WPUNJ 3290 (Exam #2) Coping x Cognition

What powerful tool will increase self-efficacy and control for a person who is stressed? 1.Self-perception 2.Denial 3.Education 4.Maladaptive coping

3. Education

Anger, anxiousness, sadness, and hopelessness are evidence of which coping type? 1.Primary 2.Positive 3.Adequate 4.Poor

4. Poor

WHAT ARE THE S/S OF DELIRIUM. WHICH ASSESSMENT FINDINGS WOULD THE NURSE EXPECT TO SEE? SELECT ALL THAT APPLY. •A. DISORIENTATION TO PLACE, TIME •B. IMPAIRED LEVEL OF CONSCIOUSNESS •C. APATHY •D. ACUTE ONSET OF CONFUSION. •E. SLOW ONSET OF CONFUSION

A,B D.

In an effort to foster a healthy grief response to the birth of a stillborn child, how should the nurse respond to the mother's questions about the cause? A. "You may be wondering whether something you did caused this." B. "This often happens when something is wrong with the baby." C. "It's God's will; we have to have faith that it was for the best."

A. "You may be wondering whether something you did caused this." The mother must be helped to identify her feelings.One's own religious bias must not be projected unto the client, it does not encourage the client to explore her feelings. Many stillborn children are apparently free of any defects.

Tell if the following signs and symptoms of dementia are: Mild, mod, severe or terminal: A. Confusion B. Mute C. Motor Impairment D. Insomnia

A. Confusion - Moderate B. Mute - Terminal C. Motor Impairment - Severe D. Insomnia - Moderate

Select all that apply: Who is most at risk for cognitive impairment? A. The elderly B. The very young C. Those who use substance abuse D. Those who have had traumatic experiences E. Pregnant women

A. Elderly C. Substance abusers D. traumatic experiences

What is the use of the confusion assessment method? A. It is used in diagnosis delirium B. it is used for direct treatment C. it is used to by client's to asses their symptoms D. It is used diagnose dementia

A. It is used in diagnosis delirium

Tell if the following signs and symptoms of dementia are: Mild, mod, severe or terminal: A. Personality changes B. Best-Fast C. Agnosia D. Impaired memory loss E. Incontinence F. Dysphagia

A. Personality changes - Mild B. Best-Fast - Terminal C. Agnosia - moderate D. Impaired memory loss - Mild E. Incontinence - severe F. Dysphagia - Terminal

Name three ways that a nurse can help with the outcomes of cognitive disorders:

A. ensure they have the things they need close to them. B. Speak loud enough for them to hear and use simpler sentences so get don't have to confabulate stories C. omit unnecessary medication

What are cognitive disorders?

Anything that interferes with the 7 traits of cognition.

A nursing student waiting to get tested on an exam decides to wait to study for an exam and puts it off until she passes her pharm exam. This is an example of? A. Intellectualization B. Repression C. Reaction Formation D. Sublimation

B. Repression

What is the priority when a nurse is formulating a plan of care for a client with a diagnosis of dementia of the Alzheimer type? A. Implementing remotivational therapy B. Structuring the environment for safety C. Arranging for long-term custodial care D. Stimulating thinking with new experiences

B. Structuring the environment for safety

Which are the most important assessment data for a nurse to gather from the client in crisis? The client's work habits A. Any significant physical health data B. A history of emotional problems in the family C. The client's perception of the circumstances surrounding the crisis

C. Knowing the client's perception of the circumstances surrounding the crisis helps the nurse determine what the situation means to the client.

A patient has been suffering the last three years with problems remembering what she did the day before and remember what is needed to prepare a meal she used to make often. This is an example of : A. Amnesia B. Parkinsonism C. Dementia D. None of the above

C. dementia is a progressive disease characterized by Difficulty with memory, problem solving.

In clients with a cognitive impairment disorder, the phenomenon of increased confusion in the early evening hours is called: A. Aphasia. B. Agnosia. C. Sundowning. D. Confabulation

C. sundowning

Mrs. Mendoza is a 75-year-old client who has dementia of the Alzheimer's type and confabulates. The nurse understands that this client: A. Denies confusion by being jovial. B. Pretends to be someone else. C. Rationalizes various behaviors. D. Fills in memory gaps with fantasy.

D. Fills in memory gaps with fantasy.

A baby throws a temper tantrum after not being able to play with his moms phone, He throws himself on the floor, this is an example of which coping mechanism? A. Undoing B. Dissociation C. Rationalization D. Acting out

D. Acting out

A patient is unable to tell her daughter that she wants to use the bathroom, because of her inability to recall how to communicate. This is an example of: A. Ataxia B. Apraxia C. Agnosia D. Aphasia

D. Aphasia (LANGUAGE) inability to express language

A student nurse was asked which of the following best describes dementia. Which of the following best describes the condition? A. Memory loss occurring as part of the natural consequence of aging B. Difficulty coping with physical and psychological change C. Severe cognitive impairment that occurs rapidly D. Loss of cognitive abilities, impairing ability to perform activities of daily living

D. Loss of cognitive abilities, impairing ability to perform activities of daily living

JUST A TIP

PREVENTION IS KEY

This is common in paranoia and OCD. as the person becomes trapped in the cycle of repeating a behavior to make amends for unacceptable behavior. (They do the opposite of what they initially intended)

Reaction formation.

How Is delirium manifested? !! Professor emphasized that this would be on the exam!!

Remember DIVA! Disorganized thought/disoriented to person/place/time. Inattention Varying levels of consciousness and activity Acute onset

What is the key element associated with an examination of coping? 1.Observation of behavior 2.Psychological testing 3.Physical examination 4.Assessment of vital signs

1. Observation of behavior

A patient with dementia attempts to brush his teeth with a spoon. Which problem is evident? A.Aphasia B.Apraxia C.Agnosia D.Perseveration

B. Apraxia (MOVEMENT) (think apraxia sounds Like practice, usually it is the physical things that we practice doing our entire lives that we forget in the types of cognitive impairments).

After a traumatic event, a client is extremely upset and exhibits pressured and rambling speech. What therapeutic technique can the nurse use when a client's communication rambles? A. Touch B. Silence C. Summarizing D. Focusing

D. focusing

JUST a reminder !

DELIRIUM IS REVERSIBLE and often secondary to another diagnosis such as hypoxemia, alcohol abuse and infection.

After failing her final exam, Yessenia is booted from her nursing program. Over the summer Yessenia puts these thoughts from her memory and looks over the nursing courses she would be taking and starts putting things down on her planner to study. this is an example of which type of defense mechanism?

Denial

What is the most primitive and original defense mechanism as said by Freud?

Denial

What are the three stages of Alzheimer's?

Early (Preclinical AD) SILENT PHASE- subtle changes in memory and personality. Hard to detect, pt knows it, doctor doesn't). Middle (Mild Cognitive Impairement) - continuing changes in memory, speech and orientation. One or more cognitive domain, Late - (Dementia) completely dependent on others for care. IT IS OBVIOUS.

What is coping?

It is a conscious means of alleviating stress using emotional, cognitive, or behavioral methods

Two reasons we use defense mechanism? !! professor said to remember this for the exam. !!

1. change in reality 2. Keeps anxiety, shock, guilt and blame in bearable limits. 3. unresolved conflicts.

The nurse tells the client to place the leftovers into the bin after eating breakfast, the patient understands but has difficulty with tilting the tray to place the food items into the bin. This is an example of? A. Ataxia B. Apraxia C. Agnosia D. Aphasia

B. Apraxia (MOVEMENT) The inability to carry out normal / learned functions although instructions given may be understood.

A patient's mother complains of frequent incontinence, severe aggression and constant agitation of her son who is suffering bouts of impairment, the primary concern of the nurse in this situation is? A. Patient's safety based on the mother's information B. Care giver burn out, ask the mother how you can help. C. Patient is exhibiting worsening of symptoms. D. Remind the mother that her role is pivotal in her son's wellbeing

B. Care giver burn out, ask the mother how you can help.

Jody has a very prominent nose & spends a great deal of time applying makeup to accentuate her eyes, & a great deal of money to emphasize her figure. A. Reaction formation B. Compensation C. Undoing D.Rationalization

B. Compensation

A person decides to start doing yoga and get counseling after her bouts of stress from nursing school this is an example of: A. Defense Mechanism B. Coping mechanism C. Intellectualization D. Dissosciation

B. Coping mechanism It is a conscious effort to cope.

Nurse Isabelle enters the room of a client with a cognitive impairment disorder and asks what day of the week it is; what the date, month, and year are; and where the client is. The nurse is attempting to assess: A. Confabulation B. Orientation C. Delirium D. Preservation

B. Orientation

Which ability should Nurse Rebecca expect from a client in the mild stage of dementia of the Alzheimer's type? A. Remembering the daily schedule B. Recalling events from 10 years ago C. Coping the anxiety D. Solving problems of daily living

B. Recalling events from 10 years ago (often in. mild stages, short term memory is affected as well as personality changes)

Patient exhibits delirium the nurse should: Select all that apply: A. Leave the room so the patient can have the time they need to calm down B. Sit with the patient until they are calmer C. Turn the light off to decrease the amount of stimulus affecting the patient D. Provide a quiet, well lit room for the patient. E. A room without glare and shadows.

B.D.E. Don't leave the patient alone, they are unstable. Do not turn of the lights while a patient is exhibiting delirium like symptoms, this can pose a threat to their safety.

A female adolescent in group therapy tells the other group members that while out on a pass she used marijuana because her boyfriend made her smoke it. What defense mechanism is the client using? A. Denial B. Undoing C. Projection D. Displacement

C. Projection involves blaming others for one's own difficulties or behaviors

A patient was brought to the ICU after exhibiting bouts of agitation, heart palpitations, feeling lost and medium anxiety throughout the day. Based upon these signs and symptoms, the nurse would suspect: A. Alzheimer B. Dementia C. Delirium D. Parkinsonism

C. Delirium •There is a reduced awareness of the environment, with symptoms possibly fluctuating over different periods of the day.

A child has been found to have acute myelogenous leukemia. The practitioner has discussed the diagnosis and prognosis with the parents. Later, after visiting their child, the parents have a bitter argument. The nurse identifies what defense mechanism? A. Denial B. Projection C. Displacement D. Compensation

C. Displacement. The parents are focusing their feelings about their child's prognosis on someone or something else—in this case, each other. Denial is ignoring, avoiding, or refusing to recognize painful realities. Projection is the attribution of one's own feelings to another person. Compensation is making up for a perceived deficiency by emphasizing another feature perceived as an asset.

A nurse caring for a pregnant client prioritizes nursing actions on the basis of Maslow's hierarchy of needs. Which statement of the client does the nurse consider to be a self-esteem need? A. "I cannot contact my family as I eloped from home in order to get married." B."If I don't comply with my husband's demands, I might not have anywhere to live." C."I deserve ill treatment from my husband as I'm incapable of doing even simple things perfectly."

C."I deserve ill treatment from my husband as I'm incapable of doing even simple things perfectly."

The patient at a nursing home is visited by her daughter who visits daily to read and send time with her mother. The daughter goes to hug the mother who becomes afraid and runs away telling her daughter to "get away from me". This is an example of: A. Ataxia B. Apraxia C. Agnosia D. Aphasia

D. Agnosia (sounds like I don't know ya) - RECOGNITION It is abnormalities of perception. The mother was once able to perceive the face of her daughter, is now unable to and perceives her as a stranger. This can happen with other senses such as smell, taste, touch and sounds.

As a child, Rhoda was abused by her step father in every way. Today she talks about these events without anxiety or any emotion. A. Intellectialization B. somatization C. Reaction Formation D. Dissociation

D. Dissociation

A husband watched his wife give birth to twins. His wife screams in pain and the husband watches holding his stomach, almost as if feeling the pain as well. This is an example of? A. Reaction formation B. Denial C. Introjection D. Somatization

D. Somatization

A 40-year-old male client begins to display signs of anger and aggression during a group therapy session. To prevent or minimize this behavior, it is important for the nurse to understand that anger and aggression are often preceded by what emotion? A. Elation B. Isolation C. Depression D. Vulnerability

D. Vulnerability

What is isolation of affect?

It is a defense mechanism, namely intellectualization.

What are defense mechanisms?

It is an unconscious means by which mental processes protect individuals from strong or stressful emotions and situations

What is sublimation ?

It is the most constructive of all the defense mechanisms. It is the use of something negative and turning it into something positive.

What are the 7 traits of cognition?

Learn know understand remember perceive problem solve and communicate

What is the difference between suppression and repression?

Supression is voluntary refusal to deal with something uncomfortable while repression is involuntary.

What is preservation?

constantly repeating the same things over and over again.

What is the main difference between coping and defense mechanisms? !! - Professor said to know this for the exam !!

coping mechanism - conscious effort to cope Defense mechanism - unconscious effort to cope

What is the scope of coping?

ineffective coping = destructive Effective coping = constructive