tend to increase rituals when anxious. Other options are not appropriate for a newly admitted client. Initially meet the client's dependency needs as necessary. Sudden and complete elimination of avenues for dependency would create anxiety and will burden the client more.
A nurse is providing education to a group of clients about addiction. The nurse should include which of the following as a definition of addiction? A. Needing more and more of a substance to get the level of high or enjoyment as earlier use B. Recurring, uncontrollable urges to engage in compulsive behaviors such as substance use in spite of negative consequences C. Physiological manifestations that happen when drug or alcohol use is stopped D. Wanting to cut down or stop using drugs and/or alcohol but not being able to
B. Recurring, uncontrollable urges to engage in compulsive behaviors such as substance use in spite of negative consequences
