Nursing Exam 2: Stress & Coping, OCD, Phobias, PTSD, Grief & Loss

A client diagnosed with a mild social phobia would like to try a treatment method that does not require pills or weekly appointments. Which statement by the nurse is appropriate when educating this​ client? "Certain lifestyle​ choices, such as decreasing caffeine​ intake, may be helpful for you." "You will have to get used to taking pills. It will be a part of your life now." "I can teach you how to treat yourself at home. You don​'t need to see a healthcare provider for this." "You should try implosion therapy. I will provide you with information."

"Certain lifestyle​ choices, such as decreasing caffeine​ intake, may be helpful for you."

The nurse is providing education to a client diagnosed with a phobia. Which suggestion by the nurse is appropriate regarding the use of physical exercise as a treatment​ option? "Exercise releases​ endorphins, which will improve your mood and decrease anxiety." "Daily physical activity will help you sleep better at night." "Thought blocking is a wonderful physical activity for you to try." "Walking outside will help you to alleviate your fear."

"Exercise releases​ endorphins, which will improve your mood and decrease anxiety."

The nurse is caring for a client diagnosed with arachnophobia who is prescribed systematic desensitization therapy. After providing education on this type of​ therapy, which statement by the client indicates the need for further​ education? "I am not looking forward to looking at pictures of​ spiders, but I know that it is part of the process." "I am going to be placed in a room with spiders during my first session." "I will be able to discover why I have a fear of spiders because of this therapy." "I should be able to talk about spiders without feeling anxious once I finish a few sessions."

"I am going to be placed in a room with spiders during my first session."

The nurse teaches a client about medications used in the treatment of​ obsessive-compulsive disorder​ (OCD). Which client statement indicates appropriate understanding of the teaching​ session? "There are no side effects associated with this medication." "Medications are not effective in the treatment of OCD." "I will have to take medication for the rest of my life." "I may only have to take medication for​ 1-2 years and gradually be weaned off."

"I may only have to take medication for​ 1-2 years and gradually be weaned off."

The nursing instructor has just finished educating a group of nursing students on the risk factors associated with the development of phobias. Which statement made by a student nurse would indicate the need for further​ education? "Social anxiety disorder typically develops between the ages of 11 and 15." "Social anxiety disorder almost never develops after the age of 25." "Girls and women are twice as likely to develop phobias as men." "Individuals are at lower risk of developing a phobia if their mom has the phobia."

"Individuals are at lower risk of developing a phobia if their mom has the phobia."

The nurse is providing care to a client who lost a child in a car crash 7 months ago. The client states that she has been feeling better over the last​ month, but that all of a sudden for the past week she has felt like the death just occurred. Which question allows the nurse to assess the reason for this resurgence of​ grief? "Did you recently sell your ​home?" "How many hours of sleep are you getting each ​night?" "Is this time of year significant for any ​reason?" "Have you been experiencing ​anger?"

"Is this time of year significant for any ​reason?"

A client is prescribed paroxetine​ (Paxil) to treat symptoms of stress after the unexpected death of her spouse. What should the nurse instruct the client about this​ medication? Select all that apply. "This medication should not be stopped abruptly." "This medication should not be taken with St. John​'s wort." "This medication may cause difficulties in achieving an orgasm." "This medication takes 4 to 6 weeks to achieve the full effect." "This medication can cause bradycardia."

"This medication should not be stopped abruptly." "This medication should not be taken with St. John​'s wort." "This medication may cause difficulties in achieving an orgasm." "This medication takes 4 to 6 weeks to achieve the full effect."

The brain waves of a client on life support are absent. In response to the family​'s question about the client being​ dead, for how long should the nurse explain that the brain waves must be absent before death can be ​declared? One week or longer 24 hours or longer 1 hour or longer 12 hours or longer

24 hours or longer

The nurse is caring for a terminally ill client. Which assessment findings indicate to the nurse that the client has passed​ away? Select all that apply. Absence of reflexes No movement Anorexia Absence of respiration Dyspnea

Absence of reflexes No movement Absence of respiration

The nurse is providing care for a client diagnosed with posttraumatic stress disorder​ (PTSD). The client​'s family has asked about nonpharmacologic therapies that may be appropriate. Which therapies will the nurse mention when responding to this​ family? Select all that apply. Acupuncture therapy ​Cognitive-behavioral therapy Selective​ serotonin/norepinephrine reuptake inhibitor therapy Eye movement desensitization and reprocessing therapy Atypical antipsychotic therapy

Acupuncture therapy ​Cognitive-behavioral therapy Eye movement desensitization and reprocessing therapy

The student nurse has completed a care plan for a client diagnosed with posttraumatic stress disorder. Which intervention is not appropriate for the student to include in the plan of care for this​ client? Help the client to express fears that interfere with daily life Teach the client the use of positive imagery Identify safe physical outlets for negative feelings Administer propranolol as ordered

Administer propranolol as ordered -beta blocker that is not a pharmacologic therapy for PTSD

The nurse is caring for an older adult who is in the process of grieving the loss of a sibling. Which response noted in the client is not typically seen at this developmental​ stage? Aggression Anger Sadness Denial

Aggression

Where is the​ brain's "worry​ center"? Brain stem Hypothalamus Amygdala Frontal lobe

Amygdala The amygdala is the​ brain's worry center. The frontal lobe regulates​ decision-making. The brain stem controls basic survival functions. The hypothalamus controls the autonomic nervous system.

The local​ woman's club has invited a public health nurse to give a seminar about mental health issues. The nurse begins by talking about the disorders that are more common among women than among men. Which disorders will the nurse​ list? Select all that apply. Phobia Anxiety disorder Insomnia Posttraumatic stress disorder​ (PTSD) ​Obsessive-compulsive disorder

Anxiety disorder PTSD Rationale: Anxiety disorder and posttraumatic stress disorder​ (PTSD) are more common among women than among men.​ Obsessive-compulsive disorder is equally common among men and women. Phobia strikes men twice as often as women. Insomnia is a​ symptom, not a disorder.

A client tells the nurse that since he lost his​ job, he cannot sleep at night and has no energy to get out of bed. Which type of grief response should the nurse educate this client about based on the symptoms​ exhibited? Psychological Behavioral Biophysical Biological

Biological Biological responses are physical manifestations a client may develop in response to grief and​ loss; they may include sleep​ problems, decreased​ energy, lack of​ appetite, or weight loss.

The nurse is assessing a client who reports anxiety associated with a previously diagnosed social anxiety disorder. What signs and symptoms would the nurse expect to​ assess? Select all that apply. Excessive sweating Mumbling speech ​Warm, dry skin Gastrointestinal distress Lethargy

Excessive sweating Mumbling speech Gastrointestinal distress

A client who is extremely distraught after losing her spouse of 45 years is sobbing with her head in her hands. The client​ says, open double quote"I don​'t want to go sit with a bunch of other old​ widows; I want to sit with Harold.close double quote" Based on this client​'s assessment​ findings, which collaborative therapy should the nurse​ recommend? Placement in a​ long-term care facility ​Cognitive-behavioral therapy A group hobby session Church attendance on Wednesdays and Sundays

CBT

Which are clinical manifestations of imminent​ death? Select all that apply. ​Cheyne-Stokes breathing Edema and increased respiratory secretions Decrease in volume of Korotkoff sounds Increased heart rate Mottling

Cheyne-Stokes breathing Decrease in volume of Korotkoff sounds Mottling

The nurse educator is teaching a group of students about​ obsessive-compulsive disorder​ (OCD). Which statement will the educator include in the teaching session regarding​ OCD? Diagnosis of OCD is easy. Brain imaging in clients with OCD is normal. Signs and symptoms of OCD occur in older adults. Children who have had a streptococcal infection may be at risk of developing the disorder.

Children who have had a streptococcal infection may be at risk of developing the disorder.

The nurse believes that a client with severe PTSD will benefit from​ cognitive-behavioral therapy​ (CBT). What can the nurse describe as the characteristics of​ CBT? Select all that apply. Client can change unhealthy thoughts. Client can safely confront fears. Client can discontinue medications. Client can remove stressors. Client can do CBT exercises.

Client can change unhealthy thoughts. Client can safely confront fears. Client can do CBT exercises.

What are the categories of types of​ stressors? Select all that apply. External environmental stressors Developmental stressors Homeostatic stressors Internal stressors Hormone stressors

External environmental stressors Developmental stressors Internal stressors

Which term best describes an individual who believes that powers outside themselves determine life​ events? Internal locus of control Locus of control External locus of control Control

External locus of control

The nurse is providing care to a client who is diagnosed with posttraumatic stress disorder​ (PTSD). Which factors could interfere with the nurse establishing trust during a therapeutic encounter with this​ client? Select all that apply. Depersonalization Hypervigilance Ineffective coping Nightmares ​Irritability, aggressiveness

Depersonalization Hypervigilance Irritability, aggressiveness

Which are manifestations of respiratory failure in the dying​ client? Select all that apply. Diaphoresis Difficulty breathing Anxiety Wheezing Breathlessness

Difficulty breathing Anxiety Wheezing Breathlessness

The nurse is developing a plan of care for a client who is experiencing anxiety related to a phobic disorder. The client states she has extreme difficulty falling asleep at night. Which would be most appropriate for the nurse to include in the plan of care for this​ client? Assisting the client in rethinking the ability to manage the anxiety Assisting the client in gaining insight to her reaction to the fear Educating the client on relaxation techniques Educating the client on healthy ways of living

Educating the client on relaxation techniques

The health care provider has prescribed an antidepressant for a​ 9-year-old client because therapy and grief counseling have been ineffective. Which selective serotonin reuptake inhibitor​ (SSRI) medication would the nurse anticipate the health care provider to ​prescribe? Escitalopram​ (Lexapro) Paroxetine​ (Paxil) Fluoxetine​ (Prozac) Nortriptyline​ (Pamelor)

Fluoxetine​ (Prozac) Fluoxetine​ (Prozac) is the only recommended SSRI for children under 12 years of age

A client dying from a terminal illness who has been receiving pain medication is now comatose. Which actions should the nurse take to ensure this client​'s ​comfort? Select all that apply. Cover with several blankets to maintain warmth Gently splint joints when repositioning the client Use incontinence pads Suggest tube feedings for nutritional support Provide artificial tears

Gently splint joints when repositioning the client Use incontinence pads Provide artificial tears

The mental health nurse is working with a​ long-term client who has struggled through many​ issues, including homelessness. The client reports finding subsidized housing. The nurse​ responds, "You persisted until you found an apartment.​ Congratulations!" What kind of independent intervention is the nurse​ implementing? Select all that apply. Validating​ client's feelings Identifying successes in life Identifying strategies to meet​ client's goals Implementing Cognitive behavioral therapy​ (CBT) interventions Reinforcing positive coping efforts

Identifying successes in life Reinforcing positive coping efforts

The nurse is providing care to a pediatric client whose mother is terminally ill. Which intervention by the nurse allows the pediatric client to express​ grief? Implementing imaginary games with the client. Allowing the client to talk about the loss. Telling the client that the parent will be in a better place. Administering medication to the client.

Implementing imaginary games with the client.

The nurse is providing care to a client with​ obsessive-compulsive disorder​ (OCD). Which interventions are appropriate for this​ client? Select all that apply. Interrupt the​ ritual, using distraction. Include time in the daily routine to perform the ritual. Assist the client with developing new coping mechanisms. Establish a loud and fun environment for the client. Encourage the client to verbalize his or her feelings.

Include time in the daily routine to perform the ritual. Assist the client with developing new coping mechanisms. Encourage the client to verbalize his or her feelings.

The​ client, a​ psychologist, is interested in the mental health clinic​ nurse's viewpoint about​ Maslow's hierarchy of needs. When it comes to prioritizing a choice to react to a​ stressor, what do both of them know about this​ model? Coping with stressors is a part of safety needs. ​Self-esteem is the most important level of need. Individuals might have their own priorities. Everyone chooses to satisfy basic requirements first.

Individuals might have their own priorities.

A client asks the nurse how​ cognitive-behavioral therapy will help her to manage her​ obsessive-compulsive disorder. Which response by the nurse is the most​ appropriate? It will help you change your belief system. It teaches techniques that will help you lower stress. It will teach you ways to increase your​ self-esteem. It will make you feel shameful and therefore the behaviors will stop.

It teaches techniques that will help you lower stress.

During change of​ shift, a unlicensed assistive personnel​ (UAP) finds a client who committed suicide by using a belt on the upper doorjamb in the hospital room. The nursing staff was in report and responded to the cries for​ help, but was not able to save the client. What should the hospital administrator do to assist the nursing​ staff? Select all that apply. ​Nothing, because the nursing staff was not at fault for the client​'s death Notify social services for immediate grief counseling Suggest all staff return to work Analyze the client​'s medical record for signs of pending suicide that were missed Encourage the staff to talk to each other about the experience and offer support

Notify social services for immediate grief counseling Encourage the staff to talk to each other about the experience and offer support

Complicated grief in older adult clients can present with many symptoms. Which symptom would the nurse not expect to see in a grieving older​ adult? Obsession with death Avoidance of people or places that arouse memories Depression Distrust of family and friends

Obsession with death

The nurse is preparing to complete a nursing assessment for a client who is diagnosed with posttraumatic stress disorder​ (PTSD). Which data will the nurse collect during the physical examination portion of the​ assessment? Alcohol use Type of trauma experienced Current job Pain rating

Pain rating

The nurse is caring for a client with​ obsessive-compulsive disorder​ (OCD) . Which clinical manifestations would the nurse expect to see in this​ client? Select all that apply. Physical complaints such as irritated skin Happy and overly excited affect Signs of distress and increased anxiety Repetitive actions or motions Intrusive thoughts

Physical complaints such as irritated skin Signs of distress and increased anxiety Repetitive actions or motions Intrusive thoughts

The nurse is providing care to a​ client, diagnosed with posttraumatic stress disorder​ (PTSD), who is experiencing frequent nightmares. Which medication does the nurse anticipate will be prescribed for this​ client? Paroxetine Risperidone Sertraline Prazosin

Prazosin - antidiuretic agent only medication that has shown effectiveness in reducing nightmares associated with PTSD

The nurse is providing care to a client diagnosed with posttraumatic stress disorder​ (PTSD). Which items in the client​'s health history place the client at risk for this​ disorder? Select all that apply. Preexisting mental illness Witnessing the death of a friend Experiencing difficulty sleeping Losing a job after a traumatic event. Being diagnosed with diabetes mellitus

Preexisting mental illness Witnessing the death of a friend Losing a job after a traumatic event.

A​ first-year nursing student goes to the​ university's counseling services. The student hopes that anxiety levels experienced during test taking could be reduced. The nurse counselor asks the student about first thoughts when a test is announced. What kind of appraisal is the counselor having the student​ consider? Primary appraisal Anxiety appraisal Secondary appraisal Cognitive appraisal

Primary appraisal Rationale: Primary appraisal happens immediately upon knowledge of the​ stressor, the upcoming test. Secondary appraisal takes place after​ that, when deciding how to react. Cognitive appraisal is the combination of both primary and secondary appraisal. There is no model called​ "anxiety appraisal."

A client with terminal cancer is experiencing dyspnea. Which actions should the nurse use to help this​ client? Select all that apply. Elevate both legs Provide oxygen as prescribed Raise the head of the bed Place pillows behind head Provide small frequent meals

Provide oxygen as prescribed Raise the head of the bed Place pillows behind head

What are some independent interventions for nurses to use with clients with anxiety​ disorders? Select all that apply. Ordering individualized medical testing Reinforcing positive coping efforts Accessing current mental health resources Validating​ clients' feelings Guaranteeing better coping abilities

Reinforcing positive coping efforts Accessing current mental health resources Validating​ clients' feelings

Which pharmacologic agent is used in the treatment of​ obsessive-compulsive disorder​ (OCD)? Sulfonlyureas Diuretics ACE inhibitors Selective serotonin reuptake inhibitors

Selective serotonin reuptake inhibitors

The school nurse is especially concerned about a specific​ first-grade student. What​ personality-related characteristic would the nurse identify as increasing the risk for development of an anxiety​ disorder? Overweight student Nearsighted student Shy student Short student

Shy student Rationale: Being shy increases the risk of a child developing an anxiety disorder.​ Weight, height, and nearsightedness are not personality characteristics.

The nurse in an endocrinology clinic is seeing a client who has both diabetes and hyperthyroidism. What clinical symptoms could the client have that would be similar to those of a client with​ anxiety? Select all that apply. Tachycardia Feelings of fear Nervousness Ritualized routines Obsessive thoughts

Tachycardia Nervousness Rationale: The clinical symptoms that a client with diabetes and hyperthyroidism has in common with a client with anxiety are tachycardia and nervousness. The client with anxiety could have obsessive​ thoughts, feelings of​ fear, and ritualized routines. Those symptoms would not arise as a result of diabetes or hyperthyroidism.

The nurse manager of an oncology unit is planning a program to assist staff with needs after the death of a client. What should the manager include in this​ staff-training program? Select all that apply. Doubling efforts to prevent another client death Talking to each other about the loss of a client Information to process the loss of a client Keeping personal feelings about death and dying within Importance of using grief counseling as a resource

Talking to each other about the loss of a client Information to process the loss of a client Importance of using grief counseling as a resource

What physical conditions could cause a similar tachycardia and nervousness as that found in an anxiety​ disorder? Select all that apply. Hedonism Hypoglycemia Hirsutism Hypothesis Hyperthyroidism

hyperthyroidism hypoglycemia

A nurse is conducting a​ follow-up assessment on a client in the clinic. The client​ states, open double quote"I usually cannot leave my house at all but now I can leave at least once a day.close double quote" This statement made by the client indicates the client has achieved which​ goal? The client will report decreased frequency of phobic episodes. The client will participate in therapeutic treatment. The client will verbalize healthy coping skills to use in response to fear. The client will demonstrate relaxation techniques.

The client will report decreased frequency of phobic episodes.

The nurse is caring for a client who is diagnosed with posttraumatic stress disorder. Which goals and outcomes may be appropriate for the nurse to include in the client​'s plan of​ care? Select all that apply. The client will demonstrate avoidance of situations related to the trauma or general social contacts. The client will report fewer or no nightmares. The client will demonstrate comorbidity that may include​ depression, substance​ abuse, or other anxiety disorders. The client will remain free of harm or injury to himself or others. The client will talk about emotions that are associated with traumatic experiences with at least one counseling professional.

The client will report fewer or no nightmares. The client will remain free of harm or injury to himself or others. The client will talk about emotions that are associated with traumatic experiences with at least one counseling professional.

The nurse is conducting a nursing assessment for a client diagnosed with​ obsessive-compulsive disorder​ (OCD). Which findings are indicative of the repetitive acts associated with ​OCD? Select all that apply. Poor grooming and stained clothing Underweight and appears older than stated age The need to lock and unlock doors Poor posture and altered motor skills Constant hand washing

The need to lock and unlock doors Constant hand washing

Which are risk factors for developing a​ phobia? Select all that apply. Peer pressure Traumatic event Age Gender Family history

Traumatic event Age Gender Family history

Under which conditions can acupuncture be an effective treatment for posttraumatic stress disorder​ (PTSD)? Select all that apply. When used as a​ short-term therapy for a period of no more than a month When used regularly When used as an adjunct to CBT and other traditional therapies When used alone as a primary therapy When used for a period of three months or more

When used regularly When used as an adjunct to CBT and other traditional therapies When used for a period of three months or more

A​ 10-year-old boy has just experienced the death of his father 1 month ago. Which signs and symptoms of grief might the nurse observe in this​ client? Select all that apply. Directing anger at the remaining parent Withdrawing from social activity Believing his poor behavior caused his father​'s death Acting out in school Being curious about death

Withdrawing from social activity Believing his poor behavior caused his father​'s death Acting out in school Being curious about death

A student nurse is attending a clinical rotation in an outpatient childhood psychiatric facility. The nursing student observes that many of the children have decreased socialization. Which possible experiences of these clients might cause this manifestation of childhood traumatic​ grief? Select all that apply. Witnessing a death from cancer Witnessing a loved one die in a motor vehicle accident Witnessing a death caused by an action of violence Witnessing a suicide Witnessing someone die in a fire

Witnessing a loved one die in a motor vehicle accident Witnessing a death caused by an action of violence Witnessing a suicide Witnessing someone die in a fire

The nurse is preparing an educational​ in-service for staff nurses regarding phobias. Which statement is appropriate for the nurse to include in the​ presentation? There is no familial link to developing a phobia. Phobias are most likely to be diagnosed during late adulthood. Phobias are caused by a decrease in norepinephrine. Women are more likely to develop a phobia than men.

Women are more likely to develop a phobia than men.

What is the term for the physical cost of adapting to a​ stressor? Biogenic stressor Distress Allostatic load Homeostasis

allostatic load

The nurse is educating a client diagnosed with​ obsessive-compulsive disorder​ (OCD) on the different therapies that are available for the disorder. Which therapies are appropriate for the nurse to include in the teaching​ session? Select all that apply. Antipsychotic medication Antihypertensive agents ​Cognitive-behavioral therapy Hypoglycemic agents Herbal​ supplements, such as St. John​'s wort

antipsychotic medication cognitive behavioral therapy

What is the most common mental health problem in the United​ States? Anxiety disorder Phobia Depression Posttraumatic stress disorder​ (PTSD)

anxiety disorder

A client learns of the death of a family member. Which manifestation of grief should the nurse expect in this​ client? Palpitations Agitation Crying Restlessness

crying

Which client should the nurse assess for depression as a result of the grieving​ process? ​School-age client Adolescent client Older adult client Adult client

older adult client

What are ways that a young child with posttraumatic stress disorder can convey to a nurse mental health professional a message about the traumatic event that caused the​ child's problem? Select all that apply. Playing Crying Jumping Dreaming Drawing

playing drawing

The nurse is assessing the mental health of a female adult client who has been under stress at work. The client wants to wash her hands every 2 to 3 minutes and wipes the flat surface areas in the clinic with a paper towel while talking to the nurse. Which aspect of​ obsessive-compulsive disorder​ (OCD) is this client​ exhibiting? Visual hallucinations Auditory hallucinations Illogical thinking Repetitive behavior

repetitive behavior

What is a risk factor for developing​ obsessive-compulsive disorder​ (OCD)? Substance abuse Allergies Vaccinations Sexual abuse

sexual abuse

The nurse educator is teaching a group of students about posttraumatic stress disorder​ (PTSD). Which statements from the students regarding factors associated with the pathophysiology of PTSD indicate appropriate​ understanding? Select all that apply. ​"Looking at photographs of a war​ zone" ​"Being taken hostage and​ tortured" ​"Watching the Twin Towers fall on television on​ 9-11" ​"Engaging in military​ combat" ​"Going to​ prison"

​"Being taken hostage and​ tortured" ​"Engaging in military​ combat" ​"Going to​ prison"

What are some common pharmacologic therapies used to manage symptoms of​ anxiety? Select all that apply. ​Beta-blockers Antipsychotics Cortisol Benzodiazepines Antidepressants

​Beta-blockers Antipsychotics Benzodiazepines Antidepressants

The parents of an adolescent client dying from complications related to cystic fibrosis ask the nurse what signs to expect when their child is about to die. What should the nurse explain as signs of cardiovascular​ failure? Select all that apply. ​Clammy, cold skin Reduced blood pressure Mottling of the skin ​Cheyne-Stokes respirations Tachycardia

​Clammy, cold skin Reduced blood pressure Mottling of the skin

A nurse therapist is assessing an older client. The client and the nurse are from different cultures. What situation could complicate the​ nurse's assessment of the​ client? Select all that apply. ​Client's age difference from the therapist ​Client's work experience ​Client's normal, healthy cultural response ​Client's physical illness ​Client's cognitive changes

​Client's normal, healthy cultural response ​Client's physical illness ​Client's cognitive changes

Which clinical manifestations must the client demonstrate to meet the​ DSM-5 criteria for a PTSD​ diagnosis? Select all that apply. Recurrent compulsive behaviors Demonstrated drug or alcohol abuse ​Persistent, frightening thoughts and memories of the event Avoidance of situations related to the trauma Significant​ symptom-related distress or functional impairment

​Persistent, frightening thoughts and memories of the event Avoidance of situations related to the trauma Significant​ symptom-related distress or functional impairment