QUIZ 4 N222

What is considered Sexual Assault and Sexual Violence?

Unwanted sexual advances and sexual harassment -Stranger rape -Marital rape -Date rape -Drug-facilitated sexual assault -Incest -Human sex trafficking

Tension-building stage

VERBAL violence (arguing)

Lorazepam is prescribed for a client who has a generalized anxiety disorder. Which of the following instructions is most important for the nurse to give the client? a. Prolonged use can result in dependence. b. Take the medication 2 hours after eating. c. Take an additional dose if you don't obtain relief. d. Return once a month to have your blood level tested.

a. Prolonged use can result in dependence.

Stress reduction is likely to result in which of the following? (Select all that apply.) a. Reduced pain b. Lower blood pressure c. Decreased cognitive functions d. Decreased GI probs e. Terminal insomnia

a. Reduced pain b. Lower blood pressure d. Decreased GI probs

A client wants to know about relaxation techniques. What does the nurse say to educate the client? a. Relaxation techniques work best when they are practiced on a regular basis. b. Heart rate should be specifically monitored while relaxing. c. The technique should not be used in children. d. To avoid dependence, only practice relaxation techniques when absolutely necessary.

a. Relaxation techniques work best when they are practiced on a regular basis.

A nurse assesses severe anxiety in a client. Which symptom would the nurse expect to see as a response of the sympathetic nervous system to anxiety? a. Tachycardia b. Bradycardia c. Constricted pupils d. Increased peristalsis

a. Tachycardia

A client is experiencing sudden, moderate-level anxiety. The nurse would anticipate that the psychiatrist would most likely prescribe which medication? a. Citalopram b. Alprazolam c. Fluoxetine d. Chlordiazepoxide

b. Alprazolam

A client with chronic ongoing stress complains of physical symptoms. The nurse caring for him is aware that the most common chronic problem caused by stress is which of the following?

b. HA

A nurse is caring for a 23-year-old client with schizophrenia. When the patient's father shows up during visitation hours, the client lies down in bed, curls up in a ball, and sucks his thumb. Which of the following defense mechanisms is the client exhibiting? a. Undoing b. Regression c. Altruism d. Displacement

b. Regression

The nurse assesses a client to be at risk for self-mutilation and implements a safety contract with the client which client behavior indicates that the contract is working? a. The client withdraws to his room when feeling overwhelmed b. The client notifies staff when anxiety is increasing c. The client suppresses his feelings when angry d. The client displaces his feelings onto the HCP

b. The client notifies staff when anxiety is increasing

A nurse observe a male client who is hyperactive and intrusive sitting very close to a female client with his arm around her shoulders. The nurse hears the male client tell a sexually explicit joke. The nurse approaches the client and asks him to walk down the hallway. Which statement by the nurse should benefit the client? a."She will not want to be around you with that kind of talk." b."Telling sexual jokes and touching others is not permitted here." c."You need to be careful about what you say to other people." d."I think a time-out in your room would be appropriate now."

b."Telling sexual jokes and touching others is not permitted here."

A client presents in the ER after being sexually assaulted. She is physiologically stable, but emotionally distraught. Which nursing action should receive priority? a. Assist with medical treatment b. Collect and prepare evidence for the police c. Attempt to reduce the client's anxiety level d. Provide anticipatory guidance about normal responses to sexual assault

c. Attempt to reduce the client's anxiety level

During an initial interview with parents, a nurse suspects child abuse. What behavior displayed by the parents would lead the nurse to be suspicious? a. Guilt b. Apathy c. Overconcern d. Ignoring the child

c. Overconcern

What is a nurse's responsibility when a child is suspected of being abused or neglected? a. Report to CPS with a physician's order. b. Parents must be informed before reporting to CPS. c. Reporting of suspected abuse or neglect is required by law in each state. d. The nurse should consult a social worker before reporting to any authority.

c. Reporting of suspected abuse or neglect is required by law in each state.

A 32-year-old male client is experiencing severe anxiety over a recent failed relationship. What nursing intervention should be given highest priority? a. Give the client an antianxiety agent immediately b. Offer him psychotherapy to calm him down c. Take the client to a quiet environment d. Place him in supervised seclusion immediately

c. Take the client to a quiet environment

Which intervention is least appropriate for a nurse to use with a rape victim? a. Never leave the woman alone b. Encourage expression of feelings c. Emphasize that she did the right thing in order to save her life d. Allow the client to shower and brush her teeth before an examination

d. Allow the client to shower and brush her teeth before an examination

The client is laughing and telling jokes to a group of clients. Suddenly, the client is crying and talking about a death in the family. A moment later, the client is laughing and joking again. The nurse should: a. Call the healthcare provider for a prescription for lorazepam as needed b. Place the client in seclusion and call the HCP for a prescription for the seclusion c. Ignore the client's behavior in order not to give the client too much attention d. Ask the client to come to a quiet area to talk to the nurse individually

d. Ask the client to come to a quiet area to talk to the nurse individually

What is the most appropriate therapeutic intervention when helping a patient resolve their agoraphobia? a. Have the client go outdoors alone. b. Advise the client to use high intensity exercises. c. Allow the client to stay in his room as long as desired. d. Discuss the client's fear of his/her feelings or sensations rather than the situation.

d. Discuss the client's fear of his/her feelings or sensations rather than the situation.

A nurse is closely monitoring a newly admitted client who is anxious. At what anxiety level might this client become assaultive and a potential threat to himself and others? a. Mild b. Moderate c. Severe d. Panic

d. Panic

Ed, an 18-year-old male, hosted a party at his parent's house while his parents were out of town. It was lit, to say the least. When Ed's parents returned, they were infuriated by how messy the house was. Ed apologized, and gave them a $50 gift card to Applebee's. Which defense mechanism is Ed using? a. Regression b. Altruism c. Reaction formation d. Undoing

d. Undoing

Maturational/internal

-ACHIEVING new developmental stages, which requires learning additional coping mechanisms. (Getting married or retiring)

Who is most likely to rape, an Acquaintance or Stranger?

-Acquaintance

What are the diff Defense Mechanisms?

-Altruism -Sublimation -Suppression -Repression -Regression -Displacement -Undoing -Rationalization -Denial -Projection

What is Guided Imagery useful for?

-Anxiety -Mild pain

Interventions for Severe/Panic Anxiety

-Attend to physical and safety needs when necessary (need for warmth, fluids, elimination, pain relief) -Maintain a calm manner -Always remain with the person experiencing severe/panic level anxiety. (NEVER LEAVE THEM) -Minimize environmental stimuli. Move to a quieter setting, and stay w/ PT. -Use clear and simple statements and repetition. -Use a low-pitched voice; speak slowly.

Projection

-Attributing unacceptable thoughts, feelings or insecurities onto others. -Projects ur INSECURITIES onto somebody else

How do u NOT to trigger the Anxious client?

-By knowing how to ACCOMODATE to the diff anxiety disorders

What are some appropriate interventions for someone who is experiencing panic level anxiety?

-Call for help -Help them relax -Take them away from a crowd to MINIMIZE STIMULI -Tend to mileu (brings them down to Mild/Mod Anxiety) -DON'T ask ?s -Deescalate the situation

What makes Guided imagery & Breathing exercises powerful?

-Calms them down/Distracts them from the stress -A coping mechanism -Controls ur emotions -Relaxes u

What will the client develop due to Rape-Trauma Syndrome?

-Client may develop a depressive or anxiety disorder -Since they may develop Depression, this puts them @ an ↑RISK FOR SUICIDE

PANIC anxiety

-Cog abilities are TRASH -Can POTENTIALLY HARM themselves or others -Client ISN'T able to process what's occurring in the enviro & can lose touch w/ reality

How to manage Stress?

-Cognitive reframing -Guided imagery & Breathing exercises

Suppression

-Consciously blocking unpleasant thoughts and feelings. -Knowing the stressor is there BUT choosing NOT to think about it

Main reason perpetrators commit rape?

-Control, to assert oneself as the authority

Moderate anxiety

-DELAYED cog abilities -Slightly reduced perception & processing of info occurs -Selective inattention can occur

Sublimation

-Dealing w/ unacceptable feelings or impulses by unconsciously substituting mature and socially acceptable activity.

Altruism

-Dealing with stress and anxiety by helping out others. -Helping others to make other urself feel better

Regression

-Demonstrating coping behavior from an earlier developmental level. -"Regresar" a tu ninez

What are 2 findings that indicate PANIC?

-Endangerment of self/others -Cognitive distortion

Denial

-Escaping unpleasant thoughts or feelings by ignoring their existence. -DENYING a fact

Honeymoon stage

-Everything is PERF

Main risk factors for rape?

-Female

When to use Guided imagery & Breathing exercises?

-For mild anxiety

Types of Anxiety Disorders

-Generalized anxiety disorder (GAD) (Uncontrollable, excess worry for the MAJORITY of days over @ LEAST 6months) -Agoraphobia (fear of being OUTISIDE of ur safe space) -Separation anxiety disorder -Specific phobias -Social anxiety disorder (social phobia) -Panic disorder

Interventions for Mild/Moderate Anxiety

-Help PT identify anxiety. (Are you comfy rn?) -Anticipate anxiety-provoking situations. (If we stayed here in the day room, would you become more anxious?) -Use nonverbal language to demonstrate interest. (SOLER) -Encourage PT to talk about their feelings & concerns. Avoid closing off avenues of communication. -Encourage problem solving w/ PT -Evaluate past coping mechanisms. (Has something like this happened before? What did you end up doing?)

Rationalization

-Justifying an unreasonable feeling or action by creating an acceptable explanations that satisfies the individual. -Making up a shitty excuse to make urself feel better

Severe anxiety

-Learning & prob. solving DON'T occur -Client may scream, cry, in shock, or may endanger their own safety

Common Characteristics of a Victim

-Low self-esteem -Helpless, Hopeless, powerless, guilt, shame -May consider the abuse as warranted

Levels of Anxiety?

-Mild -Moderate -Severe -PANIC!

Mild anxiety

-NOTABLE ↑ vitals -Improved cog. abilities -Some psychomotor agitation (finger or foot tapping, etc.)

Adventitious

-Natural disasters, crimes, national disasters -People in communities w/ LG-scale psychological trauma caused by natural disasters

What is the MOST COMMONLY reported Type of Violence?

-Neglect

Types of OCDs

-Obsessive compulsive disorder (OCD) -Hoarding disorder -Body dysmorphic disorder (U hate ur body & pick @ "every flaw")

Undoing

-Performing an act to make up for prior behavior.

What are the Diff Types of Violence (Abuse)?

-Physical (some sort of injury present) -Emotional (verbal/psychological) -Financial (economic) -Sexual -Neglect

Common Characteristics of a Perpetrator

-Poor impulse control -Poor coping skills -Lacking knowledge in role -Low self esteem -Likely to have experienced violence as a child -Possible hx of substance abuse

NSG Care for Anxiety

-Safety First! Stay with the client in distress -Know how NOT to trigger the client -Relaxation techniques / milieu management -sAdaptive / healthy coping

Displacement

-Shifting FEELINGS related to an object, person, or situation to another less threatening object, person, or situation. -About the emotions

Diff Type of Crises?

-Situational/external -Maturational/internal -Adventitious

What are the Cycles of Violence?

-Tension-building stage -Acute battering stage -Honeymoon stage

Situational/external

-UNANTICIPATED loss or change experienced in everyday, often unanticipated, life events (divorce or job change)

Repression

-Unconsciously blocking unpleasant thoughts and feelings. -INVOLUNTARILY ignoring the stressor

What would a client experience during a progressive relaxation session? A. Instruction in sequential tensing and relaxing of various muscle groups until the entire body is relaxed B. Being attached to a machine that monitors a physical parameter and receiving audible feedback about the state of that parameter C. Having a nurse enter the client's energy field to rebalance it and bring harmony D. Being led into a positive imaginary sensory experience

A. Instruction in sequential tensing and relaxing of various muscle groups until the entire body is relaxed

A patient nervously says, "Financial problems are stressing my marriage. I've heard rumors about cutbacks at work; I am afraid I might get laid off." The patient's pulse is 112/minute; respirations are 26/minute; and blood pressure is 166/88. Which nursing intervention will the nurse implement? A. Advise the patient, "Go to sleep 30 to 60 minutes earlier each night to increase rest." B. Direct the patient in slow and deep breathing via use of a positive, repeated word. C. Suggest the patient consider that a new job might be better than the present one. D. Tell the patient, "Relax by spending more time playing with your pet."

B. Direct the patient in slow and deep breathing via use of a positive, repeated word.

Child abuse perpetrators are most often: A.extended family members. B.child care workers. C.the child's parents. D.strangers.

C. the child's parents.

A parent is shopping with her much loved 2-year-old child in a large, busy urban mall. The parent suddenly realizes her stroller is missing, along with her child and purse. Which level of anxiety would likely result? A.Mild B.Moderate C.Severe D.Panic

D.Panic

Tx for Anxiety

Meds -Benzos & non-benzos ANTIDEPRESSANTS (SSRI, TCA, MAOI) for long-term pharm therapy CBT Behavioral therapies

Acute battering stage

PHYSICAL violence

Rape-Trauma Syndrome

PTSD-like: -Flashbacks -Nightmares -Hyperarousal -Avoidance -Emotional instability -May appear detached or confused