PSYCHIA LONG QUIZ

Which of the following best described on post-traumatic stress disorder? A. is not associated with a persistent avoidance of disturbing situations B. Is not associated with exposure to the threat of death C. Is associated with joyful events D. Is associated with a deterioration in cognition and mood

D. Is associated with a deterioration in cognition and mood

Which of the following is NOT a problem with factious disorder? A. It can cost society a lot of money. B. It can waste doctors' time. C. it is difficult to diagnose. D. It is rare, but extremely life threatening.

D. It is rare, but extremely life threatening.

A nurse is working with a client who has frequent angry outbursts. Which of the following statements is most helpful when working with this client A)"Anger is a normal feeling, and you can use it to solve problems." B)"You need to learn to suppress your angry feelings." C)"You can reduce your anger by hitting a punching bag." D)"You need to learn how to be less assertive in your communications."

A)"Anger is a normal feeling, and you can use it to solve problems."

Which of the following are important issues for nurses to be aware of when working with angry, hostile, or aggressive clients? Select all that apply. A)Nurses must be aware of their own feelings about anger and their use of assertive communication and conflict resolution. B)Nurses must not allow themselves to become angry under any circumstances. C)Nurses must know that a client's anger or aggressive behavior is preventable D)Nurses must discuss situations or the care of potentially aggressive clients with experienced nurses. E)Nurses must be calm, nonjudgmental, and nonpunitive when using techniques to control a client's aggressive behavior.

A, D, E A. Nurses must be aware of their own feelings about anger and their use of assertive communication and conflict resolution. D. Nurses must discuss situations or the care of potentially aggressive clients with experienced nurses. E. Nurses must be calm, nonjudgmental, and nonpunitive when using techniques to control a client's aggressive behavior.

Which of the following interventions are most effective in managing the environment to reduce or eliminate aggressive behavior? Select all that apply. A) Planning group activities such as playing games B) Scheduling one-to-one interactions with the client C) Providing structure and consistency in the unit D) Avoiding discussions among clients on the unit E) Discouraging clients from negotiating solutions

A,B,C

The spouse of a client diagnosed with complex somatic symptom disorder asks the nurse, "What causes this condition?" Which response by the nurse would be most accurate? A. "The symptoms reflect an emotion that your spouse cannot verbalize." B. "The symptoms reflect an internal preoccupation with events." C. "Your spouse is experiencing chronic stress that causes hypoarousal." D. "There is definitely an underlying genetic link for this disorder."

A. "The symptoms reflect an emotion that your spouse cannot verbalize."

Anger management is likely to be included in the care of clients with which of the following psychiatric diagnoses? Select all that apply. A) Alzheimer's dementia B) Schizophrenia C) Anorexia nervosa D) Acute alcohol intoxication E) Generalized anxiety disorde

ABE

David is preoccupied with numerous bodily complaints even after a careful diagnostic workup reveals no physiologic problems. Which nursing intervention would be therapeutic for him? A. Acknowledge that the complaints are real to the client, and refocus the client on other concerns and problems. B. Challenge the physical complaints by confronting the client with the normal diagnostic findings. C. Ignore the client's complaints, but request that the client keeps a list of all symptoms. D. Listen to the client's complaints carefully, and question him about specific symptoms.

A. Acknowledge that the complaints are real to the client, and refocus the client on other concerns and problems.

An angry client has just thrown a chair across the room and is racing to pick up another chair to throw. The most appropriate action by the nurse would be which of the following? A)Call for an emergency response from trained personnel. B)Approach the client and firmly say, "Stop, put it down." C)Calmly call the client by name and encourage verbal expression of anger. D)Assist the client to use problem-solving techniques instead of aggression.

A. Call for an emergency response from trained personnel.

When interacting with a client in the day room, the nurse determines that a violent outburst is imminent. Which of the following should the nurse do first? A) Call for assistance. B) Give the client choices. C) Remove the other clients. D) Talk to the client calmly.

A. Call for assistance Feedback: Safety is the priority; the nurse needs assistance to remove other clients and to deal with the violent outburst. The other interventions may be implemented after calling for assistance.

What information should the nurse give to the family of a client who has had a dissociative episode? A. Dissociation is a method for coping with severe stress. B. Dissociation suggests the possibility of early dementia. C Brief periods of psychotic behavior may occur. D Ways to intervene to prevent self-mutilation and suicide attempts.

A. Dissociation is a method for coping with severe stress.

In order to assume the sick role, intentionally produced physical or psychological symptoms are known as as which of the following? A. Factious disorder B. Conversion disorder C. Somatization disorder D. Hypochondriasis

A. Factious disorder

A client approaches the nurse and loudly states, I'm not putting up with this anymore! The most appropriate response by the nurse would be which of the following? A) I can see you are angry. Tell me what's going on. B) You are not allowed to make threats. Please keep your voice down. C) Why do you say that? D) You are here voluntarily. You can leave if you want.

A. I can see you are angry. Tell me what's going on. Feedback: In the triggering phase, the nurse should approach the client in a nonthreatening, calm manner in order to deescalate the client's emotion and behavior. Conveying empathy for the client's anger or frustration is important. The nurse can encourage the client to express his or her angry feelings verbally, suggesting that the client is still in control and can maintain that control. Use of clear, simple, short statements is helpful.

A physician describes a client as "malingering." The nurse knows this means that the client: A. Is falsely claiming to have symptoms. B. Experiences symptoms that cannot be explained medically. C. Experiences symptoms that have a physiological basis. D. Is seeking medication to ease pain of psychological origin.

A. Is falsely claiming to have symptoms.

One of the first steps that a nurse should take to deal effectively with aggressive clients is which of the following? A) Reflect on abilities to handle own feelings of anger B) Learn professional skills of anger management C) Become proficient using reflective communication techniques D) Understand how to activate crisis response teams

A. Reflect on abilities to handle own feelings of anger feedback: The nurse must be aware of how he or she deals with anger before helping clients do so

Providing care to a client diagnosed with a somatization disorder can be frustrating owing to the client's lack of an organic illness. In order to best manage this barrier to care the staff should implement which personal intervention? A.Regularly discuss their feelings about the client during the unit's interprofessional care meetings. B.Attend in-services that focus on the various aspects of somatic disorders. C.Rotate care of the client among the entire nursing department staff to minimize the frustration. D.Provide a unified approach to the client's behavior so as to manage and lessen the barrier itself.

A. Regularly discuss their feelings about the client during the unit's interprofessional care meetings.

Sarah's psychiatrist suspects that Sarah suffers from a factious disorder. Which of the criteria below would be reasonable evidence for this conclusion? A. Sarah is feigning symptoms of an illness she clearly doesn't have. She appears distraught at needing medical attention and has no apparent external motivation to feign sickness B. Sarah claims she really isn't sick and is upset when the psychiatrist suggests she is. C. Sarah hates her job and appears to be feigning symptoms of illness to get out of work. She appears to really enjoy the sick role. D. Sarah is feigning symptoms of an illness she clearly doesn't have. She appears to enjoy the sick role and has no apparent external motivation to feign sickness.

A. Sarah is feigning symptoms of an illness she clearly doesn't have. She appears distraught at needing medical attention and has no apparent external motivation to feign sickness

Over the past 5 years, a client has had two exploratory surgeries and numerous examinations for severe abdominal pain. All diagnostic and laboratory results have been negative for organic problems. The client has had vague descriptions of periods of anxiety and depression and has continued to seek medical assistance for the abdominal pain and various other physical problems. The nurse would assess this client as using which defense mechanism? A. Somatization B. Dissociation C. Repression D. Displacement

A. Somatization

Psychosomatic illness refers to physical symptoms that are either created or worsened by psychic influences. Which conditions are thought to be attributed to the connection between mind and body? Select all that apply. A. Diabetes B. Hypertension C. Headache D. Colitis

ABCD

Which of the following statements about anger, hostility and aggression are accurate? Select all that apply. A)Anger is an emotional response to a real or perceived provocation. B)Hostility stimulates the sympathetic nervous system. C)Physical aggression involves harming other persons or property. D)Anger, hostility, and physical aggression are normal human emotions. E)Hostility is also referred to as verbal aggression.F)Physical aggression often progresses to hostility.

ACE

An aggressive client gets hold of a glass piece and prevents anyone from entering the room. What interventions should the nurse perform to ensure safety of the client, staff, and other clients? Select all that apply. a. Leave the area immediately b. Remove glass piece from client c. Try to talk down the client d. Summon help from others e. Shift other clients to a safe place

ADE

Ever since participating in a village raid where explosives were used, a military veteran has been unable to walk. After all diagnostic testing were negative for any physical abnormalities, the client was diagnosed with conversion disorder. What is the nurse's best response when asked by the client, "Why can't I walk?" A."Your legs don't work because your brain is screwed up." B."Your emotional distress is being expressed as a physical symptom." C."You are making up your symptoms as a cry for help." D."You are overly anxious about having a severe illness."

B. "Your emotional distress is being expressed as a physical symptom."

If you are making yourself or someone else sick in order to pretend illness is present when it really isn't without any clear objective your behavior fits the criteria for of the following? A. Obsessive-compulsive disorder B. A factitious disorder C. Malingering D. Ganser Syndrome

B. A factitious disorder

The nurse decides to place an aggressive and violent client in mechanical restraints. The nurse bases this decision on which of the following? A) Client's mood B) Client's safety C) Court order D) Physician's order

B. Client's safety Feedback: The use of restraints is warranted only when the client's safety is in jeopardy and other, less restrictive measures have not been effective. The nurse does not base her decision on the client's mood or court order. Just because there is a physician's order for use of restraints, this does not mean that they are appropriate in every situation; this is based on nursing judgment

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 lists consists of three factors that may contribute to the development of generalized anxiety disorder? A. History of past trauma, a surplus of the inhibitory neurotransmitter GABA; high socioeconomic status B. Deficits of the inhibitory neurotransmitter GABA; history of past trauma; a family history of anxiety disorders C. History of past trauma, a family history of anxiety disorders, a surplus of the inhibitory neurotransmitter GABA D. High socioeconomic status; a family history of anxiety disorders; deficits of the inhibitory neurotransmitter GABA

B. Deficits of the inhibitory neurotransmitter GABA; history of past trauma; a family history of anxiety disorders

Which psychiatric disorder makes a person most susceptible to anger attacks that do not result in physical aggression? A) Delusions B) Depression C) Dementia D) Delirium

B. Depression Feedback: Some clients with depression have anger attacks that are sudden intense spells of anger that typically occur in situation where the depressed person feels emotionally trapped. Anger attacks involve verbal expressions of anger or rage but no physical aggression. Persons with delusions, dementia, and delirium are most likely to become physically aggressive.

Which of the following interventions would assist the client with the appropriate expression of anger? A) Encourage catharsis B) Encourage verbalization C) Improve self-esteem D) Isolate the client from other

B. Encourage verbalization Feedback: Verbally expressing angry feelings is a safe and appropriate way to deal with anger. Isolation and catharsis can increase angry and hostile feelings. The other choices are not appropriate responses in this situation.

In the psychiatric setting, what is the most effective intervention in preventing the hostile client's behavior from escalating to physical aggression? A) Getting as far away from him or her as possible B) Engaging the hostile person in dialogue C) Yelling at the client to settle down now D) Ensuring that the client gets his or her way

B. Engaging the hostile person in dialogue Feedback: engaging the hostile person is most effective to prevent the behavior from escalating to physical aggression. In the psychiatric setting, it is not possible to get as far away from them as possible. Yelling at the client will likely escalate the hostility. Ensuring that the client gets his or her way may eliminate frustration that may lead to acting out, but is unrealistic and not ultimately helpful to the client.

A client is observed pacing the hall with clenched fists and swearing at others. The nurse intervenes immediately to prevent the client from moving to which phase of the aggression cycle? A) Triggering B) Escalation C) Crisis D) Recovery

B. Escalation Feedback: During escalation, the client's responses represent escalating behaviors that indicate movement toward a loss of control, including pale or flushed face, yelling, swearing, agitated, threatening, demanding, clenched fists, threatening gestures, hostility, loss of ability to solve the problem or think clearly

The client's son is yelling and is hitting his hand with a rolled up newspaper. Which stage of aggression does the nurse identify that the client's son is exhibiting? A) Triggering B) Escalation C) Crisis D) Recovery

B. Escalation Feedback: During the escalation phase of aggression, a person may exhibit yelling and threatening, clenched fist, threatening gestures. During the triggering phase of aggression, a person may exhibit signs and symptoms and behaviors including restlessness, anxiety, irritability, pacing, muscle tension, rapid breathing, perspiration, loud voice, and anger.

The nurse is interviewing a client with a history of physical aggression. Which of the following should the nurse avoid? A)Anticipating that a loss of control is possible and planning accordingly B)Explaining the consequences the client will face if control is lost C)Interviewing the client with another staff member present D)Responding to verbal threats by terminating the interview and obtaining assistance

B. Explaining the consequences the client will face if control is lost

Karen feeds her elderly father a homemade concoction that makes him sick. What disorder might she have? A. Factious disorder B. Factious disorder by proxy C. Schizophrenia D. Bipolar disorder

B. Factious disorder by proxy

The primary difference between a factitious disorder and other somatic disorders is described in which statement? A.Factitious disorders respond well to confrontation as a primary therapeutic technique. B.Factitious disorders have a symptomatology that is actually controlled by the client. C.Factitious disorders have their origins in depression and anxiety. D.Factitious disorders are always self-directed.

B. Factitious disorders have a symptomatology that is actually controlled by the client.

The client identifies anger management as a problem. What is the next step in planning therapeutic interactions? A) Give the client a variety of choices on how to express anger. B) Give the client permission to be angry. C) Point out the senselessness of anger. D) Tell the client not to be angry all the time.

B. Give the client permission to be angry Feedback: Many people view anger as a negative and abnormal feeling in addition to feeling guilty about being angry; the nurse can help the client see anger as a normal, acceptable emotion. Giving choices on how to express anger would not be the next step in the planning stage. Pointing out the senselessness of anger and telling the client not to be angry all the time are not appropriate responses in this situation

Which of the following is the primary difference between malingering (faking symptoms to obtain some kind of benefit) and dissociative identity disorder? A. Malingerers are not distressed by having the disorder. B. Malingerers don't report having amnesia (memory lapses). C. Malingerers often report having little-known symptoms of dissociative identity disorder D. Malingerers report having more personalities

B. Malingerers don't report having amnesia (memory lapses).

Which nursing diagnosis would best describe the problems evidenced by the following client symptoms: avoidance, poor concentration, nightmares, hypervigilance, exaggerated startle response, detachment, emotional numbing, and flashbacks? A. Ineffective coping B. Post-trauma syndrome C. Complicated grieving D. Panic anxiety

B. Post-trauma syndrome

Jim has been experiencing symptoms of a stress disorder for close to a year. He will most likely be diagnosed with which of the following A. Neither post-traumatic stress disorder nor acute stress disorder. B. Post-traumatic stress disorder, since he has experienced symptoms for more than one month. C. Acute stress disorder, since he has experienced symptoms for more than six months. D. Acute stress disorder, since he has experienced symptoms for less than five years.

B. Post-traumatic stress disorder, since he has experienced symptoms for more than one month.

The nurse is teaching a client to recognize early signs of anger and aggression. The nurse explores ways that the client can recognize which of the following? A) Decreased problem-solving ability B) Restlessness and irritability C) Remorse D) Severe muscle tension

B. Restlessness and irritability Feedback: Earliest signs of anger include restlessness, anxiety, irritability, pacing, muscle tension, rapid breathing, perspiration, loud voice, and anger.

Which is most likely to be the subject of an aggressive attack from a client with mental illness? A) Other people B) The client C) Animals D) Objects

B. The client Feedback: Clients with psychiatric disorders are more likely to hurt themselves than other people

Cognitive behavioral theapy (CBT) has been recommended for your friend who is suffering from post traumatic stress syndrome. Does this make sense? A. Yes. It is the most often used therapy for post traumatic stress and focuses on uncovering repressed memories. B. Yes. It is the most often used therapy for post traumatic stress and focuses on rewiring the brain. C. No. Cognitive Behavioral Therapy should never be used for post traumatic stress disorder. D. It all depends on the type of trauma. There are many types of trauma where Cognitive Behavioral Therapy would not be appropriate.

B. Yes. It is the most often used therapy for post traumatic stress and focuses on rewiring the brain.

Which client is most likely to initially demonstrate behaviors suggesting a somatic disorder? A.13-year-old male B.23-year-old female C.33-year-old male D.43-year-old female

B.23-year-old female

A nurse is caring for a client with conversion disorder. What immediate outcomes (within a week) indicate successful therapy for the client? select all that apply. A. The client will express feelings related to inadequacy and fear. B. The client will identify the conflict underlying the physical symptoms experienced. C. The client will communicate the steps to solving the problems. D. The client will communicate knowledge of the illness. E. The client will discuss problems and solve conflicts with family or friends.

BC B. The client will identify the conflict underlying the physical symptoms experienced. C The client will communicate the steps to solving the problems.

A married man expresses to the nurse that his wife's frequent nagging angers him. The nurse role-plays assertive communication techniques with the husband. Which of the following indicates the husband understands how to use assertive techniques effectively? A)"I really wish you would stop nagging me." B)"You are not perfect either." C)"I feel unappreciated when you criticize me." D)"Are you telling me you want me to change?"

C)"I feel unappreciated when you criticize me."

Which statement made by a client would support the diagnosis of Illness anxiety disorder? A. "I feel confused and disoriented." B. "I feel as though I'm outside my body watching what is happening." C. "I know I have cancer, but the doctors just cannot find it." D. "I woke up one morning, and my left leg was paralyzed from the knee down."

C. "I know I have cancer, but the doctors just cannot find it."

A client with recurrent headaches has been told by the physician that the cause is likely psychosomatic. The client reports this conversation to the nurse and says, "That just can't be true! My head hurts so bad sometimes that it makes me sick to my stomach." Which is the nurse's best response? A) To give the client some privacy and time to calm down B) To say nothing and sit quietly with the client' C) "The pain in your head is very real." D) "Well, that's not what your doctor thinks."

C. "The pain in your head is very real."

What a culture considers acceptable strongly influences the expression of anger. Which culture-bound syndrome is a dissociative episode characterized by a period of brooding followed by an outburst of violent, aggressive, or homicidal behavior directed at other people and objects? A)Hwa-Byung B)Hwabyeong C)Amok D)Bouffée delirante

C. Amok

Which of the following is a possible cause of factitious disorders? A. A heart arhythmia B. Anger management issues C. Brain differences D. Multiple personalities disorder

C. Brain differences

At which point in the stages of aggressive incidents is intervention least likely to be effective in preventing physically aggressive behavior? A) Triggering B) Escalation C) Crisis D) Postcrisis

C. Crisis Feedback:Interventions during the triggering and escalation phases are key to prevent physically aggressive behavior. During the crisis phase, behavior escalation may lead to physical aggression. During the postcrisis phase, the physically aggressive behavior has stopped and the client returns to the level of functioning before the aggressive incident.

Charina, a college student who frequently visited the health center during the past year with multiple vague complaints of GI symptoms before course examinations. Although physical causes have been eliminated, the student continues to express her belief that she has a serious illness. These symptoms are typically of which of the following disorders? A. Conversion disorder. B. Depersonalization. C. Hypochondriasis. D. Somatization disorder.

C. Hypochondriasis

A woman suddenly finds she cannot see but seems unconcerned about her symptom and tells her husband, "Don't worry, dear. Things will all work out." Her attitude is an example of what process? A. Regression B. Depersonalization C. La belle indifference D. Dissociative amnesia

C. La belle indifference

Which of the following statement is true about factitious disorders? A. Compulsive behaviors, limiting calorie intake B. Limiting calorie intake; Pretending to be sick C. Making yourself sick; Pretending to be sick D. Making yourself sick, Excessive exercise

C. Making yourself sick; Pretending to be sick

Which of the following terms are applicable when a person inflicts illness or injury on someone else lo gain the attention of emergency medical personnel for saving the victim? A. Malingering B. Factitious disorder C. Munchausen's syndrome by proxy D. induced illness

C. Munchausen's syndrome by proxy

Dave is experiencing physical pains but he has been to several doctors who cannot find any physical cause. Would it be reasonable to conclude that he suffers from a factitious disorder? A. Yes. This is the hallmark symptom of a factious disorder B. Yes. Physical pains without a physical cause are definitely factious C. No. There can be other reasons for experiencing physical pain without a physical cause D. No. Factitious disorders do not involve physical pain

C. No. There can be other reasons for experiencing physical pain without a physical cause

Which of the following physical symptoms of pain that is generally unrelieved by analgesics and greatly affected by psychological factors in terms of onset, severity, exacerbation and maintenance? A. Acute pain B. Chronic pain C. Pain disorder D. phobia

C. Pain disorder

The client with a history of explosive outbursts becomes angry and states, I am really getting angry. The nurse sees this as A) controlling. B) manipulation. C) progress. D) regression.

C. Progress Feedback: When the client is able to verbalize angry feelings, this is progress from having an outburst. The client is not trying to control the situation. Manipulation occurs when a person tries to persuade another to act in a desired way. Regression occurs when one retreats to an earlier level of functioning and development.

Which nursing diagnosis should be investigated for clients with somatoform disorders? A. Deficient fluid volume B. Disturbed personal identity C. Self-care deficit D. Delayed growth and development

C. Self-care deficit

A client is experiencing a severe panic attack. Which nursing intervention would meet this client's immediate need? A. Teach deep breathing relaxation exercises B. Place the client in a Trendelenburg position C. Stay with the client and offer reassurance of safety D. Administer the ordered PRN buspirone (BuSpar)

C. Stay with the client and offer reassurance of safety

A client is clenching his fists and yelling at another client on the unit. He appears to be close to losing control of his anger. Which of the following actions by the nurse is appropriate at this time? A) Clear others out of the immediate area. B) Prepare a PRN sedative. C) Tell the client to stop and take a time-out. D) Alert the security department of an impending aggressive outburst.

C. Tell the client to stop and take a time-out Feedback: If the client progresses to the escalation phase (period when client builds toward loss of control), the nurse must take control of the situation. The nurse should provide directions to the client in a calm, firm voice. The client should be directed to take a time-out for cooling off in a quiet area or his or her room. Clearing others from the area or alerting security does not help the client regain control. Administering a sedative is not the least restrictive intervention at this time.

A nurse has been caring for a client diagnosed with post-traumatic stress disorder. What short-term, realistic, correctly written outcome should be included in this client's plan of care? A. The client will have no flashbacks. B. The client will be able to feel a full range of emotions by discharge. C. The client will not require zolpidem (Ambien) to obtain adequate sleep by discharge. D. The client will refrain from discussing the traumatic event.

C. The client will not require zolpidem (Ambien) to obtain adequate sleep by discharge.

Which of the following is true about touching a client who is experiencing a flashback? A. The nurse should stand in front of the client before touching. B. The nurse should never touch a client who is having a flashback. C. The nurse should touch the client only after receiving permission to do so. D. The nurse should touch the client to increase feeling of security.

C. The nurse should touch the client only after receiving permission to do so.

A client who has been physically aggressive arrives at the emergency room for a psychiatric assessment. Which would be the best approach for the nurse to use? A)Have a sense of humor to show a lack of fear. B)Provide close contact to increase the client's sense of safety. C)Use brief statements and questions to obtain information. D)Use open-ended questions, so the client can elaborate.

C. Use brief statements and questions to obtain information.

After an angry outburst, a client quickly appears more calm and rational. The nurse approaches the client. Which of the following is the most helpful response to the client at this time? A) We will have to talk about this later. B) You really scared me. I'm glad you are okay. C) What happened that got you so upset? D) What can you do differently next time you get angry?

C. What happened that got you so upset? feedback: As the client regains control (recovery phase), he or she is encouraged to talk about the situation or triggers that led to the aggressive behavior

A class of medications commonly prescribed for somatic disorders is A.mood stabilizers. B.antidepressants. C.anxiolytics. D.antipsychotics.

C. anxiolytics.

Individuals with somatoform disorders may often display a surprising indifference about their symptoms- especially when the symptoms to most people would be disturbing (e.g. blindness, paralysis). This is sometimes known as: A. Vive la difference B. Quelle difference C. la belle indifference D. Que ce que se la difference

C. la belle indifference

A client who developed numbness in the right hand could not play the piano at a scheduled recital. The consequence of the symptom, not having to perform, is best described as A. emotion-focused coping. B. phobia. C. primary gain. D. secondary gain.

C. primary gain.

A client has had hypochondriasis for 2 years. His wife tells the nurse "It is so difficult! Whenever we make plans to get together with another couple or go on vacation or do anything pleasant, my husband throws a monkey wrench in the works, saying he is too ill, or he needs to make a doctor's appointment. I don't know how much longer I can take it." On the basis of this report, the nurse may wish to explore the nursing diagnosis of A. interrupted family processess. B. decisional conflict. C. risk for caregiver role strain. D. impaired home maintenance.

C. risk for caregiver role strain.

The nurse working with a client during a flashback says, "I know you're scared, but you're in a safe place. Do you see the bed in your room? Do you feel the chair you're sitting on?" The nurse IDs using which of the following techniques? A. Distraction B. Relaxation C. Reality orientation D. Grounding

D. Grounding

Which one of the following statements about anger is most accurate? A)Anger is an abnormal human emotion that is always negative. B)It is best to express anger by whatever means possible to minimize its consequences. C)Most men are socialized to suppress anger. D)Anger awareness and expression are necessary for women's growth and development.

D)Anger awareness and expression are necessary for women's growth and development.

What statement by a client would indicate that goals for treatment for a somatization disorder are being achieved? A. "I feel less anxiety than before." B. "My memory is better than it was a month ago." C. "I take my medications just as the physician prescribed." D. "I don't think about my symptoms all the time as I used to."

D. "I don't think about my symptoms all the time as I used to."

A student nurse asks the mental health nurse about when somatic symptom disorder (SSD) usually begins. The nurse responds by saying that the first symptoms often appear during which time? A. After age 40 years B. Mid 30s C. Early 20s D. Adolescence

D. Adolescence

Somatoform disorders include which of the following: A Conversion disorder B. Somatization disorder C. Hypochondriasis D. All of the above

D. All of the above

It is most important for the nurse to employ which holistic strategy when managing clients diagnosed with a somatization disorder? A.Utilizing many different therapeutic strategies or modalities for enhanced coping B.Involving every member of the family as well as the patient in treatment C.Incorporating spirituality and religion into treatment D.Considering all dimensions of the patient, including biological, psychological, and sociocultural

D. Considering all dimensions of the patient, including biological, psychological, and sociocultural

Which of the following statements about the crisis phase of aggression when the client becomes physically aggressive is true? A) All staff should act to take charge of the situation. B) The client must be restrained or sedated at once. C) Staff should avoid communicating with the client. D) Four to six trained staff members are needed to restrain

D. Four to six trained staff members are needed to restrain feedback: Four to six trained staff members are needed to restrain, with four staff members each handling a limb and one protecting the client's head and one helps control the client's torso, if needed. When a client becomes physically aggressive, the staff must take charge of the situation for the safety of the client, staff, and other clients. Only staff with training in safe techniques for managing behavioral emergencies should participate

Which of the following is most important to maintain therapeutic boundaries when working with aggressive clients? A)Encourage clients to express how the nurse can avoid causing emotional irritation. B)Discuss difficult patient care situations with a supervisor. C)Reflect on your actions that may have instigated the client's anger, D)Do not personalize a client's anger

D. Do not personalize a client's anger feedback: Do not take the client's anger or aggressive behavior personally or as a measure of your effectiveness as a nurse. The client's aggressive behavior, however, does not necessarily reflect the nurse's skills and abilities. Clients should not dictate nurses' behaviors. The nurse is not responsible for angering the client. Individuals are responsible for their own emotional control. If the nurse cannot maintain boundaries, assistance should be sought form a supervisor.

The nurse observes two clients in the day room arguing. One client runs into the corner and huddles while the other follows and continues with verbal abuse. Which is the best action by the nurse? A) Take an authoritatively step between the two clients. B) Comfort the client huddled in the corner. C) Directly address both clients and ask what is going on. D) Engage the attention of the client who is still yelling and ask what is happening.

D. Engage the attention of the client who is still yelling and ask what is happening. Feedback: Engaging the attention of the dominant person will diffuse the situation and stop the argument from continuing. The other choices would not be appropriate actions in this situation. The nurse placing herself in between two arguing clients is a safety concern.

Aldo, with a somatoform pain disorder may obtain secondary gain. Which of the following statement refers to a secondary gain? A. It brings some stability to the family. B. It decreases the preoccupation with the physical illness. C. It enables the client to avoid some unpleasant activity. D. It promotes emotional support or attention for the client.

D. It promotes emotional support or attention for the client. feedback: D: Secondary gain refers to the benefits of the illness that allow the client to receive emotional support or attention. C: Primary gain enables the client to avoid some unpleasant activity. A: A dysfunctional family may disregard the real issue, although some conflict is relieved. B: Somatoform pain disorder is a preoccupation with pain in the absence of physical disease.

Which of the following do the facitious disorders involve with? A. making yourself or a loved one sick with obvious benefit B. Feeling like your personality is fractured C. Feeling like you have multiple personalities D. Making yourself or a loved one sick without obvious benefit

D. Making yourself or a loved one sick without obvious benefit

Which behavior by a client would not support a diagnosis of somatoform disorder? A. Attention seeking from significant others B. Acquiring financial gain from a disability plan C. Avoidance of certain unpleasant activities D. Performing activities of daily living unassisted

D. Performing activities of daily living unassisted feedback: somatic symptoms are reinforced by situations in which there is some sort of "payoff" for the client, such as attention, financial gain, avoidance of unpleasant situations, or getting dependent needs met. Performing activities of daily living unassisted would have no payoff of the sort mentioned.

A client lost control of his behavior, broke a window, and made verbal threats to staff and other clients. The client was placed in mechanical restraints. Which statement should the nurse make to explain the use of restraints to the client? A) The length of time you'll be in restraints is undetermined. B) The staff will monitor your behavior closely. C) This is what happens when you lose control. D) This is a means of keeping you and others safe.

D. This is a means of keeping you and others safe. Feedback: Use of restraints is a temporary, short-term way of ensuring the safety of everyone until the client regains behavioral control; it is not a punishment. The other choices are not appropriate explanations of the use of restraints

The nurse performs a thorough physical examination for a client being admitted for a somatic symptom illness. Which of the following is the best rationale for the physical exam? A) Ease the client's mind that the nurse is looking for physical illness. B) Physical disorders underlie somatic disorders. C) Physical exams are reimbursed by third-party payers. D) Underlying pathology should be ruled out.

D. Underlying pathology should be ruled out.

Nursing interventions for hospitalized clients with PTSD include? A. Encouraging a thorough discussion of the original trauma B. Providing private solitary time for reflection C. Time-out during flashbacks to regain self-control D. Use of deep breathing and relaxation technique

D. Use of deep breathing and relaxation technique

After an angry outburst, the client is tearful and remorseful. Which statement by the nurse would be most supportive? A) You still need to work on your problem-solving skills. B) I will not allow you to get that angry again. C) You should not have let your anger buildup like you did. D) What could you have done when you first started to feel angry?

D. What could you have done when you first started to feel angry? feedback: In the post-crisis phase, the nurse should not lecture or chastise the client for the aggressive behavior but should discuss the behavior in a calm, rational manner. The client can be given feedback for regaining control, with the expectation that he or she will be able to handle feelings or events in a non-aggressive manner in the future.

A client suddenly jumps up from the chair and begins yelling and cursing at the nurse. Which would be the best response by the nurse? A) I can see that you need attention; you should calmly ask for what you want. B) I don't want to hear that kind of language; don't ever do that again. C) I will limit your smoking privileges if you can't control yourself. D) You seem angry. Tell me more about how you're feeling.

D. You seem angry. Tell me more about how you're feeling. Feedback: The nurse recognizes and validates the client's feelings and offers to focus on those feelings and what the client needs. In this situation, the client is not at a point where he can be calm. Taking away privileges will not help the current situation. I don't want to hear that kind of language; don't ever do that again is demeaning to the client.

Which of the following statements of malingering may differ, from factitious disorders? A. Faking illness is a part of malingering B. Some patients make themselves sick on purpose when malingering C. It isn't it is essentially the same thing D. there is a clear objective for the behavior in malingering

D. there is a clear objective for the behavior in malingering

An adult client is pacing and yelling. Which is the best response by the nurse? a. "When did these feelings begin?" b. "With whom are you angry?" c. "Why do you feel angry?" d. "What are you doing?"

a. "When did these feelings begin?"

In which phase of the aggression cycle is the client removed from restraint or seclusion as soon as he or she meets the behavioral criteria? a. Postcrisis b. Escalation c. Crisis d. Triggering

a. Postcrisis

During which phase of the aggression cycle does the staff usually have a debriefing session? a. Recovery b. Triggering c. Escalation d. Postcrisis

a. Recovery

Which phase of the aggression cycle is defined as occurring when an event or circumstance in the environment initiates the client's response? a. Triggering b. Recovery c. Escalation d. Crisis

a. Triggering

A psychiatric-mental health nurse is teaching a class for a group of colleagues about anger, aggression, and violence. Which statement by the nurse would be most appropriate to include? a. "The terms used to describe anger are very precise." b. "Women often suppress their feelings of anger." c. "Anger is a knee-jerk reaction to external events." d. "Anger, aggression, and violence are points along a continuum."

b. "Women often suppress their feelings of anger."

When communicating with a client in the triggering phase of the aggression cycle, which intervention should the nurse include? a. Use seclusion or restraint b. Allow the client to take a "time out" in a quiet area c. Help the client relax and return a calmer state d. Suggest that the client is still in control and can maintain that control

b. Allow the client to take a "time out" in a quiet area

When an individual is suffering from body dysmorphic disorder the symptoms include: a)Having unnecessary invasive procedures b)Becoming obsessionally concerned about imagined or minor physical defects in their appearance. c)Feelings of hopelessness d)All of the above

b. Becoming obsessionally concerned about imagined or minor physical defects in their appearance.

Therapeutic intervention for a client with a somatoform disorder would include: a. Steering conversation away from the client's feelings. b. Conveying an interest in the client rather than in the symptoms. c. Encouraging the client to use benzodiazepines liberally. d. Encouraging the client to rely on the nurse to meet the client's needs.

b. Conveying an interest in the client rather than in the symptoms.

Sometimes parents or carers make up or induce physical illnesses in others (such as their children) and this is known as a)MacDonald's by proxy b)Munchausen's by proxy c)Munkaiser's by proxy d)Manchester's by proxy

b. Munchausen's by proxy

For a client with pain disorder, the etiology statement most consistent with current theory would be "related to a) difficulty expressing emotions." b) lack of coping skills." c) altered perceptions of pain stimuli." d) unmet dependency needs."

c) altered perceptions of pain stimuli."

An example of a somatoform disorder is: a. Depersonalization b. Dissociative fugue c. Conversion disorder d. Dissociative identity disorder

c. Conversion disorder

Which nursing diagnosis should be investigated for clients with somatoform disorders? a. Deficient fluid volume b. Self-care deficit c. Ineffective coping d. Delayed growth and development Incorrect

c. Ineffective coping

An extreme form of factitious disorder is known as a)MacDonald's syndrome b)Munkaiser's syndrome c)Munchausen's syndrome d)Manchester Syndrome

c. Munchausen's syndrome

During which phase of the aggression cycle does the client regain physical and emotional control? a. Postcrisis b. Escalation c. Recovery d. Triggering

c. Recovery

In which phase of the aggression cycle can techniques of seclusion or restraint be used to deal with the aggression quickly? a. Recovery b. Escalation c. Triggering d. Crisis

d. Crisis