Week 5 Sherpath Lesson Assessments
MATCH Individual sees things as all good or all bad Individual blames others Individual attributes exaggerated positive qualities to others Individual relates to another person ---------------- Projection Displacement Splitting Identification Idealization Denial
Individual sees things as all good or all bad- Individual blames others- Individual attributes exaggerated positive qualities to others- Individual relates to another person-
MATCH Man does not believe it when told his wife has died Boy dresses like a firefighter and pretends to put out fires Girl yells at a teddy bear after being picked on by the school bully Obese man talks assertively to coworkers to motivate performance ------------------- Identification Denial Displacement Compensation
Man does not believe it when told his wife has died- Denial Boy dresses like a firefighter and pretends to put out fires- Identification Girl yells at a teddy bear after being picked on by the school bully- Displacement Obese man talks assertively to coworkers to motivate performance- Compensation
MATCH Severe anxiety due to physical symptoms Persistent worry about having a serious illness Symptoms that affect body movement or sensory function Objective proof that symptoms are fabricated -------- Functional neurological disorder Somatic symptom disorder Illness anxiety disorder Factitious disorder
Severe anxiety due to physical symptoms- Somatic symptom disorder Persistent worry about having a serious illness- Factitious disorder Symptoms that affect body movement or sensory function- Illness anxiety disorder Objective proof that symptoms are fabricated- Functional neurological disorder
A patient comes to the outpatient clinic stating, "I am so stressed that I cannot concentrate in class. I am so angry, frustrated, and depressed!" A nursing care plan is developed with input from the patient. Which nursing intervention is appropriate? Allow the patient to express feelings of anger and frustration. Encourage the patient to remain in her room until she is ready to talk. Call the patient's parents to learn if similar complaints have occurred in past. Reach out to the patient's boyfriend to gain his perspective of the patient's complaints
a
A patient is the victim of a devastating flood that has led to the diagnosis of a stress disorder. Which action taken by the interdisciplinary health care team best displays Critical Incident Stress Management (CISM)? Referring the patient to crisis counseling Teaching the patient's family distraction techniques Asking a social worker to find the patient a new home Encouraging the patient to engage in self-care activities
a
The interdisciplinary health care team is treating a patient with PTSD who is experiencing chronic insomnia. Which therapy should the team recommend for this patient? Milieu Hypnosis Regression Victim assistance
a
The mental health nurse uses a PTSD checklist to screen a patient who meets the criteria for PTSD. Which action should the nurse take? Perform a comprehensive assessment Develop nursing diagnosis for the patient Set short and long term goals for the patient Contact the family to discuss treatment options
a
The nurse has identified nursing diagnoses for the patient with low self-esteem related to acute stress disorder. The initial outcome for the patient is "enhanced self-esteem." How will this outcome be demonstrated by the patient? Ability to self-validate Ability to demonstrate relaxation techniques Ability to maintain highest level of functioning Remains free of destructive behavior toward self or others
a
The patient with PTSD informs the nurse that he feels like he is "going crazy" every time he has nightmares about the traumatic event he experienced. Which information should the nurse share with the patient? The patient should understand that what he is feeling is normal. The patient should be told that reliving the experience will only make things worse. The patient should be referred to the psychiatrist for pharmacological treatment. The patient should be told not to worry because the nightmares will go away on their own.
a
Which is a key element of the "Alarm Stage" of the General Adaptation Syndrome? The body is put on high alert to the stressor. The patient is drained and tired from fighting the threat. Family notices something is wrong and steps in to help the patient. The stressor automatically resolves when the patient ignores the stress symptoms.
a
An emergency department nurse has been working a rotation in the trauma unit for the past 6 months. Which behaviors displayed by the nurse would be a cause for concern? Select all that apply. Crying regularly at work Repeated angry outbursts Decreased tolerance for frustration Seeking out a therapist to speak with Calling the Department of Veteran's Affairs on behalf of a patient
a, b, c
Which bodily responses to trauma could lead to the development of PTSD? Select all that apply. Increased heart rate Elevated cortisol levels Adrenergic hyperactivity Increased digestive response Central nervous system hypoactivity
a, b, c
Which statements made by an individual diagnosed with factitious disorder demonstrate a motivation for secondary gain? Select all that apply. "When I have headaches, I call in sick to work and my boss calls later to check on me." "I love having my sister here to take care of me. Since she moved, I hardly ever see her." "I feel bad that I can't do the laundry when I don't feel well, but my family understands." "The nurses at my provider's office are always so sweet. They make sure I'm seen right away." "I'm worried I might have a brain tumor. I've had difficulty concentrating at work recently, and that's one of the symptoms."
a, b, d
Which statements regarding somatic symptom disorders are accurate? Select all that apply. Patients with somatic symptom disorders often have seen many different providers. Somatic symptom disorders are rooted in psychologically buried and unrecognized phobias. Lack of insight on the patient's part into the psychological aspect of their symptoms is common. Organic physical conditions must be ruled out before a diagnosis of somatic symptom disorder can be made. Once a patient with a somatic symptom disorder accepts the etiology of their symptoms, treatment is often successful.
a, c, d
When assessing the current physical health of a patient who is being evaluated for a somatic illness, which questions would the nurse ask the patient? Select all that apply. "Have you had any recent falls or injuries?" "How satisfied are you with your life on a daily basis?" "How many hours of uninterrupted sleep do you get each night?" "When did you first notice that your headaches were becoming problematic?" "How much liquid do you drink daily, excluding caffeinated or alcoholic beverages?"
a, c, e
A patient with PTSD has failed to improve with psychotherapy alone. The psychiatrist has decided to add medication to this patient's treatment plan. Which medication is most beneficial for this patient? Melatonin Sertraline Alprazolam Propranolol
b
Which characteristic is the most common psychological outcome of coping? Insight Comfort Empowerment Understanding
b
Which strategies would the nurse employ to develop and maintain an empathetic relationship with a patient diagnosed with a somatic symptom or related disorder? Select all that apply. Allow the patient one office visit per month. Develop patient goals that are reasonable and attainable. Encourage the patient to continue with the same provider consistently. Encourage the patient to seek a second opinion if symptoms do not improve. Remind the patient that their symptoms are in their head and not a cause for worry.
b, c
Which factors influence an individual's appraisal of a perceived threat? Select all that apply. Time Values Beliefs Emotions Family role
b, c, d
Which examples of patient behavior would the nursing instructor present to a class of students when teaching about factitious disorder? Select all that apply. Reporting a sudden inability to speak without any other physical concerns Refusing to let one provider see the records from, or contact, a previous provider Undergoing three abdominal surgeries in 6 months for undiagnosed abdominal pain Excessively researching lung cancer on the Internet because of an occasional cough in the winter months Demanding specific diagnostic tests for symptoms within an hour of being seen in the emergency department
b, c, e
Which events occur during the Resistance Phase of the General Adaptation Syndrome? Select all that apply. Adaptive resources are depleted. More oxygen is supplied to the lungs. Death can occur if stress is excessive and sustained. Coping mechanisms are used to deal with the stress. The heart beats harder and faster to provide more blood to the muscles for increased strength and stamina.
b, d, e
Which criteria according to the DSM-5 are used to diagnose PTSD? Select all that apply. Three comorbidities Symptoms of arousal Symptoms of depression Symptoms that last 3 days to 1 month Physical or witnessed exposure to a traumatic event
b, e
Which of these PTSD symptoms could lead to spousal and child abuse? Select all that apply. Migraines Irritability Chronic pain Hallucinations Hypervigilance
b, e
A care plan with the nursing diagnosis Ineffective Coping is developed for a married mother of six who is frequently admitted for ongoing stomach distress, back pain, fatigue, and nervousness. Which is a potential outcome for this patient? The patient's family will assist with care of the children. The nurse will encourage the patient to verbalize feelings and concerns. The patient will identify effective and ineffective management techniques. The patient's spouse will arrange situations that encourage rest periods for the patient.
c
A patient is admitted to the hospital with several health concerns, including high blood pressure, difficulty concentrating, and insomnia. Yoga has been added to the nursing care plan because medication has failed to bring relief. What is an expected outcome for this patient? The patient will be discharged early. The patient will experience an increase in blood pressure. The patient will gain a more positive outlook about the situation. The patient's antihypertensive medication regimen will be discontinued.
c
When discussing somatic symptom illness in class, which example would the instructor provide to aid in the students' understanding of these disorders? A patient who was in a motor vehicle accident a year ago is being seen for chronic lower back pain. A patient who is being seen by the primary care provider for insomnia describes being out of work for 6 months. A patient, having recently lost their spouse, is seen for acute abdominal pain but has an otherwise normal examination. A patient who schedules an appointment with the primary care provider to discuss issues with excessive worry over family finances.
c
When focusing on individual strengths or weaknesses, which characteristics would the nurse explore when assessing a patient with a somatic illness? How frequently the individual seeks medical care Concurrent mental health diagnoses the individual has How the individual has dealt with past stressors or problems Enjoyment of the attention received related to physical symptoms
c
Which benefit is a patient diagnosed with factitious disorder imposed by another seeking? Medical care for their own physical symptoms The best possible care for their sick dependent The attention that comes from being a dedicated caretaker Time away from other responsibilities and life expectations
c
Which factor best determines whether a defense mechanism is adaptive or maladaptive? Presence of mental illness Presence of physical illness Degree of reality distortion Degree of compulsive behavior
c
Which intervention would be provided by the case manager involved in the care of a patient diagnosed with a somatic symptom or related disorder? Assess vital signs with each patient encounter. Schedule a diagnostic x-ray requested by the provider. Develop a schedule of routine follow-up care office visits. Facilitate a group working on assertive communication skills.
c
Which statement made by the instructor to a class of nursing students best describes the role of trauma to development of a somatic symptom disorder later in life? "A history of physical trauma is a risk factor for the development of a somatic symptom disorder." "History of childhood trauma is difficult to obtain and relies on anecdotal information from family members." "There is a direct relationship between degree of childhood trauma experienced and the likelihood of developing somatic symptomology." "Experiences of trauma early in life have not been shown to be a risk factor in the development of a somatic symptom disorder later in life."
c
Which statement regarding defense mechanisms is accurate? Defense mechanisms are a conscious reaction to stress. Defense mechanisms are developed in response to eustress. Excessive use of defense mechanisms can compromise personal growth. Humans develop defense mechanisms to prevent immature reactions to stressful events.
c
PTSD and ASD have similar etiologies and manifestations but there are also some distinct differences. Which statements are true regarding these two disorders? Select all that apply. ASD and PTSD mostly affect young adults. PTSD and ASD both have similar onsets and durations. Substance abuse, depression, and anxiety are common in both disorders. The development of PTSD or ASD is precipitated by the individual's reaction to a traumatic event. Dissociative symptoms of numbing, detachment, or lack of an emotional response are common in ASD and PTSD.
c, d
Journaling is a suggested healthy coping mechanism for patients exhibiting stress. What directions should the nurse provide the patient who journals? Select all that apply. "Make notes about your day in the journal." "Ask your family to add notes in your journal." "Write what was happening when the stress occurred." "Write what you did to cope with the stressful situation." "Each time you feel stressed, keep track of it in your journal."
c, d, e
A patient being treated for PTSD is entering an outpatient milieu activity aimed at reducing tension. Which activities would be included in this program? Psychotherapy Cognitive therapy Family support groups Recreational programs
d
A patient has been admitted to the cardiac unit experiencing the following symptoms: difficulty falling asleep, minimal appetite, palpitations, headaches, and a general feeling of "being tired all the time." The next day, the patient cuts his wrists in a suicide attempt. What important information did the nurse fail to recognize when assessing this patient? A search of the patient's belongings was inadequate. The nurse did not search the patient thoroughly enough to find the razor blade. The patient did not complete the Perceived Stress Scale during admission to the unit. The nurse did not recognize that physical symptoms could indicate an underlying psychological problem.
d
What is the purpose of corticosteroid release during a stress response? To increase immunity and to prevent illness and disease To provide a burst of energy during the initial response to a stressor To prevent the pain often seen when physical stress symptoms occur To increase muscle strength and stamina needed to withstand the stress symptoms
d
Which action would a nurse take if they felt a negative bias toward a patient in their care who is being treated for a somatic symptom or related disorder? Ask to be assigned to a different patient. Avoid lengthy interactions with the patient. Provide the care needed, ignoring the negative feelings. Work with the nursing supervisor to understand the source of the negative feeling.
d
Which statement is true regarding the development of ASD and PTSD? Gender plays a role. They are linked to recessive traits. They are considered noninheritable. Stress hormone receptors plays a role.
d
