Quiz 4 and Final Anxiety and Obsessive - Compulsive.

A Gulf War veteran is entering treatment for post-traumatic stress disorder. What assessment is of importance to this particular client?

Determine the use of chemical substances for anxiety relief. Substance abuse often coexists with post-traumatic stress disorder. It is often the client's way of self-medicating to gain relief of symptoms.

What defense mechanisms can only be used in healthy ways?

Altruism and sublimation are known as mature defenses. They cannot be used in unhealthy ways. Altruism results in resolving emotional conflicts by meeting the needs of others, and sublimation substitutes socially acceptable activity for unacceptable impulses.

Emily asks you what kind of therapy will help her. Based on current knowledge, what form of therapy is most appropriate for a client diagnosed with a conversion disorder?

Cognitive-behavioral therapy (CBT) has been shown to consistently provide the best outcome for these types of disorders." CBT is the most consistently supported treatment for the full spectrum of somatic disorders.

It is most important for the nurse to employ which holistic strategy when managing clients diagnosed with a somatization disorder?

Considering all dimensions of the patient, including biological, psychological, and sociocultural It is important to use a holistic approach in nursing care so that we may address the multidimensional interplay of biological, psychological, and sociocultural needs and its effects on the somatization process. All nurses need to be aware of the influence of environment, stress, individual lifestyle, and coping skills of each patient.

Which mental health disorder is an example of a somatoform disorder?

Conversion disorder Somatic disorders include conversion disorders that are functional neurological disorders.

Which medication is FDA approved for treatment of anxiety in children?

Duloxetine A few drugs are approved specifically for anxiety and obsessive-compulsive disorders in children and adolescents. The FDA approved the selective SNRI duloxetine (Cymbalta) in 2014 for children aged 7 to 17 years for generalized anxiety disorder. The FDA has approved four medications for use in children with obsessive-compulsive disorder. They are clomipramine (Anafranil), fluoxetine (Prozac), fluvoxamine (Luvox), and sertraline

The primary difference between a factitious disorder and other somatic disorders is described in which statement?

Factitious disorders have a symptomatology that is actually controlled by the client. Factitious disorders, in contrast to other somatic disorders, are under conscious control.

What statement by a client would indicate that goals for treatment for a somatization disorder are being achieved?

I don't think about my symptoms all the time as I used to." This statement indicates that the client's preoccupation with the physical symptom has decreased, a highly desirable outcome.

There are 4 levels:delineated by Peplau and based on Sullivan's work.

Mild, Moderate, Severe, Panic

The plan of care for a client who has elaborate washing rituals specifies that response prevention is to be used. Which scenario is an example of response prevention?

Not allowing the client to wash hands after touching a "dirty" object Response prevention is a technique by which the client is prevented from engaging in the compulsive ritual. A form of behavior therapy, response prevention is never undertaken without physician approval

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

Reaction formation! keeps unacceptable feelings or behaviors out of awareness by developing the opposite behavior or emotion.

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?

Regularly discuss their feelings about the client during the unit's interprofessional care meetings. It is helpful for health care workers, no matter the setting, to discuss responses to these patients in conferences with other health care members to allow for expression of feelings and, ultimately, to provide for consistent care.

A client frantically reports to the nurse that "You have got to help me! Something terrible is happening. I can't think. My heart is pounding, and my head is throbbing." The nurse should assess the client's level of anxiety as

Severe anxiety is characterized by feelings of falling apart and impending doom, impaired cognition, and severe somatic symptoms such as headache and pounding heart. Mild and moderate levels of anxiety do not demonstrate these feels while panic is even more intense than the scenario implies

The nurse anticipates that the nursing history of a client diagnosed with obsessive compulsive disorder (OCD) will reveal what common assessment data?

Sexual and physical abuse in childhood or trauma increases the risk of this disorder. Genetics are strongly associated with this disorder. First-degree relatives have twice the risk. OCD tends to occur along with anxiety disorders 76% of the time. Other comorbid conditions include major depressive disorder, bipolar disorder, and eating disorders.

Generally, which statement regarding ego defense mechanisms is true?

They often involve some degree of self-deception! Most ego defense mechanisms, with the exception of the mature defenses, alter the individual's perception of reality to produce varying degrees of self-deception.

Stress

leads to a variety of psychological responses the most common is anxiety.