Mental Health Nursing -chapter 10, 11,12
Which response would the nurse provide to a patient diagnosed with social anxiety disorder who asks the nurse about a new prescription for sertraline, stating the Internet indicated it is for depression?
"Certain antidepressant medications work well for managing anxiety. It may take several weeks for you to feel the full benefit."
Which question would the nurse ask when interviewing a patient who has been diagnosed with posttraumatic stress disorder (PTSD) related to a sexual assault?
"Do you experience flashbacks of the assault?"
Which question would the nurse include in an assessment of a retired football player who is recently divorced and is having problems keeping a job? Select all that apply. One, some, or all responses may be correct.
"Do you have a safe place to live?" "Are you having troubles concentrating?" "How long is your attention span?" "Are you using any drugs or alcohol?" "Do you remember a head injury event?"
Which question is most important to ask during assessment of a patient diagnosed with an anxiety disorder?
"Have you ever considered suicide?"
Which question would the nurse ask a combat veteran who is being treated for migraines and hypertension?
"How would you describe posttraumatic stress disorder?"
Which patient statement supports the existence of a comorbid condition characteristically associated with posttraumatic stress disorder (PTSD)? Select all that apply. One, some, or all responses may be correct.
"I don't have any really good friends, just acquaintances." "Marriage doesn't work for me; I've been divorced three times." "My partner is always upset because I can't seem to keep a job." "Controlling my anger is a big problem for me."
Which statement by a patient most clearly indicates that goals for treatment of a somatic symptom disorder are being achieved?
"I don't think about my symptoms all the time as I used to."
During a team meeting to discuss care for a patient diagnosed with dissociative identity disorder who was hospitalized after a suicide attempt, which statement by a staff nurse would prompt the nursing supervisor to intervene?
"I find myself more fascinated and engaged with this patient than others."
When teaching a patient and her mother about a new diagnosis of a somatic symptom disorder, which statement by the patient's mother would require further education?
"I think my daughter is making up these symptoms for attention."
Which nursing response is appropriate when a patient who has been prescribed paroxetine tells the nurse the drug information was looked up online and asks why it was prescribed when the patient has anxiety, not depression?
"It's not a mistake. Some antidepressant medications also work well for managing anxiety."
Which statement would the nurse make after a patient tells the nurse, "I have so many ailments that I need to see six different doctors. None of them has discovered what is really wrong with me"?
"Let's review all the medications you currently take."
Which comment would be made by a patient who has been diagnosed with conversion disorder, or functional neurological disorder?
"Since getting a divorce, I've had crushing chest pain, but I don't think it really means anything."
Which comment would likely be stated by a patient diagnosed with conversion disorder (functional neurological disorder)?
"Since losing my job last week, I've been unable to maintain my balance and coordination. It's probably just a little nerve irritation."
Which response would the nurse make after a foster parent tells the nurse that a child who lost his or her parents in an accident expresses feelings by making sketches?
"The child is showing constructive behavior."
Which response by the nurse is the most therapeutic response when a patient who has a long history of mental illness cries spontaneously when talking about the unexpected death of a spouse?
"The sudden death of your spouse is hard to accept. I am glad you are able to tell me about how you are feeling."
A nurse caring for a patient diagnosed with somatic system disorder states, "That patient is just taking up a bed that should go to a patient with a real problem." Which response would the nurse's colleague make?
"The symptoms and distress are real to the patient. As nurses, we have an obligation to provide compassionate care."
When discussing the symptoms of posttraumatic stress disorder (PTSD), which statement by the nurse is accurate?
"The symptoms can occur almost immediately or can take years to manifest."
Which comment would be appropriate for the nurse to make to a patient who has a long history of malingering and continues to report multiple physical problems?
"The treatment team carefully discussed your case. We'd like to begin a special case management program for you."
Which statement by the nurse is associated with burnout?
"These patients are like living with my mother and aunt."
Which response would the nurse make to help a patient experiencing a moderate level of anxiety who states, "I am so anxious that I do not know what to do"?
"What things have you done in the past that helped you feel more comfortable?"
Which patient statement supports the diagnosis of a somatic symptom disorder? Select all that apply. One, some, or all responses may be correct.
"When I was 5 years old, my father and I survived an automobile accident that killed my mother." "My partner promised to never leave me as long as I have all these medical problems." "I sometimes wonder what I've done to deserve all this physical pain." "My pain medication is the only reason I have any life at all."
Which is the nurse's best response when a patient, who was a soldier, states, "Sometimes I still hear explosions, but I know I am safe in my home," during the initial interview?
"You are describing flashbacks. These often happen after traumatic events such as war. I'd like to arrange for you to talk more about your feelings and reactions."
Which initial comment by the nurse is therapeutic for a patient who is pacing, breathing rapidly, complaining of nausea, and distracted after just learning that a family member was diagnosed with a serious illness?
"You are safe. First, take a deep breath."
Which statement by the nurse is appropriate when teaching a patient who survived a bomb blast and has symptoms of chronic depression, irritability, and insomnia? Select all that apply. One, some, or all responses may be correct.
"You should not consume alcohol." "Coffee should be avoided." "Keep practicing deep breathing and aerobic exercises." "Dreaming about the traumatic event is a normal response to your trauma."
Which response would the nurse make when a patient with conversion disorder, or functional neurologic disorder, asks what the diagnosis means?
"Your emotional distress is being expressed as physical symptoms."
Which patient is at risk for posttraumatic stress disorder (PTSD)? Select all that apply. One, some, or all responses may be correct.
A child after the violent death of his mother from spousal abuse An older woman after the death of her daughter after a long illness A woman who has just lost her child to cancer A teenage victim of sexual abuse
Which symptom would the nurse expect a patient with depersonalization disorder to exhibit?
A feeling of detachment from one's body or mental processes
Which situation is most likely to produce fear when encountered by a healthy adult?
A gunman begins firing an assault weapon in a crowded mall.
Which scenario demonstrates a secondary gain?
A husband hires a housekeeper to clean and provide childcare while his wife is having abdominal distress.
Which phrase is the definition of obsession?
A recurrent, persistent thought or impulse
Which statement is true regarding the comorbidity of anxiety disorders?
A second anxiety disorder may co-occur with the first.
Which patient description exemplifies malingering?
A. Falsely claims to have symptoms. Malingering is a consciously motivated act to falsely claim symptoms, usually based on the desire for material gain.
Which probable factor would cause a patient to report to the nurse that the patient has started using relaxation techniques and is sleeping better?Which intervention would the nurse include in the plan of care for a patient diagnosed with illness anxiety disorder? Select all that apply. One, some, or all responses may be correct.
Ability to manage anxiety
Which assessment would the nurse complete for a patient diagnosed with a somatic symptom disorder?
Addicted to medication
Which activity will the nursing director of a neighborhood clinic implement to best address a facility's evidence-based practice needs?
Advocating for the admission interviews of patients with somatic symptoms to contain questions concerning childhood trauma
Which brain structure is involved in a fear of riding in elevators and the resulting behavior of always takes the stairs?
Amygdala Rationale The amygdala plays a role in anxiety disorders. It alerts the brain to the presence of danger and brings about fear or anxiety to preserve the system.
Which scenario presents the most accurate example of altruism?
An individual who received a liver transplant volunteers at a local organ procurement agency.
Which scenario presents the most accurate example of altruism?
An individual who received a liver transplant volunteers at a local organ procurement agency. Rationale Altruism is a healthy defense mechanism in which emotional conflicts and stressors are addressed by meeting the needs of others.
Which assessment finding could attribute to a somatic symptom disorder for a patient who immigrated with family from a country that is fighting a civil war, is reporting vague headaches with no aggravating factors, and physiological causes for the pain have been ruled out? Select all that apply. One, some, or all responses may be correct.
Anxiety Trauma Depression
Which assessment finding could attribute to a somatic symptom disorder for a patient who immigrated with family from a country that is fighting a civil war, is reporting vague headaches with no aggravating factors, and physiological causes for the pain have been ruled out? Select all that apply. One, some, or all responses may be correct.
Anxiety Trauma Depression
About which type of medication would the nurse teach a patient who is diagnosed with somatic symptom disorder?
Anxiolytics
Which class of medications has been shown to be helpful in treating somatic symptom disorders? Select all that apply. One, some, or all responses may be correct.
Anxiolytics Antidepressants Benzodiazepines
Which intervention is used to care for patients with somatic symptom disorders? Select all that apply. One, some, or all responses may be correct.
Assertiveness training Self-esteem enhancement Family involvement promotion
Which action does the nurse take to protect a patient with illness anxiety disorder from self-harm?
Assessing the patient for suicidal ideation
Which action would be the nurse's priority when a combat veteran tells the nurse, "Every day something happens that makes me feel like I'm still at war. My family has grown impatient with me. They say it's time for me to move on from that time in my life, but I can't"?
Assessing the veteran for suicide risk
Which education would be included in an oncology unit support program to prevent compassion fatigue? Select all that apply. One, some, or all responses may be correct.
Balance work and personal life Develop self-care skills. Identify signs of depression. Discuss healthy work relationships. Develop a professional support team.
Which theory is evident when a patient tells the nurse "My mother and I are afraid of the dark, so we both always carry a flashlight?
Behavioral theory
Which intervention would the case manager implement for a patient demonstrating somatization-associated behaviors? Select all that apply. One, some, or all responses may be correct.
Being a contact resource for the patient Liaisoning between patient and care providers Acting as the patient's advocate
Which action would the nurse document in the health record as passive-aggressive behavior by a patient who is using immature defense mechanisms? Select all that apply. One, some, or all responses may be correct.
Being hostile after agreeing to follow unit rules Avoiding completing tasks when asked by the boss at work
Which category of medication used to treat anxiety has a potential for addiction?
Benzodiazepines
Which information will the nurse include in medication education for a patient prescribed an antianxiety medication for obsessive-compulsive behavior? Select all that apply. One, some, or all responses may be correct.
Caffeinated beverages should be avoided. Benzodiazepines have a quick onset of action. Antacid use can affect medication absorption.
Which question would assist the nurse to determine whether a patient diagnosed with obsessive-compulsive disorder has achieved treatment outcomes? Select all that apply. One, some, or all responses may be correct.
Can the patient meet self-care needs effectively? Is the patient able to maintain satisfying interpersonal relationships? Has the patient learned to use newly acquired methods to manage anxiety? Does the patient understand that anxiety is the cause of the ritualistic behavior?
Which question would assist the nurse to determine whether a patient diagnosed with obsessive-compulsive disorder has achieved treatment outcomes? Select all that apply. One, some, or all responses may be correct.
Can the patient meet self-care needs effectively? Is the patient able to maintain satisfying interpersonal relationships? Has the patient learned to use newly acquired methods to manage anxiety? Does the patient understand that anxiety is the cause of the ritualistic behavior? So close!
Which question would assist the nurse to determine whether a patient diagnosed with obsessive-compulsive disorder has achieved treatment outcomes? Select all that apply. One, some, or all responses may be correct.
Can the patient meet self-care needs effectively? Is the patient able to maintain satisfying interpersonal relationships? Has the patient learned to use newly acquired methods to manage anxiety? Does the patient understand that anxiety is the cause of the ritualistic behavior?
Which factor would the nurse consider when caring for a patient who has had recurrent severe stomach pain and weakness and suspects colon cancer? Select all that apply. One, some, or all responses may be correct.
Care of this patient takes excessive time and effort. Misdiagnosis is common when a patient has such complaints. The patient may be noncompliant with the nurse's recommendations.
Which intervention would the nurse perform for a patient who becomes increasingly anxious when preoperative information is presented, reports dizziness and heart pounding, and shows trembling and confusion?
Cease any further attempt at preoperative teaching at this time, and instead encourage deep breathing.
Which medication is used to treat anxiety disorders? Select all that apply. One, some, or all responses may be correct.
Clonidine Paroxetine Alprazolam Venlafaxine Propranolol
Which counselling approach would likely be used to counsel a patient who is diagnosed with acute stress disorder?
Cognitive behavioral therapy
Which method of treatment would the nurse use when treating a war veteran who comes to the clinic demonstrating signs of posttraumatic stress disorder (PTSD)?
Cognitive behavioral therapy
Which therapy is an example of psychotherapy?
Cognitive behavioral therapy
Which therapeutic modality helps a patient view a disturbing occurrence in a more positive light?
Cognitive restructuring
Which condition may the nurse experience while caring for a seriously ill patient over an extended time?
Compassion fatigue
Which defense mechanism is the nurse encouraging in a child who is extremely upset because of bullying by peers for having a short stature by telling the child that height does not affect fitness and could help the child excel in other sports and academics?
Compensation
Which disorder is an example of a somatic symptom disorder?
Conversion disorder
Which disorder is consistent with an acute development of bilateral lower extremity paralysis in a patient with normal neurological diagnostic results?
Conversion disorder
Which diagnosis is included among the somatic symptom disorders? Select all that apply. One, some, or all responses may be correct.
Conversion disorder Illness anxiety disorder factitious disorder imposed on self
Which nursing action is appropriate for a patient diagnosed with a somatic symptom disorder?
Conveying an interest in the patient rather than in the symptoms.
Which term applies to a patient who says, "Sometimes I feel like I'm floating above my body, watching it from the outside"?
Depersonalization
Which goal would the nurse develop with a patient who has a somatic symptom disorder, reports being alone a great deal of the time, and scores 26 on the UCLA Loneliness Scale (LS-R)?
Develop two new social support systems.
Which action would the nurse include in the plan of care when reviewing the following health history and assessment for a patient admitted with a history of a somatic symptom disorder? Select all that apply. One, some, or all responses may be correct.
Developing trust Providing education Emphasizing strengths Discussing problem-solving strategies Promoting relaxation techniques
Which intervention would the nurse apply to help a patient maintain hygiene if the patient is diagnosed with obsessive-compulsive disorder and takes several hours to perform self-care?
Discussing with the patient his or her feelings about self-care.
Which defense mechanism is being used by a patient after an argument in which the patient blamed the spouse for a new diagnosis of heart failure? Select all that apply. One, some, or all responses may be correct.
Displacement Rationale The patient is displacing anger regarding his or her diagnosis onto the spouse.
Which information would the nurse give to the family of a patient who has experienced a dissociative episode?
Dissociation is a method for coping with severe stress.
Which nursing intervention would be therapeutic for a patient experiencing a panic attack?
Encouraging the patient to take slow, deep breaths
Which substance is activated when an individual runs to escape a tornado?
Epinephrine
Which response would the nurse expect to see in a couple planning a large wedding in a city 100 miles from their home?
Eustress
Which type of stress is being experienced by a patient who exercises 60 minutes per day, 5 days a week to facilitate weight loss?
Eustress
Which type of stress is likely experienced by an employee who had to manage several similar projects on a deadline?
Eustress
The nurse understands that a patient who complains of being "stressed out" may exhibit which behavior? Select all that apply. One, some, or all responses may be correct.
Excessive appetite Loss of interest in favorite activities Headaches and back pain Difficulty concentrating
Which risk factor contributes to the development of somatic symptom disorders? Select all that apply. One, some, or all responses may be correct.
Experiencing childhood trauma Experiencing stress in school as a child Living with a family member with a chronic illness
Which action would the nurse take first for a depressed spouse of a patient who received a heart transplant 5 years ago and had multiple medical complications?
Exploring the spouse's feelings, showing care and compassion
Which treatment would the nurse expect to include when planning care for a patient with a somatic symptom disorder? Select all that apply. One, some, or all responses may be correct.
Family/relationship therapy Trauma-focused psychotherapy Cognitive behavioral therapy (CBT) Relaxation and breathing techniques Selective serotonin reuptake inhibitors (SSRIs)
Which statement describes the major distinction between fear and anxiety?
Fear is a response to a specific danger; anxiety is a response to an unknown source.
Which symptom is commonly associated with panic attacks?
Fear of impending doom
Which nursing diagnosis and etiology are most applicable for a woman who receives an abnormal Pap smear report, calls her attorney to prepare a will, and tells her family that she will not be around much longer?
Fear related to misinterpretation and misinformation about Pap tests
Which symptom would the nurse expect a patient diagnosed with depersonalization disorder to report during an interview?tion
Feeling of being an observer of one's own body
Which behavior indicates an improved ability to cope in a patient diagnosed with posttraumatic stress disorder? Select all that apply. One, some, or all responses may be correct.
Fewer physical complaints Asking for help when required More restful sleep periods
Which sign of posttraumatic stress disorder (PTSD) would the nurse assess in a young parent whose two children died in a motor vehicle crash? Select all that apply. One, some, or all responses may be correct.
Flashbacks and distressing memories Avoidance of friends with young children Persistent fear and guilt
Which sign of posttraumatic stress disorder (PTSD) would the nurse assess in a young parent whose two children died in a motor vehicle crash? Select all that apply. One, some, or all responses may be correct.
Flashbacks and distressing memories Avoidance of friends with young children Persistent fear and guilt
Which symptom would lead the health care provider to suspect posttraumatic stress disorder (PTSD) in an adult patient? Select all that apply. One, some, or all responses may be correct.
Flashbacks of the accident Hypervigilance Irritability Difficulty concentrating
According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria, which finding would the nurse expect when talking with a patient who has a diagnosis of a moderate somatic symptom disorder? Select all that apply. One, some, or all responses may be correct.
Focuses on illness most of day Reports missing work as a result of symptoms Preoccupied with researching symptoms
Which assessment finding would the nurse note in a patient who has been diagnosed with conversion disorder?
Frequent syncope
Which disorder is demonstrated by a patient who casually tells the nurse, ''I woke up this morning and couldn't move my arm''?
Functional neurological disorder
Which factor is predictive of positive outcomes for a patient with PTSD? Select all that apply. One, some, or all responses may be correct.
Good psychiatric health A solid supportive family Rapid onset of symptoms
Which assessment finding would alert the nurse to the possibility of malingering when a hospitalized patient reports abdominal pain, dizziness, and headaches although a physical workup does not indicate any physical causes? Select all that apply. One, some, or all responses may be correct.
Has a court date this week for drunk driving. Has a history of physical abuse by a stepfather.
Which factor would support a positive outcome for treatment of a recently divorced veteran who has come for treatment for depression and has diabetes and heart disease?
Has reliable family support
Which behavior clearly suggests that a patient is recovering from posttraumatic stress disorder (PTSD)?
Having breakfast with a friend weekly
Which co-occurring condition is associated with PTSD? Select all that apply. One, some, or all responses may be correct.
Heart attack Depression Osteoarthritis
Which nursing intervention is most helpful to support improvement in an anxious patient's sense of control and competence?
Helping the patient identify several stress situations that he or she has successfully managed
Which finding is consistent for a patient with somatic symptom disorder?
History of multiple medical treatments
Which defense mechanism would the nurse recognize that a patient is using who reports increased anxiety in uncomfortable situations and cracking jokes when under a lot of stress?
Humor Rationale The patient is using humor when cracking jokes in stressful situations.
Which finding would the nurse note in a 6-year-old child with a diagnosis of posttraumatic stress disorder (PTSD) resulting from parental abuse?
Hypervigilance
Which action related to health promotion would the nurse implement when caring for a patient who has a somatic symptom disorder and is experiencing the inability to provide effective self-care?
Identifying the patient's highest level of self-care and stating reasonable expectations to the patient
A patient who has frequent abdominal cramps and believes it is because of some underlying serious illness is likely to have which disorder?
Illness anxiety disorder
Which disorder is characterized by a patient's misinterpretation of physical sensations or feelings?
Illness anxiety disorder
Which patient problem would be the nurse's focus for a patient diagnosed with somatic symptom disorder?
Inability to cope
Which patient problem is important for the nurse to consider when caring for a patient who complains of body pain and is anxious about the possibility of a serious medical illness?
Ineffective coping
Which phrase describes the nurse's concern for a patient who has been diagnosed with somatic symptom disorder and cannot meet occupational, family, or social responsibilities?
Ineffective coping mechanisms
Which statement is true regarding psychopharmacological therapy for posttraumatic stress disorder (PTSD)? Select all that apply. One, some, or all responses may be correct.
Initial therapy may include fluoxetine. Monoamine oxidase inhibitors (MAOIs) may be prescribed for PTSD. Anticonvulsant medications may be used in PTSD that is resistant to treatment.
Which adjective applies specifically to factitious disorders but not somatic symptom disorders?
Intentional
Which intervention would the nurse perform when a patient with a diagnosis of conversion disorder is preparing for discharge from the hospital and states, "Now I'm having chest pain, but it's probably nothing"?
Interrupt the discharge and arrange additional medical evaluation of the patient
Which instruction would the nurse provide to a patient diagnosed with anxiety and prescribed buspirone?
It will take 3 or more weeks for you to feel the full benefit."
Which phrase describes an example of a physical stressor in the workplace?
Loud noises
Which condition is a likely cause of stress? Select all that apply. One, some, or all responses may be correct.
Low social status Threats to self-esteem Loud noises Poverty
Which nursing intervention would be the priority for a patient with dissociative identity disorder who was hospitalized with self-inflicted lacerations and tells the nurse, "I don't know what happened. I just looked down and they were there"?
Maintaining continuous observation
Which additional problem is most important for the nurse to assess in a new patient diagnosed with generalized anxiety disorder?
Major depressive disorder
Which term is applicable to a person who consumes large amounts of caffeine to increase blood pressure in an effort to qualify for disability benefits?
Malingering
Which therapeutic intervention can the nurse implement independently to help a patient experiencing mild anxiety to regain control?
Modeling
Which level of anxiety is experienced when selective inattention is first noted?
Moderate Rationale Selective inattention is noted in patients with moderate anxiety. The individual's perceptual field is reduced, and he or she is not able to see the entire picture of events.
Which intervention would the nurse use to address the short-term effects that stress has on the hypothalamus-pituitary-adrenal (HPA) cortex?
Monitor blood glucose levels
Which symptom would the nurse assess in a patient with posttraumatic stress disorder (PTSD)?
Mood alterations
Which routine activities would the nurse provide instructions to discontinue for a patient diagnosed with panic disorder who is beginning a new prescription for lorazepam?
Mowing the lawn
Which finding would the nurse expect during assessment of a patient with illness anxiety disorder? Select all that apply. One, some, or all responses may be correct.
Nervousness
For which reason would someone feel mildly tense but eager to begin a job interview?
Normal anxiety
Which cause would be the likely reason for changing study habits to earn better grades after initially failing a test?
Normal anxiety Rationale Normal anxiety is a healthy life force needed to carry out the tasks of living and striving toward goals.
Which action would the nurse take first after reviewing the following health history, assessment data, and laboratory results?
Notifying law enforcement
For which reason would a patient diagnosed with somatic symptom disorder seek medical care? Select all that apply. One, some, or all responses may be correct.
Obtaining financial benefit Seeking attention from others Gaining benefit in interpersonal relationships
Which statement regarding the presence of symptoms accurately describes somatic symptom disorders?
One somatic symptom associated with significant life impairment
Which level of anxiety is exhibited when the nurse observes a patient wide-eyed, repeating nonsensical statements, running from chair to chair, and not following staff direction or verbal efforts to calm the patient?
Panic
Which type of anxiety may be associated with delusional thinking?
Panic
Which anxiety disorder involves the inability to leave one's home because of severe anxiety?
Panic attacks with agoraphobia Rationale Panic disorder with agoraphobia is characterized by recurrent panic attacks combined with agoraphobia. Agoraphobia involves intense, excessive anxiety about being in places or situations from which escape might be difficult or embarrassing or in which help might not be available if a panic attack occurred.
Which statement is true regarding obsessive-compulsive disorder (OCD)?
Patients diagnosed with OCD should be assessed regularly for risk for suicide.
Which statement about somatic symptom disorders is true?
Patients lack awareness of the relationship among symptoms, anxiety, and conflicts.
Which statement concerning somatic symptom disorders is true? Select all that apply. One, some, or all responses may be correct.
Patients typically experience high levels of functional impairment. Chest pain, dizziness, and headache are commonly reported symptoms. Medical and psychosocial histories are vital to achieving an accurate diagnosis. The health care provider's perception of the patient is a factor in the diagnosis process.
Which sign of posttraumatic stress disorder (PTSD) would the nurse assess for in a patient who expresses difficulty with social relationships? Select all that apply. One, some, or all responses may be correct.
Persistent negative emotions of guilt and shame Long criminal history of abuse and crime Unable to sleep throughout the night without nightmares
Which statement appropriately describes somatic symptoms?
Physical symptoms of a psychological illness
Which nursing concern is the priority for a patient who reports severe headache and seeing blinding lights but whose diagnostic tests do not reveal a physical pathology?
Poor coping
Based on the following findings, which patient problem would the nurse prioritize when planning care?
Poor coping skills
Which phrase describes an example of response prevention specified in a plan of care for a patient who uses elaborate washing rituals?
Preventing the patient from washing hands after touching a dirty object
Which behavior is characteristic of an individual who is displaying passive aggression?
Procrastinating
Which intervention is directed toward minimizing the anxiety level of a patient who has a diagnosis of dissociative disorder? Select all that apply. One, some, or all responses may be correct.
Provide a simple, predictable daily routine. Allow the patient to progress at his or her own pace as memories are recovered. Teach and reinforce relaxation and deep breathing techniques.
Which type of stressor is a patient exhibiting when feeling anxious while at work as a result of an overwhelming assignment?
Psychological
A patient may experience which short-term reaction in response to a traffic accident involving death on the scene?
Psychological stress
Which defense mechanism is evident when an adult diagnosed with type 2 diabetes makes an excuse for not joining a strenuous group activity because of fear of difficulty with blood glucose management?
Rationalization
Which intervention by the nurse would be relevant for a patient with social phobia who is receiving cognitive behavioral therapy?
Re-evaluating the patient's situation
Which cause would the nurse identify as the likely reason for an elderly patient who fell several months ago to become suddenly combative when being transferred to a chair?
Recalling the original trauma from falling
Which condition is a short-term effect of stress controlled by the hypothalamus-pituitary-adrenal (HPA) cortex?
Reduced inflammation
For which reason does the nurse caring for a patient diagnosed with somatic symptom disorder build an effective relationship?
Reduces the patient's tendency toward defensiveness
Which strategy would the nurse manager offer for a nurse who is struggling with work-life balance and has missed several days of work? Select all that apply. One, some, or all responses may be correct.
Refer the nurse to the Employee Assistance Program (EAP). Identify self-care aspects to add joy, pleasure, and diversion. Help the nurse reframe struggles and challenges to find meaning.
Which behavior would the nurse note in a preschool child who has been diagnosed with posttraumatic stress disorder (PTSD)? Select all that apply. One, some, or all responses may be correct.
Reluctance to engage in previously enjoyed activities Frequent displays of irritability and negativity Expressing concern that "something bad is going to happen"
Which action by the patient with an illness anxiety disorder indicates that the goal to decrease the frequency of reported illnesses has been met
Reports one hospitalization over the past 6 months
Which action by the patient with an illness anxiety disorder indicates that the goal to decrease the frequency of reported illnesses has been met?
Reports one hospitalization over the past 6 months
Which nursing concern is most applicable for a spouse of a patient diagnosed with a somatic symptom disorder who confides to the nurse, "I've been overwhelmed by the shifting of my role from sexual partner to caregiver"?
Role strain
Which behavior indicates adaptive coping when an adult notices the turkey is burned and inedible just before guests arrive for Thanksgiving dinner?
Saying to the guests, "We are having a vegetarian Thanksgiving dinner this year."
Which action is the nurse's priority when assessing a patient diagnosed with hoarding disorder who has had recent weight loss and is wearing dirty disheveled clothing?
Scheduling a home visit to assess the safety of the patient's living conditions
Which condition is likely the cause of fatigue in a nurse who is otherwise healthy?
Secondary stress trauma
After trying several cognitive therapy sessions, which drug class is most likely to be recommended for a patient who is reporting disturbing flashbacks after serving in the army?
Selective serotonin reuptake inhibitor (SSRI)
Which level of anxiety would the nurse assess for in a patient who frantically demands help because he or she believes something terrible is happening as a result of symptoms of a pounding heart, throbbing head, and inability to think?
Severe
The nurse would expect the health care provider to prescribe an immediate dose of which type of medication for a patient experiencing a panic attack?
Short-acting benzodiazepine
Which intervention would the nurse include in the plan of care for a patient diagnosed with illness anxiety disorder? Select all that apply. One, some, or all responses may be correct.
Showing concern for the patient Teaching assertive communication Teaching stress-reduction techniques
Which intervention would the nurse include in the plan of care for a patient diagnosed with illness anxiety disorder? Select all that apply. One, some, or all responses may be correct.
Showing concern for the patient Teaching assertive communication Teaching stress-reduction techniques
Which phrase describes a likely potential problem for a patient diagnosed with severe obsessive-compulsive disorder?
Sleep disturbance
Which statement is correct regarding somatic symptom disorders from a cultural perspective?
Somatic symptoms vary widely from culture to culture.
Which maladaptive defense mechanism would the nurse find in a patient who reports headaches, backaches, and insomnia although diagnostic test results are within normal parameters?
Somatization
Which expected outcome would be appropriate for a patient diagnosed with a somatic disorder that has resulted in leg paralysis?
State two new effective coping skills within 2 weeks.
Which defense mechanism is being used when a patient tells the nurse he or she does not want to think about events related to a recent suicide attempt and suggests talking about it later?
Suppression Rationale Defenses against anxiety can be adaptive or maladaptive. Suppression is a conscious, deliberate effort to avoid painful and anxiety-producing memories.
Which information is relevant to the development of posttraumatic stress disorder (PTSD)?
Sustained a concussion 1 month ago
Which system is responsible for a patient's sensation of his or her heart racing when experiencing stress?
Sympathetic nervous system
Which phrase describes the defining characteristic of acute stress disorder that distinguishes it from posttraumatic stress disorder (PTSD)?
Symptoms resolve within 1 month
Which assessment is the nurse likely to note for a patient who is being admitted for short-term effects of stress?
Tachycardia
Which symptom indicates a moderate level of anxiety? Select all that apply. One, some, or all responses may be correct.
Talking in trembling voices Increased rates of respiration
Which action would the nurse take to relieve the anxiety of a patient who is unable to perform a group task because of a diagnosis of an anxiety disorder? Select all that apply. One, some, or all responses may be correct.
Talking slowly and calmly with the patient. Asking the patient to write a list of his or her strengths. Encouraging the patient to discuss feelings associated with the fear.
Which instruction would the nurse give to a patient who is prescribed lorazepam (4 mg/day for 1 week) for generalized anxiety disorder?
Teach the patient to limit caffeine intake.
Which action would the nurse take when a patient living near a military base where loud jets are heard tells the nurse, "They're so loud I can't hear myself think"?
Teaching relaxation and stress-reduction techniques to the patient
Which sign would indicate to the nurse that a patient's anxiety has decreased after helping the patient perform deep breathing exercises for severe anxiety?
The patient demonstrates selective inattention.
Which is the most likely diagnosis the nurse would expect the health care provider to make for a patient who compulsively looks at his or her reflection in the mirror?
The patient has body dysmorphic disorder.
Which statement describes the nurse's objective when using strategies that will induce a slight degree of anxiety for patients attending a teaching session?
The patients will be more focused during the session.
Which outcome indicates to the nurse that attending yoga sessions has helped a college student successfully manage stress associated with academic demands?
The student reports improved feelings of well-being.
Which statement describes the primary difference between factitious disorder and somatic symptom disorder?
The symptomology of factitious disorder is actually controlled by the patient.
Which statement about secondary gains is true? Select all that apply. One, some, or all responses may be correct.
They are benefits the patient receives from demonstrating symptoms. Therapy involves learning ways to communicate needs more effectively. Receiving extra attention from family members is an example of a secondary gain. Because they provide emotional support, it may be difficult to give up the symptoms.
Which statement about panic attacks is true? Select all that apply. One, some, or all responses may be correct.
They are characterized by a sudden onset of extreme apprehension. The fear is so intense that it interferes with a person's ability to function normally. People with a history of panic attacks develop a deep-seated fear of having an attack.
Which fact would prompt the nurse to double-check a benzodiazepine prescription for a patient diagnosed with Parkinson's disease and anxiety?
This medication would increase the patient's risk for falls.
Which phrase describes the primary purpose of performing a physical examination before beginning treatment for any anxiety disorder?
To determine whether the anxiety is primary or secondary in origin
Which suggestion would the nurse make to a female patient diagnosed with panic disorder and prescribed chlordiazepoxide?
Use contraceptive methods.
Which factor would indicate successful treatment for a patient with dissociative identity disorder?
integrated past events
