Mental Health: Exam 3 Study Questions

When discussing the symptoms of post-traumatic stress disorder (PTSD), the nurse should make which statement? = 1. "When experiencing a flashback, the client generally experiences a slowing of responses." 2. "PTSD causes agitation and hypervigilance but rarely chronic depression." 3. "The symptoms can neither occur almost immediately or even take years to manifest." 4. "PTSD is an emotional response that does not cause significant changes in brain chemistry."

3. "The symptoms can neither occur almost immediately or even take years to manifest."

Ali is a 17-year-old patient diagnosed with bulimia coming to the outpatient mental health clinic for counseling. Which of the following statements by Ali indicates that an appropriate outcome for treatment has been met? = 1. "I feel a lot calmer lately, just like when I used to eat four or five cheeseburgers." 2. "I always purge when I'm alone so that I'm not a bad role model for my younger sister." 3. "I purge only once a day now instead of twice." 4. "I am a hard worker and I am very compassionate toward others."

4. "I am a hard worker and I am very compassionate toward others."

Which statement, made by a client diagnosed with dissociative identity disorder, demonstrates effective understanding in response to the question, "What exactly are the 'alters'? your provider told you about?" illustrates that the education provided has been effective? = 1. "So, alters are based in mysticism and religiosity, such as demons." 2. "So, alters are never aware of each other." 3. "So, alters are just like me, but they have no memory of the trauma I went through." 4. "So, alters are separate personalities with their own characteristics that take over during stress."

4. "So, alters are separate personalities with their own characteristics that take over during stress."

A cognitively impaired resident living at a long-term care unit has become unsteady when walking alone. The family is concerned about the potential for serious injury from falls and suggests that restraints be used. What is the nurse's best response to the family's request? = 1. "The federal government forbids the use of restraints on elderly residents." 2. "Immobilization will cause constipation and necessitates the use of enemas." 3. "You will need to make your request to the physician at the planning meeting." 4. "Using restraints puts the resident at higher risk for serious injury, even death."

4. "Using restraints puts the resident at higher risk for serious injury, even death."

A client who is demonstrating a moderate level of anxiety tells the nurse, "I am so anxious, and I do not know what to do." Which response should the nurse make initially? = 1. "Try not to think about the feelings and sensations you're experiencing." 2. "Let's try to focus on that adorable little granddaughter of yours." 3. "Why don't you sit down over there and work on that jigsaw puzzle?" 4. "What things have you done in the past that helped you feel more comfortable?"

4. "What things have you done in the past that helped you feel more comfortable?"

An obsession is defined as what? = 1. Thinking of an action and immediately taking the action 2. An intense irrational fear of an object or situation 3. A recurrent behavior performed in the same manner 4. A recurrent, persistent thought or impulse

4. A recurrent, persistent thought or impulse

A client diagnosed with osteoarthritis says she is unable to sleep because of aching in her hips and shoulders. Which medication would be appropriate in this situation? = 1. Meperidine 2. A sedative-hypnotic 3. Aspirin 4. Acetaminophen

4. Acetaminophen

A client's daughter states, "My mother lives with me since my dad died 6 months ago. For the past couple of months, every time I need to leave the house for work or anything else, Mom becomes extremely anxious and cries that something terrible is going to happen to me. She seems OK except for these times, but it's affecting my ability to go to work." This information supports that the client may be experiencing which anxiety-related disorder? = 1. Social anxiety disorder 2. Agoraphobia 3. Panic disorder 4. Adult separation anxiety disorder

4. Adult separation anxiety disorder

The relaxation response calls upon the initiation of what process? = 1. Increased cortisol production by the adrenals 2. Brainstem deactivation 3. Parasympathetic activation 4. Sympathetic activation

3. Parasympathetic activation

Ageism is best explained as what? = 1. The discrimination against the elderly on the basis of age 2. A prominent personality disorganization after the age of 65 3. A learned helplessness among elderly clients 4. The behaviors of elderly persons that serve as barriers to health

1. The discrimination against the elderly on the basis of age

What symptom can the nurse expect a client diagnosed with depersonalization disorder to manifest? = 1. A feeling of detachment from one's body or mental processes 2. Worry about having a serious disease based on symptom misinterpretation 3. Aimless wandering with confusion and disorientation 4. Existence of two or more personalities that take control of behavior

1. A feeling of detachment from one's body or mental processes

An older adult client tells the nurse that he prefers not to attend senior citizens meetings because "they are all old fuddy duddies who talk subjects to death but never take action." The nurse can hypothesize that the client is demonstrating which type of reaction? = 1. Ageism 2. Projection of personal weaknesses 3. Paranoid thinking 4. Poor social skills

1. Ageism

Which assessment monitors the effect of stress attributed to the stimulation of the hypothalamus-pituitary-adrenal cortex? = 1. Blood Glucose 2. Brain nonepinephrine 3. Triglycerides 4. Heart Rate

1. Blood Glucose

A nurse teaches a client a technique for examining negative thoughts and restating them in positive ways. What term is used to identify this technique? = 1. cognitive reframing 2. Guided imagery 3. Wishful thinking 4. Confrontational assertion

1. Cognitive Reframing

A man continues to speak of his wife as though she were still alive, 3 years after her death. This behavior suggests the use of which ego defense mechanism? = 1. Denial 2. Undoing 3. Suppression 4. Altruism

1. Denial

A client diagnosed with bulimia nervosa uses enemas and laxatives to purge to maintain weight. What is the likely physiological outcome of this practice? = 1. Disruption of the fluid and electrolyte balance 2. Elevated serum potassium level 3. Elevated serum sodium level 4. Increase in the red blood cell count

1. Disruption of the fluid and electrolyte balance

a terminally ill, elderly client wants to ensure that his wishes about end-of-life care are followed and discusses them thoroughly with his daughter. Which action will best guarantee the client's wishes will be achieved? = 1. Execute the signing of advance directives 2. Issue a directive to his physician 3. Share his wishes with the nurse 4. Write a living will

1. Execute the signing of advance directive

The first stage of the general adaptation syndrome (GAS) can be characterized by which response? = 1. Fight or flight 2. Exhaustion 3. Eustress 4.Resistance

1. Fight or Flight

Which statement about the adequacy of pain management in the elderly is supported by current research? = 1. They receive less analgesia than younger adults, which makes pain relief inadequate. 2. They respond better to meperidine than to morphine sulfate when opiates are necessary. 3. They excrete analgesics more rapidly and therefore need more frequent doses. 4. They need smaller doses of pain medication to achieve adequate pain relief.

1. They receive less analgesia than younger adults, which makes pain relief inadequate.

When educating a client diagnosed with bulimia nervosa about the medication fluoxetine, the nurse should include what information about this medication? = 1. It will be prescribed at a higher than typical dose. 2. Long-term management of symptoms is best achieved with tricyclic antidepressants. 3. There are a variety of medications to prescribe if fluoxetine proves to be ineffective. 4. It will reduce the need for cognitive therapy.

1. It will be prescribed at a higher than typical dose.

An elderly client is cognitively impaired and terminally ill with breast cancer. When asked if she is in pain, she usually denies it by shaking her head, but the nurses note that she lies rigidly in bed and grimaces when she turns from side to side. In an attempt to obtain a more accurate assessment, the nurses might choose to use which assessment tool? = 1. Pain Assessment in Advanced Dementia (PAINAD) scale. 2. Present Pain Intensity Rating Scale. 3. Wong-Baker FACES Scale. 4. McGill Pain Questionnaire (MPQ).

1. Pain Assessment in Advanced Dementia (PAINAD) scale.

Inability to leave one's home because of avoidance of severe anxiety suggests the existence of which anxiety disorder? = 1. Panic attacks with agoraphobia 2. Posttraumatic stress response 3. Obsessive-compulsive disorder 4. Generalized anxiety disorder

1. Panic attacks with agoraphobia

Under the Patient Self-Determination Act of 1990, what is the nurse's responsibility when a client is admitted to a long-term care facility? = 1. Provide written materials concerning the client's rights to make decisions about medical care and to formulate advance directives and also ask whether the client has an advance directive. 2. Offer to act as the client's health care proxy for as long as he or she is a resident at the facility. 3. Explain advance directives and the agency expectation that the client will formulate such directives within 24 hours after admission. 4. Ask the client to explain the end-of-life choices he or she has made and document these in the nursing progress notes.

1. Provide written materials concerning the client's rights to make decisions about medical care and to formulate advance directives and also ask whether the client has an advance directive.

A client who lives with an adult child is quite self-sufficient but tells the community health nurse that "it gets lonely being by myself so much of the time with only the television set for company." What suggestion should the nurse make to address the client's need for socialization? = 1. Spend time at the local senior's center three times a week. 2. Attend a maintenance day care program daily. 3. Attend an adult day health program daily. 4. Have the neighborhood watch visit once daily.

1. Spend time at the local senior's center three times a week.

A 72-year-old client diagnosed with Parkinson's disease is demonstrating behaviors associated with anxiety and has had several falls lately and is reluctant to take medications as prescribed. When the healthcare provider orders lorazepam, 1 mg PO bid, the nurse questions the prescription based primarily on what fact? = 1. The client is at risk for falls. 2. The client should be treated with cognitive therapies because of his advanced age. 3. The client has a history of nonadherence with medications. 4. The client may become addicted faster than younger clients.

1. The client is at risk for falls

A 16-year-old patient being treated for anorexia, has been prescribed medication to reduce compulsive behaviors regarding food now that ideal weight has been reached. Which class of medication is prescribed for this specific issue associated with eating disorders? = 1. Mood stabilizers 2. Antidepressants 3. Atypical antipsychotics 4. Anxiolytics

2. Antidepressants

Meditation is successful in promoting stress reduction because it brings about which outcome? = 1. Prevents endorphin release 2. quiets the sympathetic nervous system 3. changes the client's energy field 4. activates the parasympathetic nervous system

2. quiets the sympathetic nervous system

A client is diagnosed with generalized anxiety disorder (GAD). The nursing assessment supports this diagnosis when the client reports which information? = 1. Repeated verbalizing prayers results in a relaxed feeling. 2. Being unable to work for the last 12 months. 3. Eating in public makes the client extremely uncomfortable. 4. Symptoms started right after being robbed at gunpoint.

2. Being unable to work for the last 12 months.

Working to help the client view an occurrence in a more positive light is referred to by which term? = 1. Flooding 2. Cognitive restructuring 3. Desensitization 4. Response prevention

2. Cognitive restructuring

The nurse is providing teaching to a preoperative client just before surgery. The client is becoming more and more anxious and begins to report dizziness and heart pounding. The client also appears confused and is trembling noticeably. Considering the scenario, what decision should the nurse make?= 1. To reinforce the preoperative teaching by restating it slowly. 2. Do not attempt any further teaching at this time. 3. Have a family member read the preoperative materials to the client. 4. Have the client read the teaching materials instead of providing verbal instruction.

2. Do not attempt any further teaching at this time.

According to current theory, which statement regarding eating disorders is accurate? = 1. Eating disorders are rarely comorbid with other mental health disorders. 2. Eating disorders are possibly influenced by sociocultural factors. 3. Eating disorders are frequently misdiagnosed. 4. Eating disorders are psychotic disorders in which patients experience body dysmorphic disorder.

2. Eating disorders are possibly influenced by sociocultural factors.

A client experiencing a panic attack keeps repeating, "I'm dying, I can't breathe.". What action by the nurse should be most therapeutic initially? = 1. Asking the client what he means when he says, "I am dying." 2. Encouraging the client to take slow, deep breaths 3. Offering an explanation about why the symptoms are occurring 4. Verbalizing mild disapproval of the anxious behavior

2. Encouraging the client to take slow, deep breaths

The nurse can determine that inpatient treatment for a client diagnosed with an eating disorder would be warranted when which assessment data is observed? = 1. Has serum potassium level of 3 mEq/L or greater. 2. Has systolic blood pressure less than 90 mm Hg. 3. Weighs 10% below ideal body weight. 4. Has a heart rate less than 60 beats/min.

2. Has systolic blood pressure less than 90 mm Hg.

A client, who is 16 years old, 5 foot, 3 inches tall, and weighs 80 pounds, eats one tiny meal daily and engages in a rigorous exercise program. Which nursing diagnosis addresses this assessment data? = 1. Death anxiety 2. Imbalanced nutrition: less than body requirements 3. Ineffective denial 4. Disturbed sensory perception

2. Imbalanced nutrition: less than body requirements

A usually quiet resident in a long-term care facility has become confused and has shouted out a number of times during the night. What is the nurse's initial action? = 1. Obtain an order for an as-needed dose of a sedative for the client. 2. Investigate the reason for the client's behavioral change. 3. Encourage the client to be quiet and go back to sleep. 4. Place the client in a geriatric chair near the nurse's station.

2. Investigate the reason for the client's behavioral change.

The record mentions states that the client habitually relies on rationalization. The nurse might expect the client to present with what behavior? = 1. Behaves in ways that are the opposite of his or her feelings. 2. Misses appointments. 3. Justifies illogical ideas and feelings. 4. Makes jokes to relieve tension.

3. Justifies illogical ideas and feelings.

A 69-year-old client with a recent history of cancer is undergoing workup for memory loss. The client asks the nurse, "Why am I having all these problems now? I thought life would get easier as I got older." The nurse's response should be guided by what knowledge? = 1. The client is exhibiting signs of acute depression. 2. Older adults experience more medical and psychiatric illnesses. 3. The client is an exception; older people usually have less medical and psychosocial issues than when younger. 4. Older adults usually have a low risk for suicide.

2. Older adults experience more medical and psychiatric illnesses.

Delusionary thinking is a characteristic of which form of anxiety? = 1. Chronic anxiety 2. Panic level anxiety 3. Severe anxiety 4. Acute anxiety

2. Panic Level Anxiety

A 4 years old is referred to the outpatient mental health clinic after being in a severe car accident during which the child's mother died. The father states that the child is withdrawn, not sleeping, having nightmares, and acts out the car accident over and over again when playing. The child states, "It's my fault because I'm bad." What trauma induced disorder does this data support? = 1. Acute stress disorder (ASD) 2. Posttraumatic stress disorder (PTSD) 3. Dissociative identity disorder 4. Adjustment disorder

2. Posttraumatic stress disorder (PTSD)

A person who recently gave up smoking and now talks constantly about how smoking fouls the air, causes cancer, and "burns" money that could be better spent to feed the poor is demonstrating which ego defense mechanism? = 1. Projection 2. Reaction formation 3. Rationalization 4. Undoing

2. Reaction formation

Dissociative identity disorder is characterized by what event? = 1. Sudden, unexpected travel away from home and inability to remember the past 2. Recurring feelings of detachment from one's body or mental processes 3. The inability to recall important information 4. The existence of two or more subpersonalities, each with its own patterns of thinking

2. Recurring feelings of detachment from one's body or mental processes

A 20-year-old was sexually molested at age 10, but he can no longer remember the incident. Which ego defense mechanism is in use? = 1. Projection 2. Repression 3. Displacement 4. Reaction formation

2. Repression

Biological theorists suggest that the cause of eating disorders may be related to which factor? = 1. Body image disturbance 2. Serotonin imbalance 3. Dopamine excess 4. Normal weight phobia

2. Serotonin imbalance

Generally, which statement regarding ego defense mechanisms is true? = 1. They seldom make the person more comfortable. 2. They often involve some degree of self-deception. 3. They are usually effective in resolving conflicts. 4. They are rarely used by mentally healthy people.

2. They often involve some degree of self-deception

After stabilization of symptoms, what is the primary focus of treatment for a client diagnosed with anorexia nervosa? = 1. Improving interpersonal skills 2. Weight restoration 3. Learning effective coping methods 4. Changing family interaction patterns

2. Weight restoration

The nurse caring for a client experiencing a panic attack anticipates that the psychiatrist would order a stat dose of which classification of medications? = 1. Anticholinergic medication. 2. Standard antipsychotic medication. 3. A short-acting benzodiazepine medication. 4. Tricyclic antidepressant medication.

3. A short-acting benzodiazepine medication.

A client who lives with a daughter's family is often left alone during the day and even some evenings. The client has expressed being lonely and socially isolated. Considering the situation, which support option is most appropriate? = 1. Partial hospitalization 2. Nursing home admission 3. Adult day care 4. Home health nursing care

3. Adult day care

What defense mechanisms can only be used in healthy ways? = 1. Idealization and splitting 2. Suppression and humor 3. Altruism and sublimation 4. Reaction formation and denial

3. Altruism and sublimation

The nurse is caring for a client on day 1 post-surgical procedure. The client becomes visibly anxious and short of breath, and states, "I feel so anxious! Something is wrong!" What action should the nurse take initially in response to the client's actions? = 1. Reassure the client that what they are feeling is normal anxiety and do deep breathing exercises with her. 2. Reassure the client that you will stay until the anxiety subsides. 3. Call for staff help and assess the client's vital signs. 4. Use the call light to inquire whether the client has been prescribed prn anxiety medication.

3. Call for staff help and assess the client's vital signs.

What can be said about the comorbidity of anxiety disorders? = 1. Substance abuse disorders rarely coexist with anxiety disorders. 2. Anxiety disorders virtually never coexist with mood disorders. 3. Depression may occur prior to onset of anxiety. 4. Anxiety disorders generally exist alone.

3. Depression may occur prior to onset of anxiety.

Which of the following statements about dissociative disorders is true? = 1. Dissociative symptoms are usually always negative. 2. Dissociative symptoms are usually a cry for attention. 3. Dissociative symptoms are not under the person's conscious control. 4. Dissociative symptoms are under the person's conscious control.

3. Dissociative symptoms are not under the person's conscious control.

Which medication is FDA approved for treatment of anxiety in children? = 1. Sertraline 2. Clomipramine 3. Duloxetine 4. Fluoxetine

3. Duloxetine

What is the major distinction between fear and anxiety? = 1. Fear enables constructive action; anxiety is dysfunctional. 2. Fear is a universal experience; anxiety is neurotic. 3. Fear is a response to a specific danger; anxiety is a response to an unknown danger. 4. Fear is a psychological experience; anxiety is a physiological experience.

3. Fear is a response to a specific danger; anxiety is a response to an unknown danger.

A symptom commonly associated with panic attacks? = 1. Apathy 2. Obsessions 3. Fear of impending doom 4. Fever

3. Fear of impending doom

A client reveals that she induces vomiting as often as a dozen times a day. The nurse would expect assessment findings to support which electrolyte imbalance? = 1. Hypercalcemia 2. Hypernatremia 3. Hypokalemia 4. Hypolipidemia

3. Hypokalemia

The client experiencing bulimia differs from the client diagnosed with anorexia nervosa by exhibiting which characteristic? = 1. Purging to keep weight down 2. Holding a distorted body image 3. Maintaining a normal weight 4. Doing more rigorous exercising

3. Maintaining a normal weight

An individual who is able to regain mental stability after a traumatic event is said to be demonstrating what trait? = 1. Autonomy 2. Maturity 3. Resilience 4. Independence

3. Resilience

A cultural characteristic that may be observed in a teenage, female Hispanic client in times of stress would include what behavior? = 1. Report both nausea and vomiting 2. Exhibit stoic behavior 3. Suddenly tremble severely 4. Laugh inappropriately

3. Suddenly tremble severely

The nurse working with clients diagnosed with eating disorders can help families develop effective coping mechanisms by implementing which intervention? = 1. Stressing the need to suppress overt conflict within the family 2. Encouraging the family to use their usual social behaviors at meals 3. Teaching the family about the disorder and the client's behaviors 4. Urging the family to demonstrate greater caring for the client

3. Teaching the family about the disorder and the client's behaviors

Effective care of a client suspected of experiencing bulimia nervosa calls for the nurse to perform which assessment? = 1. body fat analysis. 2. a range of motion assessment. 3. inspection of the oral cavity. 4. inspection of body cavities.

3. inspection of the oral cavity.

When a client is prescribed lorazepam 1 mg po four times a day (qid) for 1 week for generalized anxiety disorder, the nurse should which intervention as the priority? = 1. question the physician's order because the dose is excessive. 2. explain the long-term nature of benzodiazepine therapy. 3. teach the client to limit caffeine intake. 4. tell the client to expect mild insomnia.

3. teach the client to limit caffeine intake

The nurse admitting an older, Hispanic, adult for a possible urinary tract infection is overheard stating, "I probably won't be able to get accurate information until the client's family comes in and can answer my questions." The nurse is exhibiting which bias? = 1. Gender bias 2. Racism 3. Ageism 4. Cultural bias

3.Ageism

What is a possible outcome criterion for a client diagnosed with anxiety disorder? = 1. Client reports reduced hallucinations. 2. Client demonstrates persistent avoidance behaviors. 3. Client reports feelings of tension and fatigue. 4. Client demonstrates effective coping strategies.

4. Client demonstrates effective coping strategies.

Which statement concerning syndromes seen in other cultures but not seen in our own, such as amok should be considered true? = 1. Myths, or rumors, because they have not been sufficiently studied to be classified as real. 2. Dissociative disorders such as dissociative identify disorders 3. Physical disorders, not mental disorders 4. Culture-bound syndromes that are not dissociative disorders

4. Culture-bound syndromes that are not dissociative disorders

Which coping mechanism is used excessively by clients diagnosed with bulimia nervosa to cope with their obsession with their body image? = 1. Projection 2. Humore 3. Altruism 4. Denial

4. DENIAL

A Gulf War veteran is entering treatment for post-traumatic stress disorder. What assessment is of greatest importance to this particular client? = 1. Find out if the client uses acting-out behavior. 2. Establish whether the client has chronic hypertension related to high anxiety. 3. Ascertain how long ago the trauma occurred. 4. Determine the use of chemical substances for anxiety relief.

4. Determine the use of chemical substances for anxiety relief.

Panic attacks in Latin American individuals often involve demonstration of which behavior? = 1. Blushing 2. Repetitive involuntary actions 3. Offensive verbalizations 4. Fear of dying

4. Fear of dying

Which subjective symptom should the nurse expect to note during assessment of a client diagnosed with anorexia nervosa? = 1. Hypotension 2. Lanugo 3. 25-lb weight loss 4. Fear of gaining weight

4. Fear of gaining weight

A client hospitalized with anorexia nervosa has a weight that is 65% of normal. For this client, what is a realistic short-term goal for the first week of hospitalization regarding the physical impact of his/her weight? = 1. Verbalize awareness of the sensation of hunger. 2. Develop a pattern of normal eating behavior. 3. Discuss fears and feelings about gaining weight. 4. Gain a maximum of 3 lb.

4. Gain a maximum of 3 lb.

Empathic listening is therapeutic because it focuses on what form of action? = 1. Encouraging resilience 2. Enhancing self-esteem 3. Reducing anxiety 4. Lessening feelings of isolation

4. Lessening feelings of isolation

Selective inattention is first noted when experiencing which level of anxiety? = 1. Mild 2. Panic 3. Severe 4. Moderate

4. Moderate

The plan of care for a client who has elaborate washing rituals specifies that response prevention is to be used. Which scenario is an example of response prevention? = 1. Telling the client that he or she must relax whenever tension mounts 2. Not allowing the client to seek reassurance from staff 3. Having the client repeatedly touch "dirty" objects 4. Not allowing the client to wash hands after touching a "dirty" object

4. Not allowing the client to wash hands after touching a "dirty" object

Which statement is true of the eating disorder referred to as bulimia? = 1. Patients with bulimia severely restrict their food intake. 2. One sign of bulimia is lanugo. 3. Patients with bulimia binge eat but do not engage in compensatory measures. 4. Patients with bulimia often appear at a normal weight.

4. Patients with bulimia often appear at a normal weight.

Which diagnosis from the list below would be given priority for a client diagnosed with bulimia nervosa? = 1. Chronic low self-esteem 2. Ineffective coping: impulsive responses to problems 3. Disturbed body image 4. Risk for injury: electrolyte imbalance

4. Risk for injury: electrolyte imbalance

A client frantically reports to the nurse that "You have got to help me! Something terrible is happening. I can't think. My heart is pounding, and my head is throbbing." The nurse should assess the client at what level of anxiety? = 1. mild. 2. panic. 3. moderate. 4. severe.

4. Severe

A nurse planning continuing education programs for nursing staff members at a multipurpose senior center will plan programs based on the knowledge that which mental health problem is most common among the elderly? = 1. Obsessive-compulsive disorder 2. Agoraphobia 3. Schizophrenia 4. Suicidal ideation

4. Suicidal ideation

Which intervention would be least useful for accurate assessment of the weight of a client diagnosed with anorexia nervosa? = 1. Do not reweigh client when client requests. 2. Weigh 2 times daily first week, then three times weekly. 3. Permit no oral intake before weighing. 4. Weigh fully clothed before breakfast.

4. Weigh fully clothed before breakfast.

A 68-year-old recently retired client is referred to the mental health clinic for symptoms of depression, social isolation, and irritability. The client's son states, "My dad never used to be like this. My mom's been gone for 10 years and he has been doing fine." When the nurse asks the client directly about alcohol intake, he becomes defensive and refuses to discuss the issue. The nurse's response should be guided by what knowledge? (Select all that apply.): = A. Alcohol abuse often goes undetected in older adults. B. Depression plays a role in increased drinking. C. The client is exhibiting dysfunctional grieving. D. Older men are more likely to abuse substances other than alcohol. E. Being single is a risk factor for alcohol abuse. F. The client is most likely reacting to his retirement.

A. Alcohol abuse often goes undetected in older adults. B. Depression plays a role in increased drinking. E. Being single is a risk factor for alcohol abuse.

The nurse anticipates that the nursing history of a client diagnosed with obsessive compulsive disorder (OCD) will reveal what common assessment data? (Select all that apply.) = A. An eating disorder B. A previous suicide attempt C. A history of sexual abuse D. A history of childhood trauma E. A sibling with the disorder

A. An eating disorder C. A history of sexual abuse D. A history of childhood trauma E. A sibling with the disorder

Which psychosocial disorder is more often initially seen in late life? (Select all that apply.) = A. Anxiety B. Bipolar disorder C. Dissociative disorder D. Schizophrenia E. Depression

A. Anxiety E. Depression

The symptoms of an adjustment disorder can include which characteristics? (Select all that apply.) = A. Depression B. Guilt C. Anger D. Social withdrawal E. Overachieving

A. Depression B. Guilt C. Anger D. Social withdrawal

Which approach to reducing client stress is most effective for children experiencing postoperative pain? = A. Guided Imagery B. Meditation C. Breathing Exercises D. Journaling

A. Guided Imagery

What tool should the nurse use in assessing the amount of stress a client has experienced in the past year? = A. Life-Changing Event Questionnaire B. NANDA Handbook C. DSM-IV-TR D. Quick Mental Status Assessment

A. Life-Changing Event Questionnaire

What are the physiologic responses associated with successful guided imagery? Select all that apply. = A. Reduction of obsessive thoughts B. Reduction of anxiety C. Increase in Appetite D. Improved Sleep Patterns E. Reduction of muscle pain

A. Reduction of obsessive thoughts B. reduction of anxiety D. Improved sleep patterns

What stress-reduction technique should a nurse teach an individual experiencing severe performance anxiety? = A. deep breathing. B. Journal keeping C. restructuring and setting priorities. D. assertiveness

A. deep breathing.

What would a client experience during a progressive relaxation session? = A. Having a nurse enter the client's energy field to rebalance it and bring harmony B. Instruction in sequential tensing and relaxing of various muscle groups until the entire body is relaxed C. Being attached to a machine that monitors a physical parameter and receiving audible feedback about the state of that parameter D. Being led into a positive imaginary sensory experience

B. Instruction in sequential tensing and relaxing of various muscle groups until the entire body is relaxed

Which of the following symptoms would lead a provider to suspect that a client is experiencing PTSD? (Select all that apply.) = A. Talking with strangers about the events of the accident B. Irritability C. Flashbacks of the accident D. Difficulty concentrating E. Visiting the scene of the accident over and over F. Hypervigilance G. Mania

B. Irritability C. Flashbacks of the accident D. Difficulty concentrating F. Hypervigilance

Stress can be attributed to stimulation of the hypothalamus-pituitary-adrenal cortex. Which assessment finding would confirm the long-term effects of such stress? (Select all that apply.) = A. Chronic muscle tension B. Obesity C. Insulin Resistance D. Digestive problems E. A high resting heart rate

B. Obesity C. Insulin Resistance

A client diagnosed with hypertension uses an automatic cycling blood pressure cuff with audible changing tones. The client uses relaxation techniques to lower her blood pressure and is informed of her ongoing success by the tone. This process describes this technique? = A. guided imagery. B. therapeutic touch. C. biofeedback. D. assertiveness training.

C. Biofeedback

What factor exerts the greatest influence on the degree to which various life events upset a specific individual? = A.The effect of the individual's health-sustaining behaviors B. The individual's degree of spirituality C. The individual's perception of the event D. The amount of social support available to the individual

C. The individual's perception of the even

Self-help groups are useful for reducing stress because they provide the individual with the stress mediator that take what form? = 1. Cognitive reframing 2. Cultural support 3. Social Support 4. Life satisfaction

Social support