CH 34

Which Freudian concept describes what drives a patient to strive for perfection and morality? 1 Poor self-concept 2 Id 3 Ego 4 Superego

4 Superego

According to Freud, superego is responsible for which concept? 1 The reality factor 2 Reducing tension 3 Immediate gratification 4 The parental or societal value system

4 The parental or societal value system

An 8-year-old patient beginning to suck his thumb while he is hospitalized for a tonsillectomy exemplifies which defense mechanism? 1 Regression 2 Repression 3 Introjection 4 Dissociation

1 Regression

Which type of abuse is the most common among older adults? 1 Drug 2 Alcohol 3 Physical 4 Emotional

2 Alcohol

The mother of a teenage girl says that the girl is always trying to dress like her favorite pop star and is not willing to dress normally. Which concept would explain this behavior? 1 Unconscious conflict 2 Threat to self-concept 3 Frustration due to stress 4 Moderate level of anxiety

2 Threat to self-concept

Which description best defines stress? 1 Ability to adjust to changing life situations 2 Gathering of personal resources to complete a task 3 A situation that can facilitate growth or ineffective coping 4 A simultaneous presence of opposing thoughts, ideas, or goals

3 A situation that can facilitate growth or ineffective coping

Which defense mechanism has a positive influence on the person's behavior? 1 Denial 2 Regression 3 Sublimation 4 Displacement

3. Sublimation

A person has an argument at the office and then comes home and yells at family members. Which defense mechanism is this person using? 1 Projection 2 Dissociation 3 Introjection 4 Displacement

4 Displacement

A student has an argument with his teacher and comes home and yells at his younger brother. The nurse recognizes this as an example of which defense mechanism? 1 Denial 2 Projection 3 Displacement 4 Rationalization

3 Displacement

A fatigued patient tells the nurse, "I have a feeling that something will go wrong." The nurse is having difficulty communicating with the patient because the patient's communication is distorted. The nurse also notices a marked increase in the patient's blood pressure. Which level of anxiety would the nurse document in the patient's medical record? 1 Mild 2 Panic 3 Severe 4 Moderate

3 Severe

Which characteristics are associated with a patient with mental illness? Select all that apply. 1 Poor self-concept 2 Fickle pessimism 3 Independent behavior 4 Maladaptive behavior 5 Avoidance of problems

1 Poor self-concept 4 Maladaptive behavior 5 Avoidance of problems

Which behaviors are common with mental illness? Select all that apply. 1 Shock 2 Anger 3 Denial 4 Excitement 5 Bargaining

1 Shock 2 Anger 3 Denial

Which common behaviors are seen with illness? Select all that apply. 1 Shock 2 Anxiety 3 Acceptance 4 Forgiveness 5 Withdrawal 6 Questioning

1 Shock 2 Anxiety 5 Withdrawl

Which assessment helps determine a patient's level of anxiety? 1 Vital signs 2 Speech patterns 3 Thought content 4 Sensorial function

1 Vital signs

A nursing student reports that the teacher is not providing the correct study material, and this is why the student is failing. Which defense mechanism is the student displaying? 1 Projection 2 Regression 3 Repression 4 Introjection

1. Projection

A 17-year-old patient who plays competitive sports has trouble dealing with aggression. Which defense mechanism is this patient displaying? 1 Regression 2 Sublimation 3 Displacement 4 Rationalization

2 Sublimation

Which goals are associated with crisis intervention? Select all that apply. 1 The victim will have a positive self-image. 2 The victim's emotional stress will be decreased. 3 The victim will be educated on relaxation techniques. 4 The victim will deny having any suicidal or homicidal ideation. 5 The nurse will help the victim organize and mobilize resources.

2 The victim's emotional stress will be decreased. 5 The nurse will help the victim organize and mobilize resources.

Which occurrence may precipitate feelings of anxiety? 1 Emotional growth 2 Threats to self-esteem 3 Threats to those around us 4 Encouragement in physical strengths

2 Threats to self-esteem

A 9-year-old tells a story, while smiling and joking, about witnessing a house burning down across the street. The nurse recognizes this as an example of which defense mechanism? 1 Denial 2 Regression 3 Dissociation 4 Compensation

3 Dissociation

Which domains are the id responsible for? Select all that apply. 1 Formation of ideals 2 Striving for perfection 3 Demand for constant gratification 4 Reducing tension and increasing pleasure 5 Determining decisions about how to act

3. Demand for constant gratification 4 Reducing tension and increasing pleasure

Which statement by a patient indicates the need for further teaching regarding ways to reduce anxiety? 1 "I should play baseball when I am anxious." 2 "I should talk to someone when I feel anxious." 3 "I should do relaxation exercises if I am anxious." 4 "I should listen to soothing music when I feel anxious."

1 "I should play baseball when I am anxious."

The nursing instructor is teaching the student nurses about caring for a patient who is undergoing a crisis and showing symptoms of anger and hostility. Which statement by the practicing nurse indicates a need for further teaching? 1 "The nurse should provide empathic gestures, such as giving a hug to the patient." 2 "The nurse should instruct the patient to develop assertive communication skills." 3 "The nurse should encourage the patient to describe the current state of anxiety." 4 "The nurse should advise the patient to use progressive muscle relaxation techniques."

1 "The nurse should provide empathic gestures, such as giving a hug to the patient."

The patient is experiencing extreme terror and distortion of reality, characteristic of which term? 1 Panic 2 Crisis 3 Conflict 4 Frustration

1 Panic

The nurse is caring for a patient who is in crisis because of the death of a spouse. Which statement by the patient indicates the final phase of the crisis? 1 "I talked to my spouse this morning in my room." 2 "I plan to find a job so I can take care of my child." 3 "I will never be able to get over my spouse's death." 4 "I do not want to live in this miserable life anymore."

2 "I plan to find a job so I can take care of my child."

Which processes does the nurse teach a patient with anxiety due to depression to encourage positive emotional growth? Select all that apply. 1 How to avoid stress in the person's daily life 2 Adaptive mechanisms to deal with stress 3 How to avoid thoughts that may lead to conflict 4 Using coping mechanisms to deal with anxiety 5 Techniques of reminiscence and life review to cope with life changes

2 Adaptive mechanisms to deal with stress 4 Using coping mechanisms to deal with anxiety

The nurse is caring for a patient who reports, "I am not feeling well, but I do not want to consult my health care provider because I don't want to hear bad news." Which issue does the nurse suspect in the patient? 1 Shock 2 Conflict 3 Frustration 4 Withdrawal

2 Conflict

Who developed the humoral theory of mental illness? 1 Erik Erikson 2 Hippocrates 3 Philippe Pinel 4 Sigmund Freud

2 Hippocrates

A high school student who is diagnosed with exercise-induced asthma cannot play sports, so instead, he focuses his attention on academics and the student council. The nurse identifies this as an example of which defense mechanism? 1 Denial 2 Identification 3 Displacement 4 Compensation

4 Compensation

Which factors determine the sensorial function of a patient? Select all that apply. 1 Speech 2 Memory 3 Attention 4 Orientation 5 Impulse control

2 Memory 3 Attention 4 Orientation

A patient is detached from family members and is having an emotional crisis because of unemployment. Which nursing action should be the primary intervention to help the patient during this crisis? 1 Encourage the patient to develop problem-solving and decision-making skills. 2 Explain the patient's emotional status to the health care provider. 3 Encourage the patient to recognize constructive aspects of mild or moderate anxiety. 4 Consult the health care provider to include other psychosocial professionals.

4 Consult the health care provider to include other psychosocial professionals

Which term best describes the external manifestation of inner feelings or emotions that is often reflected by one's facial expressions? 1 Affect 2 Adaptation 3 Coping response 4 Defense mechanism

1 Affect

Sublimation is a defense mechanism that helps the patient do which action? 1 Exclude painful experiences from memory 2 Incorporate characteristics of another individual 3 Return to an earlier, less mature, stage of development 4 Channel unacceptable impulses into socially acceptable ones

4 Channel unacceptable impulses into socially acceptable ones

The nurse documents that a patient who is restricted from physical activity is using denial as a defense mechanism. Which patient behavior led the nurse to this conclusion? 1 Walking the halls every hour 2 Taking frequent rest periods 3 Playing with grandchildren 4 Doing sit-ups and push-ups

4 Doing sit-ups and push-ups

The nurse learns that a patient is apathetic, hostile, and in denial after losing a friend in an accident. What does the nurse expect the patient to be experiencing? 1 A crisis 2 Anxiety 3 Conflict 4 Frustration

1 A crisis

A 74-year-old woman with stage 3 breast cancer is crying in her room. Which intervention should the nurse perform to help the patient through the grief process? 1 Call the patient's husband. 2 Encourage venting of feelings. 3 Offer to bring her medicine at a later time. 4 Give the patient a brochure on chemotherapy options

2 Encourage venting of feelings.

Which interventions should the nurse provide to validate a patient's anger and grief as normal responses to the crisis? 1 Give the patient a hug. 2 Hold the patient's hand. 3 Encourage ventilation of feelings. 4 Help the patient develop decision-making skills.

3 Encourage ventilation of feelings.

A nurse is caring for a patient who has anxiety attacks. Which symptoms would indicate that the patient is experiencing a severe anxiety attack? 1 Increased motivation 2 Decreased perceptions 3 Feeling of impending danger 4 Cause harm to self or others

3 Feeling of impending danger

Which inference would the nurse make about a patient who is demonstrating maladaptive behavior and has lost contact with reality? 1 Large ego 2 Mild anxiety 3 Mental illness 4 Poor self-concept

3 Mental illness

What are ways to assess and document a patient's emotional status? Select all that apply. 1 Skin color 2 Pain location 3 Speech pattern 4 Content of thought 5 Insight and judgment

3 Speech pattern 4 Content of thought 5 Insight and judgment

"Self" is a complex concept comprising four distinct parts that influence behavior. Which part includes feeling about the way one's body functions? 1 Body image 2 Self-esteem 3 Personal identity 4 Role performance

1 Body image

A woman discovers that her spouse is having an affair and starts to experience sudden blindness with no medical cause. The nurse understands this to be an example of which defense mechanism? 1 Conversion 2 Sublimation 3 Displacement 4 Rationalization

1 Conversion

A patient in the psychiatric unit for treatment of psychotic behaviors goes to the locked exit door and begins shouting at the staff, "Let me out. I don't belong here. I'm not sick." Which term does the nurse identify the patient's behavior as? 1 Denial 2 Projection 3 Regression 4 Rationalization

1 Denial

A patient who has just been sexually assaulted has come to the emergency department and is very calm and quiet. The nurse identifies this behavior as part of which defense mechanism? 1 Denial 2 Projection 3 Suppression 4 Rationalization

1 Denial

A patient with type 2 diabetes and a blood sugar level of 415 is eating candy bars and drinking soda. The nurse identifies this as an example of which defense mechanism? 1 Denial 2 Suppression 3 Identification 4 Compensation

1 Denial

Which lessons would the nurse include to help a group of patients improve their mental health? Select all that apply. 1 Develop assertive communication skills. 2 Recognize the power of positive thinking. 3 Seek help from family in decision making. 4 Identify personal characteristics of anxiety. 5 Incorporate progressive muscle relaxation

1 Develop assertive communication skills. 2 Recognize the power of positive thinking. 4 Identify personal characteristics of anxiety. 5 Incorporate progressive muscle relaxation

Which nurse is credited as developing mental hospitals throughout the United States in the 19th century? 1 Dorothea Dix 2 Clifford Beers 3 Benjamin Rush 4 Martha Mitchell

1 Dorothea Dix

Which nursing intervention to help a patient with cancer frequently experiencing episodes of stress and depression is best? 1 Encourage the patient to develop adaptive patterns of behavior. 2 Encourage the patient to avoid events that may cause stress. 3 Offer the patient as much flexibility in visiting hours as possible. 4 Use therapeutic communication techniques, such as active listening.

1 Encourage the patient to develop adaptive patterns of behavior

Who provided a framework for understanding personality development in terms of task mastery? 1 Erik Erikson 2 Hippocrates 3 Philippe Pinel 4 Sigmund Freud

1 Erik Erikson

The nurse is caring for a patient who is experiencing a mental health crisis after losing his spouse. Which patient outcome indicates that the nursing interventions are effective? Select all that apply. 1 Organizes resources 2 Rationalizes his behavior 3 Returns to a precrisis state 4 Finds ways to engage himself 5 Emotional stress is decreased

1 Organizes resources 3 Returns to a precrisis state 4 Finds ways to engage himself 5 Emotional stress is decreased

The nurse is caring for a patient who reports having an illness every time his child leaves town to go on vacation. Which defense mechanism is the patient displaying? 1 Emotional conflict 2 Threat to self-concept 3 Frustration due to stress 4 Moderate level of anxiety

1. Emotional Conflict

Which major change would the nursing instructor include in a discussion about the changes brought about by the introduction of psychotherapeutic drugs in the treatment of mental illness? 1 The development of electroconvulsive therapy 2 Deinstitutionalization of patients with psychiatric disorders 3 Reduction of funding for the mental health system 4 Establishment of the National Institute of Mental Health

2 Deinstitutionalization of patients with psychiatric disorders

The nurse finds that a patient is overusing the mechanisms of introjection, denial, eating, and reaction formation in daily life. Which suspicion would the nurse have about the patient's mental health? 1 May be undergoing a crisis 2 Has maladaptive behavior 3 Has a high level of anxiety 4 May have low self-esteem

2 Has maladaptive behavior

Which clinical signs of are associated with severe anxiety? Select all that apply. 1 Increased appetite 2 Increased pulse rate 3 Increased respiration 4 Increased perspiration 5 Increased blood pressure

2 Increased pulse rate 3 Increased respiration 4 Increased perspiration 5 Increased blood pressure

A patient with anxiety who reports nausea and vomiting is exhibiting argumentative behavior. Which degree of anxiety is the patient experiencing? 1 Mild 2 Moderate 3 Severe 4 Panic

2 Moderate

A patient who is admitted involuntarily to a psychiatric facility is angry and wants to leave to see his wife. Which nursing intervention would be appropriate? 1 Encouraging the patient to talk to other patients 2 Offering as much flexibility in visiting hours as possible 3 Offering the patient as-needed (PRN) lorazepam (Ativan) 4 Refusing to let him see family because his admission is involuntary

2 Offering as much flexibility in visiting hours as possible

The parents of a 10-year-old child report that the child wets the bed when tests are scheduled at school. Which defense mechanisms does the nurse suspect the child is using? 1 Projection 2 Regression 3 Repression 4 Introjection

2 Regression

Which effective technique is used to help older adults cope with changing life circumstances? 1 Meditation 2 Reminiscing 3 Vigorous exercise 4 Listening to music

2 Reminiscing

An elderly patient is feeling hopeless and depressed due to social isolation. Encouraging the patient to do which action would best help the patient overcome these feelings? 1 To improve decision-making skills 2 To do a life review, and reminisce 3 To perform progressive muscle relaxation 4 To develop assertive communication skills

2 To do a life review, and reminisce

How would the nurse describe a person who constantly seeks pleasure and keeps discomfort to a minimum? 1 In the state of preconsciousness 2 Under the leadership of the id 3 Under the leadership of the ego 4 Under the leadership of the superego

2 Under the leadership of the id

An older patient who has been recently admitted to a long-term care facility has been staying in his room and not attending meals or activities since his son was killed in a car accident. Which concern would be the highest priority for this patient? 1 Grieving related to loss of son 2 Isolation related to loss of son 3 Grief related to relocation to a nursing home 4 Inability to cope related to the number of personal losses

4 Inability to cope related to the number of personal losses

A nurse is instructing a wife about giving heparin injections to her husband. The wife is unable to focus and frequently asks the nurse to repeat instructions. Which degree of anxiety is the wife experiencing? 1 Mild 2 Panic 3 Severe 4 Moderate

4 Moderate

What is responsible for rapid deinstitutionalization as a result of severe fiscal cuts? 1 Electroconvulsive therapy 2 Committee for Mental Hygiene 3 President's Commission on Mental Health 4 Omnibus Budget Reconciliation Act (OBRA)

4 Omnibus Budget Reconciliation Act (OBRA)

The parents of a child are worried because the child tattles on others to justify his or her mistakes. Which defense mechanism should the nurse document in the child's medical record? 1 Regression 2 Introjection 3 Identification 4 Rationalization

4 Rationalization

Which therapeutic technique can the nurse establish for a patient crying in her room? 1 Turn on the television as a distraction. 2 Stand next to the patient and ask what is wrong. 3 Close the door, and let the patient cry in her room alone. 4 Sit next to the patient, and allow the patient to verbalize feelings.

4 Sit next to the patient, and allow the patient to verbalize feelings.

Which signs and symptoms are associated with anxiety? Select all that apply. 1 Nausea 2 Tremors 3 Increased appetite 4 Increased heart rate 5 Decreased perspiration

Nausea Tremors Increased Heart Rate

Which characteristics does the nurse expect in a mentally ill patient as evidence of improved mental health? Select all that apply. 1 Hallucinations 2 Positive self-concept 3 Adaptability to change 4 Acceptance of emotions 5 Seeking immediate gratification

Positive self-concept Adaptability to change Acceptance of emotions