NURS 311 Quiz 9

a nurse is caring for a client diagnosed with an obsessive-compulsive disorder. what is the basis for the obsessions and compulsions? 1. unconscious control of unacceptable feelings 2. conscious use of this method to punish themselves 3. acceptance of voices that tell them the doorknobs are unclean 4. fulfillment of a need to punish others by carrying out an annoying procedure

1. unconscious control of unacceptable feelings

A client is using ritualistic behaviors. Why should a nurse allow the client ample time for the performance of the ritual? 1. Denial of this activity may precipitate panic levels of anxiety. 2. Anger turned inward on the self should be allowed to be expressed. 3. Successful performance of independent activities enhances self-esteem. 4. Ample time provides an opportunity to point out the inappropriate behavior

1. Denial of this activity may precipitate panic levels of anxiety.

A nurse is caring for a client with a somatoform disorder. What should the nurse anticipate that this client will do? 1. Redirect the conversation with the nurse to physical symptoms. 2. Monopolize conversations about the anxiety being experienced. 3. Write down conversations to assist in remembering information. 4. Start a conversation asking the nurse to recommend palliative care.

1. Redirect the conversation with the nurse to physical symptoms.

an anxious client reports experiencing pain in the abdomen and feeling empty and hollow. a diagnostic workup reveals no physical causes of these clinical findings. what term best reflects what the client is experiencing? 1. dissociation 2. somatization 3. stress response 4. anxiety reaction

2. somatization

196 A nurse is developing a care plan for a client with an obsessive-compulsive behavior disorder. Which nursing intervention will most likely increase the client's anxiety? 1. Helping the client understand the nature of the anxiety 2. Limiting the client's ritualistic acts to three times a day 3. Involving the client in establishing the therapeutic plan 4. Providing the client with a nonjudgmental environment

2. Limiting the client's ritualistic acts to three times a day

what characteristic of anxiety is associated with a diagnosis of conversion disorder? 1. free floating 2. relieved by the symptom 3. consciously felt by the client 4. projected onto the environment

2. relieved by the symptom

A nurse is caring for a client who uses ritualistic behavior. What common antiobsessional medication does the nurse anticipate will be prescribed? 1. Benztropine 2. Amantadine 3. Fluvoxamine 4. DiphenhydrAMINE

3. Fluvoxamine

What should a nurse consider when planning care for a client who is using ritualistic behavior? 1. Nurses must attempt to limit the ritualistic behavior. 2. Clients need to realize that ritualistic behavior serves no purpose. 3. Nurses should try to divert the ritual immediately after it is started. 4. Clients do not want to repeat the ritual but feel compelled to do so.

4. Clients do not want to repeat the ritual but feel compelled to do so.

A nurse is preparing to care for a client who engages in ritualistic behavior. What should the plan of care include? 1. Redirect energy into activities to help others. 2. Teach the client that the behavior is not serving a realistic purpose. 3. Administer antianxiety medications that block out the memory of internal fears. 4. Help the client to understand that the behavior is caused by maladaptive coping to increased anxiety.

4. Help the client to understand that the behavior is caused by maladaptive coping to increased anxiety.

a client comes to a mental health center with severe anxiety evidenced by crying, wringing the hands, and pacing. what should be the first nursing intervention? 1. stay physical close to the client 2. gently ask what is bothering the client 3. tell the client to try to relax by sitting quietly 4. involve the client in a nonthreatening activity

1. stay physical close to the client

a client believes that doorknobs are contaminated and refuses to touch them, except with a paper tissue. what nursing intervention is most therapeutic for this client? 1. supply the client with paper tissues to help functioning until anxiety is reduced 2. have the client scrub the doorknobs with a strong antiseptic so that tissues are no longer needed 3. encourage the client to touch doorknobs by removing all available paper tissue until learning how to manage the situation 4. explain to the client that the idea about doorknobs being contaminated is part of the illness, so precautions are not necessary

1. supply the client with paper tissues to help functioning until anxiety is reduced

What is the priority discharge criterion for a client who is using ritualistic behaviors? 1. Verbalizes positive aspects about the self 2. Follows the rules of the therapeutic milieu 3. Intervenes to maintain increasing anxiety at a manageable level 4. Recognizes that hallucinations occur at times of extreme anxiety

3. Intervenes to maintain increasing anxiety at a manageable level

what is an appropriate way a nurse can help a client to decrease anxiety? 1. avoid unpleasant events 2. prolong exposure to fearful situations 3. acquire skills with which to face stressful events 4. introduce an element of pleasure into fearful situations

3. acquire skills with which to face stressful events

a nurse considers that in a conversion disorder pseudoneurologic symptoms such as paralysis or blindness: 1. are unconscious methods for getting attention 2. will subside if the client is helped to focus on getting healthy 3. are generally necessary for the client to cope with a stressful situation 4. will usually resolve when the client learns to cope with ongoing family conflicts

3. are generally necessary for the client to cope with a stressful situation

a nurse is caring fora client who has a diagnosis of conversion disorder with paralysis of the lower extremities. which is the most therapeutic nursing intervention? 1. encouraging the client to try to walk 2. explaining to the client that there is nothing wrong 3. avoiding focusing on the clients physical symptoms 4. helping the client follow through with the physical therapy plan

3. avoiding focusing on the clients physical symptoms

a client newly diagnosed with a conversion disorder is manifesting paralysis of a leg. the nurse can expect this client to: 1. demonstrate a spread of paralysis to other body parts 2. require continuous psychiatric treatment to maintain independent functioning 3. recover the use of the affected leg but, under stress, again develop similar symptoms 4. follow an unpredictable emotional course in the future, depending on exposure to stress

3. recover the use of the affected leg but, under stress, again develop similar symptoms

What should a nurse include in the initial plan of care for a client with the long-standing, obsessive-compulsive behavior of hand washing? 1. Determine the purpose of the ritualistic behavior. 2. Limit the time allowed for the ritualistic behavior. 3. Suggest a symptom substitution technique to refocus the ritualistic behavior. 4. Develop a routine schedule of activities to reduce the need for the ritualistic behavior.

4. Develop a routine schedule of activities to reduce the need for the ritualistic behavior.

A client with a history of obsessive-compulsive behaviors has a marked decrease in symptoms and expresses a wish to obtain a part-time job. On the day of a job interview the client arrives at the mental health center displaying signs of anxiety. What is the nurse's best response to the client's behavior? 1. "I know you're anxious, but by forcing yourself to go to the interview, you may conquer your fear." 2. "If going to an interview makes you this anxious, it seems as though you're not ready to go back to work." 3. "It must be that you really don't want that job after all. I think you should reconsider going to the interview." 4. "Going for your interview triggered some feelings in you. Perhaps you could call a friend to drive you there."

4. "Going for your interview triggered some feelings in you. Perhaps you could call a friend to drive you there."

A nurse is caring for a client with an obsessive-compulsive personality disorder that involves rituals. What should the nurse conclude about the ritual? 1. Has a purpose but is useless 2. Is performed after long urging 3. Appears to be performed willingly 4. Seems illogical but is needed by the person

4. Seems illogical but is needed by the person

Which is the best nursing intervention during the working phase of the therapeutic relationship to meet the needs of individuals who demonstrate obsessive-compulsive behavior? 1. Restricting their movements 2. Calling attention to the behavior 3. Keeping them busy to distract them 4. Supporting rituals while setting realistic limits

4. Supporting rituals while setting realistic limits

Hospitalization or day-treatment centers are often indicated for the treatment of a client with an obsessive-compulsive disorder because these settings: 1. prevent the client from completing rituals. 2. allow the staff to exert control over the client's activities. 3. resolve the client's anxiety because decision making is minimal. 4. provide the neutral environment the client needs to work through conflicts.

4. provide the neutral environment the client needs to work through conflicts.

what characteristic uniquely associated with psychophysiologic disorders differentiates them from somatoform disorders? 1. emotional cause 2. feeling of illness 3. restriction of activities 4. underlying pathophysiology

4. underlying pathophysiology