PSYCH Exam 2: Chapters 13-28

A patient with OCD has a fear of contamination. Which nursing diagnosis would be a priority? A.Impaired Skin Integrity B.Hopelessness C.Ineffective Role Performance D.Social Isolation

A Although hopelessness, ineffective role performance, and social isolation may be appropriate, fear of contamination, the most common obsession, results in compulsive handwashing, placing the patient at risk for impaired skin integrity.

A patient with PTSD startles easily and reacts irritably to small annoyances. The nurse interprets this as which of the following? A.Hyperarousal B.Intrusion C.Avoidance D.Numbing

A Hyperarousal is manifested by being hypervigilant for signs of danger, becoming easily startled, reacting irritably to small annoyances, and sleeping poorly. Intrusion refers to the individual continually experiencing the event through flashbacks and nightmares. Avoidance and numbing reflect complete powerlessness by the individual.

Which of the following reflects a biologic theory of aggression and violence? A.Monoamine oxidase A gene affects neurotransmitters. B.Person and situation factors are involved in an ongoing social interaction. C.Aggression is a learned response to a stimulus. D.Expression of aggression is rewarded.

A. An aggression-related gene (monoamine oxidase A) that affects norepinephrine, serotonin, and dopamine reflects a biologic theory for aggression and violence. Person and situation factors, aggression as a learned response, and rewarding of aggression expression reflect psychological theories for aggression and violence.

A nurse is engaged in case finding. Which activity would be involved? A.Identifying those at risk B.Assessing for suicidal ideation C.Ascertaining for a suicide plan D.Determining the severity of the intent

A. Case finding involves identifying people who are at risk for suicide to initiate proper treatment. Identifying suicidal ideation, ascertaining a suicidal plan, and determining the severity of the intent are activities involved in risk assessment.

A group is in the honeymoon stage of development. Which of the following would most likely occur? A.Testing of members B.Sharing of ideas C.Forming a group personality D.Realizing the group's purpose

A. During the beginning or honeymoon stage, the members begin to test whether they can trust one another and the leader. Sharing of ideas, forming a group personality, and realizing the group's purpose occur during the working stage of the group.

When creating a genogram, which of the following would a nurse use to denote a male family member? A.Square B.Circle C.Horizontal line D.Vertical line

A. In a genogram, squares represent males, and circles represent females. Horizontal lines represent marriages, and vertical lines connect parents and children.

Which of the following would the nurse assess as part of the physical health assessment for a patient experiencing crisis? A. Changes in health practices B. Emotions C. Coping strengths D. Individual's ability to respond

A. The nurse would assess changes in health practices as part of the physical health assessment. Assessing emotions and coping strengths are part of the psychological domain. Assessing an individual's ability to respond would be part of the social domain.

Which of the following is addressed in the family systems theory model? A.Triangles B.Internal structure C.Expressive functions D.Boundaries

A. Triangles are a concept addressed in the family systems theory model. Internal structure and expressive functions are addressed in the Calgary family model. Boundaries are addressed in the Family structure model.

Which of the following characterizes a person with a type B personality? A.Aggressiveness B.Easygoing C.Introverted D.Pessimistic

B. A person with a type B personality is relaxed and easygoing. A person with a type A personality is aggressive and competitive. A person with a type C personality is introverted. A person with a type D personality is pessimistic.

Which of the following would the nurse expect to assess in a patient experiencing akathisia? A.Resting tremor B.Motor restlessness C.Masklike face D.Shuffling gait

B. Akathisia is manifested by obvious motor restlessness such as rocking, pacing, or shifting from foot to foot. Resting tremor, masklike face, and a shuffling gait would characterize Parkinsonism.

Which intervention reflects the psychological domain when providing care to a patient who has attempted suicide? A.Providing care for the self-inflicted injury B.Challenging the patient's suicidal mindset C.Providing social skills training D.Administering medications

B. Challenging the patient's suicidal mindset would be an intervention addressing the patient's psychological domain. Providing care for the self-inflicted injury and administering medications reflect the biologic domain. Providing social skills training reflects the social domain.

Which of the following is considered a protective factor for separation and divorce? A.Irregular visitation B.Structured home environment C.Creation of new routines D.Allowance for parental conflict

B. Protective factors include a structured home and school environment, regular and predictable visitation, reduction of conflict between parents, and continuance of regular routines.

Which of the following would be considered a challenge to the psychological domain for an older adult? A.Diminished sensory function B.Slowing of mental processes C.Retirement D.Family relationship changes

B. Slowing of mental processes reflects cognitive function and psychological challenge. Diminished sensory function is a biologic challenge. Retirement and family relationship changes are social challenges.

In the stage theories of grief and bereavement which stage or phase closely resembles clinical depression?? A. Shock and disbelief B. Conservation withdrawal C. Renewal D. Awareness of loss

B. During the conservation withdrawal stage or phase the response closely resembles clinical depression.

Which agent would most commonly be prescribed for a patient with bipolar I disorder? A.Lamotrigine B.Lithium C.Carbamazepine D.Divalproex

B. Lithium Although divalproex, carbamazepine, and lamotrigine may be used as mood stabilizers, lithium is the most widely used mood stabilizer.

Which of the following is considered a task role? A.Compromiser B.Group observer C.Elaborator D.Encourager

C. The elaborator is a task role. The compromiser, group observer, and encourager are maintenance roles.

Which of the following would a nurse identify as a neurovegetative symptom? A.Impaired occupational functioning B.Flat affect C.Disturbed sleeping D.Hyperactivity

C. Disturbed sleeping Neurovegetative symptoms include appetite and weight changes; sleep disturbance; and decreased energy, tiredness, and fatigue.

Which of the following reflects the psychoanalytic theory related to the cause of borderline personality disorder? A.Increased dopamine secretion B.Structural change in the limbic system C.Lack of ability to separate from the primary caregiver D.Issues of emotional vulnerability and dysregulation

C. Lack of ability to separate from the primary caregiver •One focus of the psychoanalytic view is separation-individuation in which the individual lacks the ability to separate from the primary caregiver and develop a separate and distinct personality. Increased dopamine secretion and limbic system changes reflect biologic theories. Issues of emotional vulnerability and dysregulation reflect the biosocial viewpoint.

Which of the following would be considered a protective factor? A.Gender B.Unemployment C.Parenting stress D.Education

D. Education is considered a protective factor. Gender, unemployment, and parenting stress are considered psychosocial risk factors.

What nursing diagnosis would a nurse most likely identify as reflecting the social domain for a patient experiencing stress? A.Ineffective Therapeutic Regimen B.Ineffective Coping C.Hopelessness D.Ineffective Role Performance

D. Ineffective role performance reflects the social domain. Ineffective therapeutic regimen reflects the biologic domain. Ineffective coping and hopelessness reflect the psychological domain

Which of the following would the nurse be least likely to assess in a patient experiencing neuroleptic malignant syndrome? A.Diaphoresis B.Muscle rigidity C.Incontinence D.Unreactive dilated pupils

D. Unreactive dilated pupils would suggest anticholinergic crisis. Diaphoresis, muscle rigidity, and incontinence would be associated with neuroleptic malignant syndrome.

When applying the ABCs of psychological first aid, the nurse addresses which of the following with cognition? A. Decreasing excitement B. Providing for safety C. Assisting to function more effectively D. Providing reality testing

D. When applying the "C" of the ABCs, the nurse would perform reality testing and provide clear information. Decreasing excitement occurs with "A," arousal. Providing for safety and assisting the person to function more effectively occurs with "B," behavior.

Which agent would a nurse least likely expect to administer to a patient experiencing panic disorder? A.Fluoxetine B.Sertraline C.Imipramine D.Buspirone

D. Buspirone Buspirone is more likely to be prescribed for a patient experiencing generalized anxiety disorder. Fluoxetine, sertraline, and imipramine are used to treat panic disorder.

A patient with BPD is receiving dialectical behavior therapy. Which type of skills training would least likely be involved? A.Mindfulness B.Distress tolerance C.Self-management D.Self-awareness

D. Self-awareness •The nurse needs to develop self-awareness skills when working with patients diagnosed with BPD. Mindfulness, distress tolerance, and self-management skills are part of dialectical behavior therapy.

Which of the following would the nurse be alert for in a patient receiving fluoxetine? A.Hypertensive crisis B.Sedation C.Weight gain D.Serotonin syndrome

D. Serotonin syndrome Fluoxetine is an SSRI and may lead to the development of serotonin syndrome. Tricyclic antidepressants are commonly associated with sedation and weight gain. Hypertensive crisis occurs with MAOIs if they are coadministered with food or other substances containing tyramine.

A crisis is an event that typically occurs over a prolonged period of time and is associated with negative outcomes. True or false?

False. A crisis is a time-limited event that triggers adaptive or maladaptive responses in which the outcomes can be positive or negative.

An expansive mood is characterized by euphoria. True or false?

False. An elevated mood is characterized as euphoria. An expansive mood is one involving a lack of restraint in expression and overvalued self-importance.

A patient with depression is at greatest risk for suicide when his or her mood is at the lowest point. True or false?

False. As patients begin to feel better and have increased energy, they may be at greater risk for suicide.

Inwardly directed anger causes more problems than outwardly directed anger. True or false?

False. Both outwardly directed and inwardly directed anger produce adverse consequences.

Confidence and awe are considered positive emotions. True or false

False. Confidence and awe are emotional reactions that are too ambiguous to fit into the categories of positive, negative, or borderline emotions and are thus classified as nonemotions.

Young and middle-aged development is currently viewed as a relatively stationary plateau. True or false?

False. Currently, young and middle-aged development is viewed as dynamic and multifaceted. In previous years, however, it was viewed as a relatively stationary plateau with rapid and complex changes of childhood and adolescence forming one steep side and the declining changes of old age as the other.

The size of the typical family has been shown to increase in recent years. True or false?

False. Family size in the United States has decreased, such that the average family household in 2013 was 2.6 people

Groupthink is a common occurrence in psychoeducation groups. True or false?

False. Groupthink commonly occurs in a decision-making group when group members form opinions consistent with the group consensus rather than critically evaluating the situation. Psychoeducation groups are formally planned, and members are purposefully selected.

Hallucinations are considered positive symptoms, but delusions are considered negative symptoms. True or false?

False. Hallucinations and delusions are considered positive symptoms.

As a person reaches middle age, the brain undergoes major structural changes. True or false?

False. In middle age, brain structural changes are minimal, and although neurons are gradually being lost, changes in cognition are not evident.

Women account for more cases of deaths from suicide than men. True or false?

False. More men complete suicide resulting in death than women.

Panic is considered abnormal regardless of the situation and degree of threat. True or false?

False. Panic is considered normal during periods of threat; it is considered abnormal when it is continuously experienced in situations of no real physical or psychological threat.

The aim of parasuicide is death. True or false?

False. Parasuicide refers to a voluntary, apparent attempt at suicide in which the aim is not death.

Preschool-aged children commonly express their grief with physical complaints. True or false?

False. Preschool-aged children react more to others' responses than to death itself. School-aged children commonly express grief through somatic complaints.

The disaster event marks the first phase of a disaster. True or false ?

False. The prewarning of the disaster is considered the first phase of a disaster. This is followed by the disaster event and finally recuperative efforts.

To meet the diagnostic criteria, a person with GAD must experience excessive worry and anxiety for a minimum of 3 months. True or false?

False. To be diagnosed with GAD, a person must experience excessive worry and anxiety for at least 6 months.

During adaptation, if health is affected, psychological well-being and social functioning will not be affected.

False. With adaptation, if one area such as health is affected, then most likely psychological well-being and social functioning will also be affected.

Is the following statement true or false? •Long-term use of psychopharmacologic agents is a primary mode of treatment for BPD.

False. •Less medication is better for patients with BPD. Patients should take medications only for target symptoms for a short time.

A small group is typically more cohesive than a large group. True or false?

True. A small group, because of its size, typically provides a more cohesive group because the leader and members can get to know each other very well.

Children commonly react to physical illness with regression.

True. Although children can react to physical illness in different ways, a common reaction is regression.

The family life cycle is assessed as part of the family's psychological domain.

True. Assessment of the family's psychological domain includes family development, family life cycle, communication patterns, stress and coping abilities, and problem-solving skills.

Children experiencing depression commonly exhibit an irritable mood. True or false?

True. Children commonly exhibit an irritable mood rather than a sad mood with depression.

Protecting the patient from self-harm is crucial during a manic phase. True or false?

True. During mania, patients usually violate others' boundaries, and they may miss the cues indicating anger and aggression from others. Thus, protecting the patient from self-harm as well as harm from others is important.

Instrumental aggression is premeditated and unrelated to person's pain. True or false?

True. Instrumental aggression is premeditated and unrelated to person's pain.

Older adults who view aging positively actually live longer. True or false?

True. Research has shown that those with a positive attitude toward aging age better and live longer.

Social theories contribute to changes in brain function that result in schizophrenia. True or false

True. Social factors can contribute to the changes in brain function that result in schizophrenia and add to the day-to-day challenges of living with a mental illness

A key intervention for promoting safety and preventing violence is the development of the nurse-patient relationship. True or false?

True. When working with aggressive and violent patients, promoting safety and preventing violence are the major goals. To achieve these goals, the nurse works to establish the therapeutic nurse-patient relationship and create a therapeutic milieu.

Is the following statement true or false? •A person with a borderline personality disorder often experiences difficulties in his or her ability to relate to others.

True. •With borderline personality disorder, the person typically experiences a disturbance in interpersonal functioning such that he or she has difficulty maintaining interpersonal relationships.