Mental Health Chapter 27 Anxiety-Related, Obsessive-Compulsive, Trauma- and Stressor-Related, Somatic, and Dissociative Disorders

15. The nurse would expect which comment from a patient diagnosed with depersonalization disorder? a. "I feel like I'm outside my body, watching what's happening." b. "I feel as though someone is reading thoughts in my mind." c. "I know I have cancer, but the doctors can't find it." d. "When I woke up, my legs were paralyzed."

a. "I feel like I'm outside my body, watching what's happening."

11. What is the nurse's initial action when working with a patient with diagnosed with posttraumatic stress disorder (PTSD)? a. Assure the patient that the nurse can be trusted. b. Work with the patient to find a way to reduce stress. c. Encourage verbalization rather than physical acts to address anger. d. Support the patient's ability to evaluate past behaviors as either effective or noneffective.

a. Assure the patient that the nurse can be trusted.

13. After a mass transit disaster many injured patients are expected at the emergency room. The nurse prepares to plan interventions for which likely mental health assessment findings? a. Dissociative symptoms, numbing, detachment, and derealization b. Auditory hallucinations and other perceptual distortions including paranoia c. Somatic neurologic disorders and amnesia d. Exaggerated mood including both depression and manic-related elation

a. Dissociative symptoms, numbing, detachment, and derealization

17. What should the priority focus of milieu management be for a client diagnosed with dissociative identity disorder (DID)? a. Ensuring client safety b. Stimulating memory return c. Attending insight-oriented group therapy d. Gathering data about family relationships

a. Ensuring client safety

8. A patient is hospitalized with somatic blindness. The patient is unconcerned about the blindness and says, "I'm sure things will turn out all right." Which term best describes this reaction? a. La belle indifference b. Trance c. Dissociation d. Fugue

a. La belle indifference

1. A patient diagnosed with posttraumatic stress disorder (PTSD) has frequent flashbacks and persistent hyperarousal symptoms. Which nursing interventions should be planned to effectively need the patient's needs? (Select all that apply.) a. Offer empathy and support. b. Encourage relaxation activities. c. Encourage verbalization of anger. d. Set limits when the patient begins to tell of the story of the traumatic incident. e. Help the patient associate current feelings and behaviors with trauma experience.

a. Offer empathy and support. b. Encourage relaxation activities. c. Encourage verbalization of anger. e. Help the patient associate current feelings and behaviors with trauma experience.

18. What is the most important assessment question to ask a patient suspected of having a dissociative disorder? a. "Do any members of your family have problems with drugs or alcohol?" b. "Do you ever find yourself in places with no idea how you got there?" c. "How would you describe your current level of anxiety?" d. "How do you think we can be of help to you?"

b. "Do you ever find yourself in places with no idea how you got there?"

14. Which statement by a patient diagnosed with somatic symptom disorder indicates that goals for treatment are being achieved? a. "I need to be very careful about what I eat." b. "I can focus on things other than my symptoms." c. "I understand that my doctor is not an expert in everything." d. "I try to figure out my diagnosis by reading articles on the Internet."

b. "I can focus on things other than my symptoms."

1. Which statement demonstrates a nurse's understanding of the first intervention when caring for a patient experiencing severe anxiety over an impending divorce? a. "Let me you solve the biggest problem the divorce will cause you." b. "I want you to know I'll be here to keep you safe." c. "Please tell me what today's date is." d. "You can go into your room and close the door when you need privacy."

b. "I want you know I'll be here to keep you safe."

25. The nurse is assigned to care for a patient with moderate anxiety (+2). Which intervention will best manage the patient's signs and symptoms? a. Appropriate use of time-out b. Initiating problem-solving techniques c. Planning care to include firm guidance and control d. Assessing the need for a parenteral antianxiety drug

b. Initiating problem-solving techniques

24. A nurse is assigned to care for a patient diagnosed with moderate (+2) anxiety. Which assessment findings are most likely? a. Distorted perceptions, disorientation, and defensiveness b. Poor concentration, narrow perceptions, and irritability c. Irrational reasoning and loss of contact with reality d. Alertness, attentiveness, and accurate perceptions

b. Poor concentration, narrow perceptions, and irritability

20. The effects of stress can be seen by measurement of clinical changes of the body. This statement is a tenet of which theorist? a. Freud b. Selye c. Peplau d. Sullivan

b. Selye

A patient diagnosed with obsessive-compulsive disorder (OCD) experiences improvement after beginning treatment with a selective serotonin reuptake inhibitor (SSRI). This phenomenon supports the theory that OCD is associated with what neurotransmitter issue? a. Norepinephrine deficiency b. Serotonin dysregulation c. Dopamine excess d. GABA deficiency

b. Serotonin dysregulation

21. If a patient's threshold set point for anxiety is lowered, the nurse can expect subsequent stressors to: a. have a lesser effect. b. easily reactivate the anxiety response. c. produce marked personality disorganization. d. be easily managed using familiar coping strategies.

b. easily reactivate the anxiety response.

9. Which principle best applies to care of a patient diagnosed with conversion disorder? a. Structure care to provide time for rituals. b. Facilitate progressive review of the trauma. c. Give attention to the patient, not the symptom. d. Permit dependence while the symptoms are acute.

c. Give attention to the patient, not the symptom.

5. When working with a patient diagnosed with dissociative amnesia, the nurse should begin the care by implementing which intervention? a. Setting mutual goals for behavioral changes b. Instituting measures to prevent identity diffusion c. Identifying and supporting the patient's strengths d. Helping the patient develop a realistic self-concept

c. Identifying and supporting the patient's strengths

22. An anxious patient has distorted perceptions and ineffective reasoning. On an anxiety rating scale, the nurse would expect to record the patient's level of anxiety at what level? a. Mild, +1 b. Moderate, +2 c. Severe, +3 d. Panic, +4

c. Severe, +3

4. A patient's family member died in the 9/11 World Trade Center explosion. The patient says, I can't go into tall buildings because I get sweaty, my heart races, and I can't breathe. I get terrifying feelings the building will explode." Which response demonstrates the nurse's understanding of this symptoms/signs? a. "What rituals do you preform to control your anxiety?" b. "Have you ever been diagnosed with generalized anxiety disorder (GAD)?" c. "Your symptoms/signs suggest possible acute stress disorder (ASD)." d. "It appears you are experiencing a specific phobia associated with your family's tragedy."

d. "It appears you are experiencing a specific phobia associated with your family's tragedy."

12. Which statement made by an individual diagnosed with PTSD best indicates that treatment was effective? a. "I'm drinking less now that I've faced my problems." b. "I feel like the accident happened to someone else." c. "I sleep for 3 to 4 hours a night without nightmares." d. "My artwork distracts me and eases my anxiety."

d. "My artwork distracts me and eases my anxiety."

23. A patient is demonstrating severe (+3) anxiety. Nursing interventions should center around which patient need? a. Encouraging ventilation and refocusing attention b. Discussing possible sources of anxiety c. Taking control to guide the patient d. Decreasing stimuli and pressure

d. Decreasing stimuli and pressure

16. Which assessment data supports a patient's diagnosis of dissociative fugue? a. Preoccupation about having a serious disease b. Feeling of detachment from one's body c. Believing that part of the body is ugly or disproportionate d. Having no memory of assuming a new identity

d. Having no memory of assuming a new identity

10. A patient diagnosed with panic attacks frequently awakens from sleep and is diaphoretic and hyperventilating. What instruction should the nurse provide the patient to help manage this situation in the future? a. Immediately use one of the various relaxation techniques they've learned. b. Immediately use the call bell to alert staff of the panic attack. c. Get out of bed immediately and watch television as a distraction. d. Immediately breathe into a paper bag kept in the nightstand.

d. Immediately breathe into a paper bag kept in the nightstand.

3. A patient says, "I have the same continuous and intrusive thoughts that my house is contaminated with lethal bacteria. I spend hours cleaning the walls, floors, and furniture." These symptoms are most consistent with which diagnosis? a. Social phobia b. Panic disorder c. Somatoform disorder d. Obsessive compulsive disorder (OCD)

d. Obsessive compulsive disorder (OCD)

6. A patient diagnosed with obsessive-compulsive disorder (OCD) paces up and down the corridor, counting every floor tile. How should the nurse address the patient's behavior? a. Offer to play cards with the patient in the dayroom as a distraction. b. Encourage the patient to focus by asking, "Why are you pacing and counting?" c. Interrupt the behavior by taking the patient's arm and escort the patient to a quiet area. d. Permit the patient to pace and count while monitoring for safety.

d. Permit the patient to pace and count while monitoring for safety

7. A driver was trapped in a car for several hours after an earthquake caused a bridge to collapse. A year later this person still has nightmares and re-experiences feelings of fear associated with being trapped in the car. The assessment findings are consistent with symptoms of which mental health diagnosis? a. Agoraphobia b. Panic attacks c. Generalized anxiety disorder (GAD) d. Posttraumatic stress disorder (PTSD)

d. Posttraumatic stress disorder (PTSD)

19. Which term describes the final stage in the normal process of anxiety? a. Panic b. Crisis c. Disorganization d. Coping

d. coping