Unit 2 Flashcards
(155 cards)
1
Q
What are warren fundamentals point about anger
A
Anger is not a primary emotion, it is learned
Anger is physiological aroussal
Anger and aggression are significantly different
The expression of anger is learned
The expressions f anger can come under personal control
2
Q
A client has not received what was expressed for lunch and directs an angry verbal outburst at the nurse. What is an accurate description of this display
A
The expression of anger can come under personal control and is a learned behavior
3
Q
What is modeling
A
Role modeling is one of the strongest forms of learning
Role models can be positive or negative
Earliest role models are the primary caregivers
Role models are not always in the home
4
Q
evidence supports the role of television and video violence as a predisposing factor to later aggressive
Is this biological or learned
A
Learned
5
Q
What is operant conditioning
A
Operant conditioning is a learning method that uses reward and punishments to modify behavior
-positive reinforcement is a response to the specific behavior that is pleasurable
A negative reinforcement is a response to the specific behavior that prevents and undesireable result from occurring
6
Q
What is serotonin do in response of neurobiology of anger and aggression
A
Serotonin lower levels of serotonin are related to the inability to control impulses, anxiety, and aggression
7
Q
What does dopamine do in response in neurobiology of anger and aggression
A
Dopamine lower levels of depressed patients may produce anger
8
Q
T/F neurobiology of anger and aggression areas of the brain involved temporal lob e amygdala
A
T
9
Q
How is serotonin associated with impulsivity
A
Deficits in serotonin have been associated with an increase in impulsivity
10
Q
What is the priority assessment of possibility of violence
A
History of violence
11
Q
A patient with a history of chronic heart failure is admitted with shortness of breath and edema. Which assessment finding would the nurse expect?
A) Crackles in the lungs
B) Increased urine output
C) Bradycardia
D) Dry skin
A
A
12
Q
Which side effect should a nurse monitor for in a patient receiving lithium?
A) Weight gain
B) Hypotension
C) Constipation
D) Insomnia
A
A
13
Q
A patient diagnosed with major depressive disorder has been prescribed an SSRI. Which statement by the patient indicates the need for further teaching?
A) “I will take my medication first thing in the morning.”
B) “I will avoid drinking alcohol while on this medication.”
C) “I might feel relief from symptoms within 3 days.”
D) “I should not abruptly stop taking this medication.”
A
C
14
Q
You observe that a postoperative patient is reluctant to perform deep breathing exercises due to pain. How should the nurse respond?
A
“I understand it’s uncomfortable, but deep breathing helps prevent complications like pneumonia. Let’s work together to manage your pain so that you can do these exercises safely.”
15
Q
A patient expresses anxiety about their recent diagnosis of Type 2 diabetes. What is the best response by the nurse?
A
“It’s normal to feel this way. Let’s discuss your questions and review how we can manage diabetes together. I’m here to support you.”
16
Q
“It’s normal to feel this way. Let’s discuss your questions and review how we can manage diabetes together. I’m here to support you.”
A
“Patients with dementia are more prone to falls due to cognitive and mobility changes. The assessment helps us create a safer environment for them.”
17
Q
How does providing culturally sensitive care improve patient outcomes in a diverse population?
A
Culturally sensitive care promotes trust, enhances communication, and encourages patient engagement in their own health, leading to better health outcomes and patient satisfaction.
18
Q
Why is it important for nurses to involve families in the care of patients with chronic illnesses?
A
Involving families in care can provide emotional support to the patient, ensure continuity of care, and help family members understand the patient’s needs and care plan, leading to improved management and outcomes
19
Q
Describe how a holistic approach to pain management can benefit a patient with chronic pain.
A
A holistic approach, integrating physical, emotional, and psychological support, addresses more than just the physical symptoms. It can reduce stress, improve mental well-being, and potentially lower pain levels, enhancing overall quality of life.
20
Q
The nurse is providing education to a patient on the side effects of benzodiazepines like diazepam (Valium). Which symptoms should the patient be instructed to report to the healthcare provider? (Select all that apply.)
A) Drowsiness
B) Difficulty breathing
C) Headache
D) Muscle spasms
E) Confusion
A
B E
21
Q
A nurse is educating a patient who is starting lithium therapy. Which instructions should be included to help prevent lithium toxicity? (Select all that apply.)
A) Maintain a consistent salt intake.
B) Avoid drinking excessive amounts of water.
C) Report any symptoms of tremors or excessive thirst.
D) Take lithium with food to prevent stomach upset.
E) Avoid nonsteroidal anti-inflammatory drugs (NSAIDs) unless prescribed.
A
A C E
22
Q
The nurse is reviewing the common side effects of SSRIs with a patient. Which of the following are typical side effects? (Select all that apply.)
A) Nausea
B) Increased libido
C) Weight gain
D) Dry mouth
E) Orthostatic hypotension
A
A C D
23
Q
A patient on lithium presents with symptoms of nausea, diarrhea, and hand tremors. What is the nurse’s priority intervention?
A) Hold the next dose and notify the provider immediately.
B) Instruct the patient to drink a sports drink to replenish electrolytes.
C) Reassure the patient that these symptoms are expected.
D) Monitor vital signs and reassess symptoms in one hour.
A
A
24
Q
A patient taking SSRIs reports feeling agitated and experiencing insomnia. Which of the following interventions should the nurse consider?
A) Instruct the patient to avoid caffeine and take the medication in the morning.
B) Suggest taking the SSRI before bedtime to reduce agitation.
C) Encourage the patient to increase water intake.
D) Advise the patient to skip doses until the symptoms resolve.
A
A
25
When educating a patient on lithium therapy, the nurse should emphasize the importance of monitoring for signs of toxicity, which include symptoms like ________, ________, and ________.
Tremors, confusion, nausea
26
A patient expresses anger after not receiving the lunch they expected and directs a verbal outburst at the nurse. How should the nurse interpret this behavior?
A) Anger is a primary emotion that is automatically expressed.
B) Anger is physiological arousal that needs immediate intervention.
C) The expression of anger can come under personal control and is a learned behavior.
D) Anger and aggression are always closely related and require intervention.
C
27
A patient expresses anger after not receiving the lunch they expected and directs a verbal outburst at the nurse. How should the nurse interpret this behavior?
A) Anger is a primary emotion that is automatically expressed.
B) Anger is physiological arousal that needs immediate intervention.
C) The expression of anger can come under personal control and is a learned behavior.
D) Anger and aggression are always closely related and require intervention.
A
28
A patient expresses anger after not receiving the lunch they expected and directs a verbal outburst at the nurse. How should the nurse interpret this behavior?
A) Anger is a primary emotion that is automatically expressed.
B) Anger is physiological arousal that needs immediate intervention.
C) The expression of anger can come under personal control and is a learned behavior.
D) Anger and aggression are always closely related and require intervention.
B
29
A nurse observes that a patient with aggressive tendencies has clenched fists, rapid speech, and a rigid posture. The nurse recognizes these as:
A) Characteristics of anger
B) Indicators of improved behavior
C) Early signs of violent behavior
D) Signs of satisfaction
C
30
A nurse observes that a patient with aggressive tendencies has clenched fists, rapid speech, and a rigid posture. The nurse recognizes these as:
A) Characteristics of anger
B) Indicators of improved behavior
C) Early signs of violent behavior
D) Signs of satisfaction `
A, B, D
31
Which neurophysiological conditions are associated with increased aggression and violent behavior? (Select all that apply.)
A) Brain tumors
B) Encephalitis
C) Loss of function in the cortex
D) Chronic fatigue syndrome
E) Stroke
A, B, C, E
32
A nurse is educating a patient on managing anger effectively. Which strategies should be included in the teaching? (Select all that apply.)
A) Practice deep breathing exercises
B) Use of assertive communication
C) Engage in physical exercise regularly
D) Suppress feelings of anger
E) Focus on relaxation of tense muscles
A, B, C, E
33
A client is demonstrating signs of prodromal syndrome, including pacing and clenched fists. What is the nurse’s priority action?
A) Remove any potential weapons from the area.
B) Document the behavior in the patient’s chart.
C) Ignore the patient to avoid escalation.
D) Provide the patient with positive reinforcement.
A
34
A patient who was recently placed in restraints for aggressive behavior has now calmed down. After removing the restraints, what should the staff do next?
A) Debrief with the patient and discuss guidelines for future behavior.
B) Reprimand the patient to discourage future aggression.
C) Avoid any discussion about the incident to prevent agitation.
D) Assign a new nurse to the patient to prevent a repeat incident.
A
35
A patient who was recently placed in restraints for aggressive behavior has now calmed down. After removing the restraints, what should the staff do next?
A) Debrief with the patient and discuss guidelines for future behavior.
B) Reprimand the patient to discourage future aggression.
C) Avoid any discussion about the incident to prevent agitation.
D) Assign a new nurse to the patient to prevent a repeat incident.
B C
36
What are the physiological and biological changes in anger
Increased HR, BP, and levels of the energy hormones adrenaline and noradrenaline
37
What are warren’s outlines fundamentals points of anger?
Anger is not a primary emtion; it is learned
Anger is physiological arousal
Anger and aggression are significantly different
The expression of anger is learned
The expression of anger can come under personal control
38
A client has not received what was expected for lunch and directs an angry verbal outburst at the nurse. What is an accurate description this display of emotion?
A anger is a primary emotion that is automatically experienced
B anger is a psychological arousal
C expression of anger can come under personal control
D Expression of anger and aggression are closely related
C
The expression of anger can come under personal control and is a learned behavior
39
The term anger often takes on a negative connotation because of its link with aggression
What is aggression?
Is one way that individuals express anger
Is a behabior that is intended to threaten or injure the victim’s security or self-esteem
Can cause damage with words, fists, or weapon, but it is virtually always designed to punish
40
Predisposing factors to anger and aggression.
What is modeling
Role modeling is one of the strongest forms of learning
Role modeling can be positive or negative
Earliest role modeling are the primary caregivers
Role models are not always in the home
Evidence supports the role of television and video violence as a predisposing factor to later aggressive behavior (Learned, not biological)
41
Predisposing factors to anger and aggression
What is Operant conditioning
Operant conditioning is a learned method that uses reward and punishments to modify behavior
-a positive reinforcement is a response to the specific behavior that is pleasureable or produces the desired results
-a negative reinforcement is a response to the specific behabior that prevents and undesirebale results from occurring
—-anger and aggression can be learned through operant conditioning
42
Which of the following statements about anger are true? (Select all that apply)
A. Anger is always a negative emotion.
B. Anger is a normal human emotion when expressed appropriately.
C. Anger can lead to problem-solving and decision-making.
D. Anger is a primary emotion that is not learned.
E. Anger becomes a problem when expressed assertively.
Correct Answer: B, C
Rationale: Anger is a normal emotion that can be used positively when expressed appropriately. It can lead to problem-solving and decision-making. However, it becomes a problem when it is not expressed or when expressed aggressively.
43
Which of the following factors may predispose a client to anger and aggression? (Select all that apply)
A. Modeling negative behavior by role models
B. Operant conditioning, especially with positive reinforcement
C. Neurological disorders such as brain trauma
D. Increased serotonin levels in the brain
E. Environmental factors like noise and crowding
Correct Answer: A, B, C, E
Rationale: Anger and aggression can be learned through modeling and operant conditioning. Neurophysiological disorders, such as brain trauma or loss of cortical function, can increase aggression. Environmental factors like noise, crowding, and discomfort can also predispose individuals to aggressive behaviors.
44
A nurse is caring for a client who is showing signs of increasing agitation, such as pacing, clenched fists, and a raised voice. What should be the nurse’s priority intervention?
A. Ignore the behavior to avoid reinforcing it.
B. Confront the client and demand that they calm down.
C. Offer support through therapeutic communication and empathy.
D. Administer a PRN sedative to calm the client.
Correct Answer: C
Rationale: The priority intervention is to offer support using therapeutic communication and empathy. Confronting or ignoring the behavior would not address the underlying issue, and sedation should only be considered after assessing the situation thoroughly.
45
Which of the following are common characteristics of aggression in a client? (Select all that apply)
A. Intense discomfort
B. Restlessness and pacing
C. Soft, gentle tone of voice
D. Use of profanity and threats
E. Increased agitation and overreaction to stimuli
Correct Answer: A, B, D, E
Rationale: Aggression typically includes restlessness, pacing, verbal threats, profanity, intense discomfort, and increased agitation. A soft, gentle tone of voice would not be characteristic of aggression
46
A nurse is assessing a client for signs of impending violence. Which of the following are key warning signs? (Select all that apply)
A. Rigid posture and clenched fists
B. Calm demeanor and low energy
C. Hyperactive patterns and pressured speech
D. Recent history of violence or verbal abuse
E. Clear, logical thinking
Correct Answer: A, C, D
Rationale: Signs of impending violence include hyperactive patterns, pressured speech, rigid posture, clenched fists, and a recent history of violence. A calm demeanor and clear thinking are not indicative of impending violence.
47
A nurse notices that a client in the psychiatric unit is exhibiting a "prodromal syndrome," which includes agitation, profanity, and pacing. What is the nurse's most appropriate action?
A. Attempt to reason with the client to calm them down.
B. Wait for the client to express their anger before intervening.
C. Immediately intervene to prevent escalation and ensure safety.
D. Ignore the behavior until the client is no longer upset.
Correct Answer: C
Rationale: Prodromal syndrome is an early indicator of potential violence, characterized by agitation and verbal abuse. Immediate intervention is necessary to prevent escalation and ensure safety.
48
Which of the following are appropriate interventions for managing a client’s anger and aggression? (Select all that apply)
A. Set clear, consistent limits for behavior.
B. Use therapeutic touch to calm the client.
C. Offer reasonable choices and consequences.
D. Use humor to defuse the situation.
E. Avoid discussing the behavior to prevent conflict.
Correct Answer: A, C
Rationale: Setting clear, consistent limits and offering reasonable choices and consequences are effective interventions for managing anger and aggression. Therapeutic touch may be appropriate in some situations, but humor and avoiding discussions about behavior may escalate the situation.
49
A nurse is discussing an incident with a client who had to be restrained. Which unit procedure is the nurse implementing?
A. Milieu reenactment
B. Treatment planning
C. Crisis intervention
D. Debriefing
Correct Answer: D
Rationale: Debriefing is a process used after an incident, such as the use of restraints, to review the event, discuss triggers, and establish guidelines for future behavior. It helps the patient return to the therapeutic milieu.
50
Which of the following environmental factors can increase the risk of aggression? (Select all that apply)
A. Overcrowding
B. Low noise levels
C. High environmental temperature
D. Physical discomfort
E. Staff inexperience
Correct Answer: A, C, D, E
Rationale: Overcrowding, high environmental temperature, physical discomfort, and staff inexperience can all increase the risk of aggression in a healthcare setting.
51
Which of the following are important nursing interventions when managing a client’s aggression? (Select all that apply)
A. Avoid power struggles by defending your position.
B. Use active listening to show understanding.
C. Consistently enforce consequences for inappropriate behavior.
D. Ignore the client’s feelings of anger.
E. Establish clear objectives and limits for behavior.
Correct Answer: B, C, E
Rationale: Active listening, enforcing consistent consequences, and establishing clear limits are essential interventions when managing aggression. Avoiding power struggles and ignoring the client's anger would not be effective in this situation.
52
After a client’s restraints are removed, the nurse should assess whether the client can:
A. Recognize when they are angry and take responsibility for their feelings.
B. Immediately return to the therapeutic milieu without any assistance.
C. Rely on others to control their anger during emotional outbursts.
D. Maintain complete control over their behavior without any further intervention.
Correct Answer: A
Rationale: After restraints are removed, the nurse should assess whether the client is able to recognize when they are angry, take responsibility for their feelings, and manage their anger in a constructive way.
53
Which of the following behaviors indicate that a client may be at risk for violence? (Select all that apply)
A. Hyperactive behavior and rapid speech
B. Aggressive verbal threats and use of obscenities
C. Calm demeanor with minimal agitation
D. Recent history of violence or a threat of harm to others
E. Ability to maintain control over emotions without frustration
Correct Answer: A, B, D
Rationale: Hyperactivity, rapid speech, aggressive verbal threats, and a history of violence are indicators that a client may be at risk for violence. A calm demeanor and ability to manage emotions indicate a lower risk.
54
Which of the following is a characteristic of a self-help group?
A. Members are required to have a professional leader.
B. The group focuses on teaching social norms.
C. Leadership is often rotated among group members.
D. The purpose is to provide information to a large group of individuals.
Correct Answer: C Self-help groups are typically led by members, and leadership may rotate. They provide support for individuals with similar problems.
55
What is the main goal of group therapy?
A. To provide information and education about a specific topic.
B. To facilitate personal insight and improve interpersonal coping strategies.
C. To teach group members social norms and appropriate behaviors.
D. To focus on problem-solving and decision-making related to specific tasks.
Correct Answer: B Group therapy helps individuals gain personal insight and improve interpersonal coping strategies.
56
During the orientation phase of group development, the nurse should focus on:
A. Facilitating the completion of the group’s tasks.
B. Encouraging members to express feelings of loss.
C. Establishing rules, goals, and trust within the group.
D. Promoting conflict resolution between group members.
Correct Answer: C In the orientation phase, the group’s rules and goals are established, and trust between members is developed.
57
Which of the following statements best describes the curative factor of universality in group therapy?
A. Members develop new social skills through interaction with others.
B. Members assist each other and experience personal growth.
C. Members realize that others share similar problems and feelings.
D. Members have the opportunity to express both positive and negative emotions.
Correct Answer: C Universality occurs when group members realize they are not alone in their experiences, which helps reduce feelings of isolation.
58
Which leadership style is characterized by limited group member participation, with the leader making decisions and providing direction?
A. Democratic
B. Laissez-faire
C. Autocratic
D. Supportive
Correct Answer: C Autocratic leadership involves the leader taking control, making decisions, and providing direction, limiting group participation.
59
Which of the following are functions of a therapeutic group? (Select all that apply.)
A. To provide socialization through the teaching of social norms.
B. To complete tasks that are beyond the capacity of an individual.
C. To teach specific skills to enhance individual productivity.
D. To empower individuals to create change when alone they cannot.
E. To provide leadership to govern the group.
A, B, D Therapeutic groups provide socialization, support, task completion, and empowerment. They do not typically focus on individual productivity or leadership for governance.
60
Which of the following group conditions influence dynamics and interaction among members? (Select all that apply.)
A. Group size.
B. Seating arrangements.
C. Open-ended vs. closed-ended group formats.
D. Group member level of education.
E. Presence of external distractions.
A, B, C Group size, seating arrangements, and whether the group is open-ended or closed-ended are all factors that can affect group dynamics.
61
True or False: In an autocratic leadership style, group members are encouraged to participate in decision-making and problem-solving.
Correct Answer: False Autocratic leadership is characterized by the leader making decisions independently, with limited input from group members.
62
True or False: A self-help group is led by a professional therapist who guides the group through structured exercises.
Correct Answer: False Self-help groups are often led by the members themselves, rather than by a professional therapist.
63
Which of the following are benefits of group therapy? (Select all that apply.)
A. Development of new socializing techniques.
B. Expression of both positive and negative emotions (catharsis).
C. Achievement of personal goals independent of group interaction.
D. Increased group cohesiveness and sense of belonging.
E. Learning to manipulate group members to gain personal advantages.
Correct Answer: A, B, D Benefits of group therapy include learning new social skills, emotional expression (catharsis), and fostering a sense of belonging within the group.
64
A nurse is leading a therapeutic group focused on teaching stress management techniques. During the middle phase of the group’s development, several members begin to express differing views about the techniques being discussed. The nurse encourages open discussion and helps the group work through the conflict. Which phase of group development is this?
A. Initial or Orientation Phase
B. Middle or Working Phase
C. Final or Termination Phase
D. Maintenance Phase
Correct Answer: B The middle or working phase of group development is characterized by productive work and the management of conflicts with minimal leader intervention.
65
In psychodrama, the individual selected to portray a life situation is referred to as the _________.
Correct Answer: Protagonist The protagonist is the individual selected to play the central role in a psychodrama, portraying a life situation or unresolved issue.
66
Which of the following is NOT a type of behavior included in Intimate Partner Violence (IPV)?
A. Physical violence
B. Sexual violence
C. Psychological aggression
D. Economic coercion
Correct Answer: D
Economic coercion, while sometimes related to IPV, is not specifically listed as one of the four core types of IPV behaviors. The four core types are physical violence, sexual violence, psychological aggression, and stalking.
67
Which of the following is a common characteristic of victims of intimate partner violence (IPV)?
A. High self-esteem
B. Strong support network
C. Social isolation
D. History of financial independence
Correct Answer: C
Victims of IPV often experience social isolation and may have a history of abuse, which can lead to learned helplessness.
68
In the cycle of battering, which phase is characterized by the perpetrator being loving and kind, promising to change, and begging for forgiveness?
A. Phase 1: Build-up
B. Phase 2: Acute battering
C. Phase 3: Honeymoon/Reconciliation
D. Phase 4: Post-violence reflection
Correct Answer: C
The Honeymoon/Reconciliation phase is where the abuser may show affection and remorse, promising to change.
69
Which of the following screening tools is commonly used to assess the level of danger an abused woman has of being killed by her intimate partner?
A. Danger Assessment
B. Abuse Risk Assessment
C. Partner Violence Risk Assessment Tool
D. Lethality Risk Score
Correct Answer: A
The Danger Assessment is a widely used tool developed by Dr. Jacquelyn Campbell to assess the lethality risk of intimate partner violence.
70
Which of the following is an example of psychological aggression in intimate partner violence (IPV)?
A. Physical hitting or kicking
B. Stalking and following a partner
C. Using verbal threats to harm or control a partner
D. Forcing a partner into unwanted sexual activity
Correct Answer: C
Psychological aggression involves the use of verbal and non-verbal communication to harm or control a partner mentally or emotionally.
71
Which of the following are common reasons victims of IPV may remain in an abusive relationship? (Select all that apply.)
A. Fear of retaliation
B. Lack of support network
C. Hope that the situation will improve
D. Desire to seek revenge on the abuser
E. Financial independence
Correct Answer: A, B, C
Victims often remain due to fear of retaliation, a lack of support, and a false hope that the abuser will change. Financial dependence can also be a factor, but desire for revenge is not typical.
72
Which of the following behaviors are included in trauma-informed care for victims of intimate partner violence? (Select all that apply.)
A. Realize the widespread impact of trauma.
B. Recognize signs of trauma in clients.
C. Respond by integrating trauma knowledge into practices.
D. Ignore client safety in favor of promoting independence.
E. Resist retraumatization by maintaining trust and transparency.
Correct Answer: A, B, C, E
Trauma-informed care involves recognizing the impact of trauma, responding with care, and resisting retraumatization by maintaining a trustworthy environment.
73
True or False: Intimate Partner Violence (IPV) only affects women.
Correct Answer: False
While most IPV victims are women, IPV can affect individuals of all genders.
Correct Answer: False
While most IPV victims are women, IPV can affect individuals of all genders.
74
True or False: The “honeymoon” phase in the cycle of battering can last for an indefinite amount of time.
Correct Answer: True
The honeymoon phase varies in length and may end when the cycle of tension and abuse begins again.
75
Which of the following are potential outcomes of the "acute battering" phase in the cycle of IPV? (Select all that apply.)
A. Victim may provoke the abuser.
B. This is the shortest and most violent phase.
C. The victim takes responsibility for the batterer’s actions.
D. The victim may experience physical harm.
E. The abuser promises to change.
Correct Answer: B, D
The acute battering phase is marked by intense violence and harm to the victim. The victim may not provoke the abuser but may feel blamed in earlier phases.
76
Which of the following are safety planning strategies for victims of intimate partner violence? (Select all that apply.)
A. Keep a "safe word" for emergencies.
B. Make an escape bag with essential items.
C. Maintain secrecy about the escape plan.
D. Stay at home until the abuser leaves.
E. Change daily routines and tell a trusted friend.
Correct Answer: A, B, E
Safety planning includes practical steps like creating a safe word, having an escape bag ready, and changing routines to avoid the abuser.
77
A nurse is assessing a female patient in a healthcare setting and suspects intimate partner violence. The patient has low self-esteem, is socially isolated, and appears fearful when discussing her partner. Which of the following is the nurse’s best next step?
A. Ask the patient directly if her partner is abusive.
B. Confront the partner and assess for abuse.
C. Encourage the patient to leave the partner immediately.
D. Use a validated IPV screening tool to assess the level of danger
Correct Answer: D
The nurse should use a validated IPV screening tool, such as the Danger Assessment, to assess the patient's situation without causing further harm or making premature judgments.
78
In the cycle of battering, the __________ phase is the most violent and is characterized by an escalation of tension and the potential for serious harm.
Correct Answer: Acute battering
The acute battering phase is the most violent stage of the cycle, where harm is most likely to occur.
79
What are the four phases of the cycle of battering in intimate partner violence?
Correct Answer: The four phases of the cycle of battering are: (1) Build-up, (2) Acute battering, (3) Honeymoon/Reconciliation, and (4) The cycle repeats.
80
Which of the following is a defining characteristic of substance use disorder?
A) The individual can always control their use of the substance.
B) The individual experiences intense cravings and spends excessive time obtaining the substance.
C) The individual has no difficulty with interpersonal relationships.
D) The individual only uses the substance occasionally, without withdrawal symptoms.
Correct Answer: B
Explanation: Substance use disorder is characterized by compulsive use, cravings, and negative effects on relationships and daily functioning.
81
What is the primary difference between substance use disorders and substance-induced disorders?
A) Substance use disorders cause withdrawal symptoms; substance-induced disorders do not.
B) Substance use disorders involve addiction, while substance-induced disorders involve symptoms caused by the substance.
C) Substance-induced disorders are chronic, while substance use disorders are short-term.
D) There is no difference; they are synonymous terms.
Correct Answer: B
Explanation: Substance use disorders involve the habitual use of substances, while substance-induced disorders are temporary and occur when a substance causes another disorder (e.g., anxiety, psychosis).
82
Which of the following is a potential effect of chronic alcohol use?
A) Decreased risk of liver disease
B) Wernicke's encephalopathy
C) Improved cognitive function
D) Increased muscle strength
Correct Answer: B
Explanation: Wernicke's encephalopathy is a serious neurological condition caused by thiamine deficiency in chronic alcoholics.
83
Which phase of alcohol use is characterized by the individual requiring alcohol to function, along with a loss of control and clear physical dependence?
A) The prealcoholic phase
B) The early alcoholic phase
C) The crucial phase
D) The chronic phase
Correct Answer: C
Explanation: In the crucial phase, alcohol dependence is clearly evident, and the individual has lost control over their drinking.
84
A client with alcohol use disorder presents with slurred speech, impaired motor coordination, and a blood alcohol level of 347 mg/dL. The physician orders thiamine. What is the primary reason for this intervention?
A) To prevent pancreatitis
B) To prevent alcoholic hepatitis
C) To prevent Wernicke’s encephalopathy
D) To improve memory function
Correct Answer: C
Explanation: Wernicke's encephalopathy is a life-threatening condition caused by thiamine deficiency in people with chronic alcohol use. Thiamine replacement is critical to prevent it.
85
Which of the following opioids is 50 to 100 times more potent than morphine and can be lethal at doses as low as 2mg?
A) Oxycodone
B) Hydrocodone
C) Fentanyl
D) Methadone
Correct Answer: C
Explanation: Fentanyl is an extremely potent opioid, often responsible for overdose deaths due to its high potency.
86
A client presenting with signs of opioid intoxication, including euphoria, drowsiness, and impaired judgment, is most likely using which type of substance?
A) Benzodiazepines
B) Opioids
C) Stimulants
D) Hallucinogens
Correct Answer: B
Explanation: Opioid intoxication typically causes euphoria, drowsiness, and impaired judgment, among other symptoms.
87
Which of the following is the most common method of administering opioids, especially heroin?
A) Oral ingestion
B) Injection
C) Smoking
D) Snorting
Correct Answer: B
Explanation: Heroin and other opioids are often injected to quickly achieve their desired effects.
88
Which of the following is a characteristic effect of stimulant intoxication?
A) Euphoria, hypervigilance, and restlessness
B) Drowsiness, confusion, and slow movements
C) Decreased heart rate and blood pressure
D) Hallucinations and distorted perceptions of time
Correct Answer: A
Explanation: Stimulants such as cocaine and methamphetamines lead to increased brain activity, causing euphoria, hypervigilance, and restlessness.
89
What is a common withdrawal symptom experienced by individuals who stop using stimulants like methamphetamines or cocaine? A) Fatigue, depression, and headaches
B) Increased appetite and agitation
C) Nausea, vomiting, and tremors
D) Seizures and loss of consciousness
Correct Answer: A
Explanation: Stimulant withdrawal symptoms, often referred to as "crashing," include fatigue, depression, and headaches.
90
Which of the following hallucinogens is commonly known as “shrooms”?
A) LSD
B) PCP
C) Psilocybin
D) Mescaline
Correct Answer: C
Explanation: Psilocybin mushrooms are commonly known as “shrooms” and are a type of hallucinogen.
91
Which of the following symptoms is commonly associated with hallucinogen intoxication?
A) Euphoria, impaired judgment, and slurred speech
B) Visual hallucinations, altered time perception, and paranoia
C) Decreased heart rate, drowsiness, and confusion
D) Memory loss, agitation, and irritability
Correct Answer: B
Explanation: Hallucinogens like LSD and psilocybin cause visual hallucinations, altered perceptions of time, and heightened feelings of paranoia or euphoria.
92
Which of the following is a common symptom of cannabis intoxication?
A) Impaired motor coordination and dry mouth
B) Euphoria, paranoia, and slurred speech
C) Increased appetite and pupil dilation
D) Restlessness and elevated blood pressure
Correct Answer: A
Explanation: Cannabis intoxication can cause impaired motor coordination, dry mouth, euphoria, and increased appetite.
93
Which of the following is a common reason people use marijuana, according to research?
A) For its stimulant effects
B) As a recreational drug for relaxation or stress relief
C) To experience auditory hallucinations
D) To enhance focus and attention
Correct Answer: B
Explanation: Marijuana is commonly used recreationally for relaxation and stress relief, though its effects can vary.
94
Which of the following is an example of a medication used in the treatment of opioid withdrawal?
A) Benzodiazepines
B) Methadone
C) Haloperidol
D) Naloxone
Correct Answer: B
Explanation: Methadone is a long-acting opioid used in medication-assisted treatment to reduce cravings and withdrawal symptoms in opioid use disorder.
95
What is the primary goal of Alcoholics Anonymous (AA)?
A) To promote social drinking in a controlled environment
B) To provide a structured inpatient treatment for alcoholism
C) To offer a peer support network and encourage total abstinence from alcohol
D) To administer medications for detoxification
Correct Answer: C
Explanation: Alcoholics Anonymous (AA) focuses on peer support and promotes complete abstinence from alcohol to help individuals achieve sobriety.
96
Which of the following is a potential consequence of alcohol use during pregnancy?
A) Increased fetal blood flow
B) Fetal alcohol spectrum disorders (FASDs)
C) Improved brain development in the fetus
D) No impact on fetal development
Correct Answer: B
Explanation: Alcohol use during pregnancy can cause fetal alcohol spectrum disorders (FASDs), which result in cognitive, behavioral, and physical developmental issues in the child.
97
A 45-year-old male client presents with a history of alcohol use disorder. His medical history includes hypertension, cirrhosis, and a recent diagnosis of Wernicke’s encephalopathy. Upon examination, the nurse notes signs of chronic alcohol use, including physical tremors, poor coordination, and confusion. What is the most likely reason for the client's confusion, and how should this condition be managed?
A) Alcohol withdrawal syndrome; managed with tapering benzodiazepines
B) Wernicke's encephalopathy; managed with intravenous thiamine replacement
C) Severe hypoglycemia; managed with glucose supplementation
D) Delirium tremens; managed with high-dose lorazepam therapy
Correct Answer: B
Rationale: Wernicke's encephalopathy is a serious complication of alcohol use disorder caused by a thiamine deficiency. It can lead to confusion, ataxia, and ophthalmoplegia. Immediate treatment with thiamine is critical to prevent permanent brain damage.
98
A patient is admitted to the emergency department after an overdose of fentanyl. The nurse anticipates that the primary medication used to reverse the effects of the opioid overdose will be:
A) Methadone
B) Naloxone (Narcan)
C) Flumazenil
D) Benzodiazepines
Correct Answer: B
Rationale: Naloxone (Narcan) is an opioid antagonist used to reverse opioid overdose, including fentanyl. It is the most effective and rapid intervention in opioid intoxication.
99
A nurse is assessing a patient with alcohol use disorder who reports using alcohol to relieve everyday stress and tension. Which phase of alcohol use is most consistent with the client’s description?
A) Prealcoholic Phase
B) Early Alcoholic Phase
C) Crucial Phase
D) Chronic Phase
Correct Answer: A
Rationale: The prealcoholic phase is characterized by the use of alcohol to relieve stress or tension, with no apparent physical dependence. It is the initial stage of alcohol use disorder.
100
A patient who has been using methamphetamine regularly for the past 6 months is now presenting with extreme agitation, paranoia, and auditory hallucinations. Which substance-induced psychiatric disorder is the patient most likely experiencing?
A) Stimulant intoxication
B) Alcohol withdrawal delirium
C) Cannabis-induced psychosis
D) Opioid overdose
Correct Answer: A
Rationale: Methamphetamine is a stimulant, and its use can lead to stimulant intoxication, characterized by symptoms like euphoria, paranoia, agitation, and hallucinations. These symptoms are consistent with stimulant-induced psychiatric disorders.
101
A nurse is caring for a patient with a history of chronic alcohol use who is now experiencing symptoms of confusion, altered consciousness, and ataxia. The healthcare provider suspects a thiamine deficiency. What is the pathophysiology of this deficiency and the primary clinical manifestation the nurse should monitor for?
A) Impaired glucose metabolism leading to hypoglycemia
B) Disruption of myelin sheaths leading to neuropathy
C) Inability to metabolize fats leading to fatty liver
D) Inhibition of neurotransmitter synthesis leading to Wernicke’s encephalopathy
Correct Answer: D
Rationale: Wernicke’s encephalopathy is caused by a thiamine deficiency, often seen in chronic alcohol use. It results from impaired metabolism of carbohydrates and affects the central nervous system, leading to confusion, ataxia, and ophthalmoplegia.
102
A 30-year-old female with a history of opioid use disorder is admitted to the hospital for detoxification. The treatment plan includes the use of methadone. Which of the following is the primary reason methadone is used in the treatment of opioid use disorder?
A) To induce a euphoric high while reducing withdrawal symptoms
B) To reverse opioid overdose symptoms
C) To replace the opioid and prevent withdrawal symptoms
D) To prevent relapse by promoting abstinence
Correct Answer: C
Rationale: Methadone is a long-acting opioid used in medication-assisted treatment (MAT) to reduce cravings and withdrawal symptoms in individuals with opioid use disorder. It prevents withdrawal symptoms by substituting for the abused opioid without producing euphoria.
103
A nurse is assessing a client with alcohol use disorder using the Clinical Institute Withdrawal Assessment of Alcohol Scale (CIWA). The client reports feeling anxious, tremulous, and begins sweating heavily. The nurse notes increased blood pressure and pulse. Based on these findings, which stage of alcohol withdrawal is the client most likely experiencing?
A) Mild withdrawal
B) Moderate withdrawal
C) Severe withdrawal
D) Delirium tremens
Correct Answer: B
Rationale: Moderate alcohol withdrawal includes symptoms like anxiety, tremors, sweating, increased blood pressure, and tachycardia. Severe withdrawal (delirium tremens) would present with more extreme symptoms like confusion, hallucinations, and seizures.
104
A pregnant woman has been consuming alcohol daily throughout her pregnancy. After the birth, the infant exhibits growth retardation, hyperactivity, and poor motor coordination. Which of the following is the most likely diagnosis for this infant?
A) Alcohol-related neurodevelopmental disorder (ARND)
B) Fetal alcohol syndrome (FAS)
C) Alcohol-related birth defects
D) Fetal alcohol spectrum disorders (FASD)
Correct Answer: B
Rationale: Fetal alcohol syndrome (FAS) is characterized by growth retardation, facial abnormalities, poor motor coordination, hyperactivity, and developmental delays, all of which are present in this infant.
105
A patient with a history of chronic benzodiazepine use is being gradually tapered off their medication. Which of the following withdrawal symptoms is most likely to occur if the benzodiazepine taper is not properly managed?
A) Severe agitation and psychosis
B) Excessive sleep and fatigue
C) Severe seizures and delirium tremens
D) Severe headache and visual disturbances
Correct Answer: C
Rationale: Abrupt or poorly managed withdrawal from benzodiazepines can lead to severe symptoms, including seizures, psychosis, and in extreme cases, delirium tremens, similar to alcohol withdrawal.
106
A client enrolled in a treatment program for cocaine use disorder is practicing cognitive-behavioral strategies to prevent relapse. Which of the following interventions is a core component of this approach?
A) Encouraging the client to avoid all stressful situations
B) Helping the client identify and challenge irrational thoughts related to drug use
C) Promoting complete social isolation from individuals who use drugs
D) Recommending the client discontinue all medications that might interfere with drug use
Correct Answer: B
Rationale: Cognitive-behavioral therapy (CBT) focuses on identifying and challenging irrational or maladaptive thoughts and behaviors related to substance use. The goal is to help clients develop healthier thought patterns and coping strategies.
107
Which of the following is true regarding the prevalence of anorexia nervosa in the general population?
A) It is more common in men than women.
B) The lifetime prevalence is between 2.4% and 4.3%.
C) The prevalence has significantly decreased in recent years.
D) It is most commonly diagnosed in childhood.
Correct Answer: B
Rationale: Anorexia nervosa has a lifetime prevalence of 2.4% to 4.3% across all ages and genders, with women being at higher risk, though men do account for a significant percentage.
108
Which of the following is a characteristic clinical manifestation of anorexia nervosa?
A) Weight loss of less than 5% of body weight
B) Elevated body mass index (BMI) greater than 30
C) Distorted body image, where the individual believes they are overweight despite being underweight
D) Preoccupation with eating and food
Correct Answer: C
Rationale: Anorexia nervosa is characterized by a gross distortion of body image, where individuals perceive themselves as overweight despite being underweight.
109
Psychodynamic influences suggest that eating disorders may result from which of the following?
A) Childhood trauma related to sexual abuse
B) Poor attachment to primary caregivers and unresolved ego development issues
C) Societal pressure regarding body image
D) Genetic predisposition to mental health disorders
Correct Answer: B
Rationale: Psychodynamic theories suggest that disturbances in early mother-infant interactions, delayed ego development, and unfulfilled separation-individuation needs may contribute to the development of eating disorders.
110
Which of the following is a common physical finding in clients with bulimia nervosa?
A) Extreme underweight, often below 85% of expected weight
B) Calluses or abrasions on the knuckles due to self-induced vomiting
C) Increased body hair growth (lanugo)
D) Severe dehydration and malnutrition
Correct Answer: B
Rationale: Russell's sign, which refers to calluses or abrasions on the knuckles or back of the hands, is a common physical finding in individuals who engage in self-induced vomiting.
111
A client with anorexia nervosa has a body mass index (BMI) of 16.1. What does this suggest about the client’s condition?
A) The client is at an increased risk for obesity-related diseases.
B) The client’s weight is within the normal range for their height.
C) The client is severely malnourished, with a BMI below the threshold for anorexia nervosa.
D) The client has a mild form of anorexia nervosa, with a BMI slightly below the threshold.
Correct Answer: C
Rationale: A BMI of 16.1 is significantly lower than the expected range for a healthy adult and is indicative of severe malnutrition associated with anorexia nervosa.
112
Which of the following medications is commonly prescribed to treat symptoms associated with bulimia nervosa?
A) Fluoxetine (Prozac)
B) Lithium carbonate
C) Clozapine (Clozaril)
D) Haloperidol (Haldol)
Correct Answer: A
Rationale: Fluoxetine (Prozac), a selective serotonin reuptake inhibitor (SSRI), is commonly used to treat bulimia nervosa due to its effects on reducing binge-eating episodes and purging behaviors.
113
A client with anorexia nervosa presents with cold extremities, low blood pressure, and a low heart rate. What is the most likely underlying cause of these symptoms?
A) Electrolyte imbalance due to purging
B) Malnutrition and severe weight loss
C) Excessive fluid retention
D) High metabolic rate from over-exercising
Correct Answer: B
Rationale: Cold extremities, bradycardia, and hypotension are common signs of severe malnutrition and weight loss in anorexia nervosa, indicating compromised physiological functioning.
114
What is the body mass index (BMI) threshold that is typically used to diagnose obesity in adults?
A) 25 or greater
B) 30 or greater
C) 35 or greater
D) 40 or greater
Correct Answer: B
Rationale: Obesity is defined as a BMI of 30 or greater, which indicates an excessive accumulation of fat in the body.
115
Which of the following best differentiates binge-eating disorder (BED) from bulimia nervosa?
A) Individuals with BED engage in purging behaviors after binge eating.
B) Individuals with BED are usually underweight, unlike those with bulimia nervosa.
C) BED involves binge eating without compensatory behaviors such as purging.
D) BED is characterized by a preoccupation with food but not by distorted body image.
Correct Answer: C
Rationale: BED is characterized by recurrent binge-eating episodes without the compensatory behaviors (such as purging) seen in bulimia nervosa.
116
A client with anorexia nervosa has been admitted to the hospital with a weight of 75% of their expected body weight. Which is the priority nursing diagnosis for this client?
A) Disturbed body image
B) Low self-esteem
C) Imbalanced nutrition, less than body requirements
D) Ineffective coping
Correct Answer: C
Rationale: Imbalanced nutrition, less than body requirements, is the priority nursing diagnosis because the client is malnourished, and physiological integrity must be addressed first.
117
Which statement best reflects the role of family in the treatment of eating disorders?
A) Family members are blamed for causing the disorder and should be excluded from treatment.
B) Family dynamics should be explored and blamed as the primary cause of the disorder.
C) Family members should be involved in treatment to support the recovery process.
D) Family therapy is not helpful in treating eating disorders.
C
Rationale: Family members should be involved in the treatment process to provide support and help the client develop healthy functioning patterns, not to be blamed for the disorder.
118
Which of the following medications has been used with some success in the treatment of anorexia nervosa?
A) Olanzapine (Zyprexa)
B) Methylphenidate (Ritalin)
C) Sertraline (Zoloft)
D) Diazepam (Valium)
Correct Answer: A
Rationale: Olanzapine (Zyprexa), an atypical antipsychotic, has been used with some success in treating anorexia nervosa, particularly to help address symptoms of anxiety and mood disturbances.
119
In the treatment of eating disorders, which of the following is a key feature of behavior modification?
A) The client has no control over their treatment decisions.
B) The client must be motivated to achieve weight loss at all costs.
C) The client contracts for privileges based on weight gain or other behaviors.
D) The client’s family is excluded from the therapeutic process
Correct Answer: C
Rationale: Behavior modification involves rewarding clients for weight gain or other healthy behaviors, allowing them to contract for privileges based on progress.
120
What is the significance of Russell's sign in bulimia nervosa?
A) It is a sign of self-induced vomiting, marked by calluses or abrasions on the hands.
B) It indicates a high body mass index (BMI).
C) It shows that the client is highly motivated to stop purging behaviors.
D) It signifies a decreased risk for developing electrolyte imbalances.
Correct Answer: A
Rationale: Russell's sign refers to the calluses or abrasions that appear on the knuckles or the back of the hands due to repeated self-induced vomiting.
121
What is the primary difference between anxiety and fear?
A. Anxiety is a response to an actual threat, while fear is emotional.
B. Anxiety is anticipatory, whereas fear is in response to an actual danger. (Correct)
C. Anxiety involves physical symptoms, but fear does not.
D. Fear is long-lasting, whereas anxiety is short-term.
B
122
Which of the following is considered the most common psychiatric illness in the population?
A. Schizophrenia
B. Anxiety disorders (Correct)
C. Depression
D. Bipolar disorder
B
123
Which neurotransmitter imbalance is associated with heightened anxiety?
A. Serotonin only
B. Epinephrine and norepinephrine (Correct)
C. GABA deficiency
D. Dopamine excess
B
Panic disorder is characterized by recurrent and unexpected panic attacks. These attacks involve intense fear or discomfort and are often accompanied by physical symptoms such as chest pain, palpitations, and shortness of breath.
124
What physiological symptoms are commonly associated with a panic attack?
A. Increased heart rate, sweating, and dizziness (Correct)
B. Decreased heart rate, nausea, and fatigue
C. Insomnia, irritability, and tremors
D. Muscle rigidity, weight gain, and numbness
A
Panic attacks are often accompanied by acute physiological symptoms like tachycardia (increased heart rate), sweating, dizziness, shortness of breath, and chest discomfort. These symptoms mimic a physical emergency but are actually psychological in origin.
125
Which of the following is a characteristic symptom of Generalized Anxiety Disorder (GAD)?
A. Chronic, excessive worry about multiple areas of life (Correct)
B. Fear of public speaking
C. Intrusive thoughts about a past trauma
D. Intense, sudden fear with no warning signs
A GAD is marked by persistent and excessive worry about a variety of topics, including health, work, and social situations. This worry occurs more days than not for at least six months and is not limited to specific situations or triggers like social phobia or PTSD.
126
What is the primary treatment for phobic disorders?
A. Medication alone
B. Exposure therapy and CBT (Correct)
C. Cognitive restructuring
D. Medication combined with hypnotherapy
B
The most effective treatment for phobias is exposure therapy, a type of cognitive-behavioral therapy (CBT), which helps patients gradually face their fears in a controlled environment. This allows them to desensitize to the feared stimulus and reduce anxiety over time.
127
What are common physical symptoms of PTSD?
A. Hallucinations and delusions
B. Increased appetite and weight gain
C. Intrusive memories, hypervigilance, and irritability (Correct)
D. Excessive socialization and positive affectivity
C
PTSD is characterized by intrusive memories (flashbacks, nightmares), heightened arousal (hypervigilance, irritability), and avoidance of reminders of the traumatic event. These symptoms are the body's response to stress and trauma.
128
In a panic attack, what is typically NOT a symptom?
A. Nausea and abdominal distress
B. Decreased heart rate and hypotension
C. Fear of losing control
D. Shortness of breath and chest discomfort
B
During a panic attack, the body is in "fight-or-flight" mode, so heart rate and blood pressure increase (tachycardia and hypertension), not decrease. Nausea, shortness of breath, and chest pain are common symptoms, while hypotension (low blood pressure) is not.
129
A nurse is educating a group of students about the neurobiological aspects of anxiety. Which of the following neurotransmitter imbalances is MOST commonly associated with anxiety disorders?
A. Increased serotonin
B. Decreased dopamine
C. Decreased GABA
D. Increased norepinephrine
C
GABA (gamma-aminobutyric acid) is an inhibitory neurotransmitter that helps regulate the nervous system. A deficiency in GABA is associated with symptoms of anxiety, as it results in heightened physiological arousal and tension.
130
A 32-year-old female presents to the clinic with a complaint of chronic and excessive worry about her job performance, health, and family, which has lasted for over six months. She reports restlessness, muscle tension, and insomnia. Based on these symptoms, which diagnosis would be most likely?
A. Panic disorder
B. Post-traumatic stress disorder (PTSD)
C. Generalized anxiety disorder (GAD)
D. Social anxiety disorder
Correct Answer: C. Generalized anxiety disorder (GAD)
Rationale: GAD is characterized by excessive and unrealistic worry about various life situations that lasts for at least six months. Symptoms include restlessness, muscle tension, and sleep disturbances. This is the most likely diagnosis based on the patient’s chronic anxiety and physical symptoms.
131
A patient with panic disorder is admitted for treatment. When planning care for this patient, which of the following interventions should the nurse prioritize during an acute panic attack?
A. Encourage the patient to focus on their breath and reassure them that the symptoms will resolve.
B. Guide the patient through a relaxation exercise to help lower anxiety.
C. Offer an explanation of the patient’s symptoms and what triggers them.
D. Provide the patient with an educational handout on panic disorder to read.
Correct Answer: A. Encourage the patient to focus on their breath and reassure them that the symptoms will resolve.
Rationale: During a panic attack, the immediate goal is to help the patient regain control of their breathing and reduce the acute physiological symptoms of anxiety. Reassurance that the symptoms are temporary can also help reduce fear.
132
Correct Answer: A. Encourage the patient to focus on their breath and reassure them that the symptoms will resolve.
Rationale: During a panic attack, the immediate goal is to help the patient regain control of their breathing and reduce the acute physiological symptoms of anxiety. Reassurance that the symptoms are temporary can also help reduce fear.
Correct Answer: C. "I can stop taking Xanax abruptly when I feel better."
Rationale: Benzodiazepines like alprazolam can cause physical dependence, and abrupt discontinuation can lead to withdrawal symptoms such as anxiety, seizures, and agitation. Gradual tapering of the dose is necessary to prevent withdrawal.
133
A 45-year-old male presents to the emergency department complaining of palpitations, chest pain, and shortness of breath. The symptoms began suddenly and have lasted for about 15 minutes. His vitals are stable, and he denies any recent trauma or stress. Which of the following is the MOST important next step in the assessment process?
A. Perform a detailed assessment to rule out a myocardial infarction.
B. Provide reassurance that the symptoms are likely due to anxiety.
C. Start an SSRI medication regimen to address underlying anxiety.
D. Ask the patient about any obsessive or compulsive behaviors.
Correct Answer: A. Perform a detailed assessment to rule out a myocardial infarction.
Rationale: The patient’s presentation is suggestive of a potential medical emergency, such as a myocardial infarction (heart attack), which can have similar symptoms to a panic attack. It is essential to rule out any life-threatening conditions before diagnosing an anxiety disorder.
134
A nurse is reviewing a patient’s medical history, which includes a family history of anxiety disorders and childhood trauma. The nurse recognizes that this patient is at increased risk for developing anxiety disorders due to which of the following factors?
A. Genetic predisposition
B. Low socioeconomic status
C. Positive childhood experiences
D. Gender identity`
Correct Answer: A. Genetic predisposition
Rationale: A family history of anxiety disorders increases the patient’s risk due to genetic factors. Additionally, childhood trauma is a significant environmental risk factor.
135
Question 7: Evaluation of Treatment for OCD
A patient diagnosed with obsessive-compulsive disorder (OCD) reports that they are struggling to refrain from performing their compulsive hand-washing rituals, especially when they feel anxious. Which of the following outcome criteria is MOST appropriate to evaluate for this patient?
A. The patient will refrain from performing rituals when anxiety level rises.
B. The patient will verbalize a plan to manage anxiety without using compulsions.
C. The patient will maintain a daily log of obsessive thoughts.
D. The patient will be able to perform all activities of daily living independently without anxiety.
Correct Answer: A. The patient will refrain from performing rituals when anxiety level rises.
Rationale: The goal in treating OCD is to reduce the need to perform compulsive behaviors in response to anxiety.
136
A 34-year-old woman presents with unexplained gastrointestinal symptoms and frequent doctor visits, but all tests are normal. She appears preoccupied with her symptoms and expresses distress about the possibility of a serious illness. Which disorder is most consistent with this presentation?
A. Illness anxiety disorder
B. Conversion disorder
C. Somatic symptom disorder
D. Factitious disorder
Correct Answer: C. Somatic symptom disorder
Explanation: Somatic symptom disorder involves multiple unexplained symptoms, often leading to significant distress and frequent medical visits. The preoccupation with the symptoms, despite lack of organic findings, fits this diagnosis.
137
A client with conversion disorder suddenly loses the ability to move their legs after a stressful argument. Which of the following symptoms would most likely be associated with conversion disorder?
A. Severe chest pain with no cardiac abnormalities
B. Sudden onset of blindness following a traumatic event
C. Hallucinations triggered by stress
D. Paralysis of an arm following a physical injury
Correct Answer: B. Sudden onset of blindness following a traumatic event
Explanation: Conversion disorder presents with neurological symptoms (e.g., blindness, paralysis) that cannot be explained by medical conditions, often triggered by psychological stress.
138
A client is admitted with symptoms of paralysis, but no physical cause can be found after extensive medical testing. The client denies any emotional distress. Which disorder is most likely based on this presentation?
A. Somatic symptom disorder
B. Malingering
C. Conversion disorder
D. Dissociative identity disorder
Correct Answer: C. Conversion disorder
Explanation: Conversion disorder involves the sudden onset of neurological symptoms (e.g., paralysis, blindness) following psychological stress, but the client may not acknowledge the emotional causes.
139
A 28-year-old woman frequently visits multiple doctors seeking treatment for various vague symptoms but avoids undergoing testing. She is convinced that she has a life-threatening disease despite medical reassurances. Which diagnosis would be most appropriate?
A. Conversion disorder
B. Illness anxiety disorder
C. Malingering
D. Factitious disorder
Correct Answer: B. Illness anxiety disorder
Explanation: Illness anxiety disorder involves excessive preoccupation with having a serious illness, often leading to doctor shopping or avoiding medical tests.
140
Which nursing intervention would be most appropriate when caring for a client with somatic symptom disorder?
A. Focusing primarily on the client’s physical complaints to provide reassurance
B. Discussing social and personal issues to address underlying psychological factors
C. Frequently reminding the client that there is no medical cause for their symptoms
D. Meeting the client’s dependency needs to avoid further stress
Correct Answer: B. Discussing social and personal issues to address underlying psychological factors
Explanation: The underlying psychological issues, rather than focusing solely on physical symptoms, should be addressed in somatic symptom disorder care.
141
client with dissociative amnesia experiences an inability to recall personal information after a traumatic event. Which subtype of dissociative amnesia would be most likely if the client is unable to remember any details of their identity?
A. Localized amnesia
B. Selective amnesia
C. Generalized amnesia
D. Dissociative fugue
Correct Answer: C. Generalized amnesia
Explanation: Generalized amnesia involves complete loss of memory for one’s identity and life history.
142
In which situation would a nurse expect to see a client with dissociative fugue?
A. A client forgetting their name after a traumatic event
B. A client engaging in compulsive behaviors following a stressful life event
C. A client traveling to unfamiliar places and assuming a new identity after a traumatic experience
D. A client experiencing sudden blindness after an emotional conflict
Correct Answer: C. A client traveling to unfamiliar places and assuming a new identity after a traumatic experience
Explanation: Dissociative fugue involves sudden, unexpected travel with inability to recall one’s past and sometimes assuming a new identity.
143
A client with dissociative identity disorder (DID) describes experiences of feeling as though they are “a different person” at times. What is the most likely reason for the development of DID?
A. Severe traumatic experiences during childhood, such as abuse
B. A history of chronic physical illness
C. Genetic factors that influence brain chemistry
D. Social and cultural factors contributing to multiple personality expression
Correct Answer: A. Severe traumatic experiences during childhood, such as abuse
Explanation: DID often develops as a coping mechanism in response to severe, repeated childhood trauma, particularly abuse.
144
Which of the following would a nurse most likely observe in a client with depersonalization-derealization disorder?
A. A sense of detachment from the body and environment
B. Memory loss following a traumatic experience
C. Sudden onset of paralysis without physical cause
D. Persistent belief of having a serious illness despite reassurance
Correct Answer: A. A sense of detachment from the body and environment
Explanation: Depersonalization-derealization disorder is characterized by feelings of unreality and detachment from oneself or the external world.
145
Which of the following defense mechanisms would most likely be used by a client with dissociative amnesia, according to psychodynamic theory?
A. Suppression
B. Sublimation
C. Repression
D. Displacement
Correct Answer: C. Repression
Explanation: Repression involves blocking distressing memories or emotions from conscious awareness, which is common in dissociative amnesia.
146
A nurse is caring for a client with somatic symptom disorder who is frequently preoccupied with minor bodily sensations. Which of the following interventions would be most appropriate?
A. Encouraging the client to avoid focusing on physical sensations and to redirect attention to social and personal issues
B. Reassuring the client that the symptoms are not real
C. Allowing the client to continue to engage in excessive medical visits to reduce anxiety
D. Providing constant attention to the client’s physical complaints to ensure comfort
Correct Answer: A. Encouraging the client to avoid focusing on physical sensations and to redirect attention to social and personal issues
Explanation: Redirecting focus from physical symptoms to underlying emotional or social issues is an important part of managing somatic symptom disorder.
147
Which of the following statements by a client with illness anxiety disorder would indicate that the client is demonstrating maladaptive behavior?
A. “I’ve had multiple doctor visits, and they’ve all told me I’m healthy, but I’m still convinced something is wrong.”
B. “I worry about getting sick, but I know it’s probably just anxiety.”
C. “I’ve learned to manage my fear by focusing on healthy habits and not obsessing about illness.”
D. “I understand that my fear of illness may not be rational, but it still feels real.”
Correct Answer: A. “I’ve had multiple doctor visits, and they’ve all told me I’m healthy, but I’m still convinced something is wrong.”
Explanation: This statement reflects the client’s preoccupation with health despite medical reassurance, which is characteristic of illness anxiety disorder.
148
Which statement by a nurse about the treatment of dissociative identity disorder (DID) would be most accurate?
A. "Medications are used to help stabilize the personality states."
B. "The goal of therapy is to integrate the separate personalities into one cohesive identity."
C. "Hypnotherapy is avoided due to its potential to worsen dissociation."
D. "Supportive care focuses on maintaining the separate personalities rather than integrating them."
Correct Answer: B. "The goal of therapy is to integrate the separate personalities into one cohesive identity."
Explanation: The goal of treatment for DID is to integrate the fragmented identities into a unified sense of self.
149
A client is diagnosed with conversion disorder and is unable to walk after a car accident, despite no physical injury. What is the most important aspect of nursing care for this client?
A. Encouraging the client to engage in physical rehabilitation to restore mobility
B. Focusing on the physical symptoms and providing comfort measures
C. Exploring the emotional stressors or psychological factors that may contribute to the condition
D. Reassuring the client that their symptoms are caused by a psychological disorder and not a real injury
Correct Answer: C. Exploring the emotional stressors or psychological factors that may contribute to the condition
Explanation: Conversion disorder often has an emotional or psychological component, and addressing the underlying psychological factors is critical in treatment.
150
A client with somatic symptom disorder frequently reports various physical complaints without any identifiable medical cause. The nurse's most appropriate response would be to:
A. Reassure the client that their symptoms are likely psychological in origin
B. Focus on the client’s physical complaints to validate their experience
C. Avoid discussing the client’s psychological symptoms and focus on the physical symptoms
D. Encourage the client to seek psychological support to address the underlying emotional issues
Correct Answer: D. Encourage the client to seek psychological support to address the underlying emotional issues
Explanation: Clients with somatic symptom disorder benefit from addressing underlying psychological issues, such as anxiety or stress, rather than focusing solely on the physical complaints.
151
Which of the following is a common predisposing factor for somatic symptom disorders?
A. Family history of psychotic disorders
B. Low socioeconomic status and limited education
C. A history of substance abuse
D. Genetic predisposition to neurological conditions
Correct Answer: B. Low socioeconomic status and limited education
Explanation: Factors such as low socioeconomic status and limited education have been associated with a higher prevalence of somatic symptom disorders
152
In the treatment of dissociative amnesia, which approach is most likely to assist in memory retrieval?
A. Hypnosis and free association
B. Antidepressant medication
C. Cognitive-behavioral therapy (CBT)
D. Aversive conditioning techniques
Correct Answer: A. Hypnosis and free association
Explanation: Hypnosis and free association are commonly used techniques to assist clients with dissociative amnesia in recovering lost memories.
153
When caring for a client with dissociative identity disorder (DID), which is the priority nursing diagnosis?
A. Ineffective coping
B. Risk for suicide
C. Impaired memory
D. Disturbed sensory perception
Correct Answer: B. Risk for suicide
Explanation: Clients with DID may have a history of significant trauma and are at higher risk for self-harm or suicide, making safety the top priority.
154
Which of the following would most likely contribute to the development of dissociative identity disorder (DID)?
A. Chronic medical illness
B. Severe childhood trauma or abuse
C. Genetic predisposition to dissociation
D. Substance use disorder
Correct Answer: B. Severe childhood trauma or abuse
Explanation: DID is often linked to severe childhood trauma, especially physical, sexual, or psychological abuse.
155
Which of the following is a goal for a client with somatic symptom disorder during nursing care?
A. To help the client achieve immediate relief from all physical symptoms
B. To assist the client in recognizing the psychological factors contributing to their physical complaints
C. To provide constant reassurance that there is no physical illness
D. To encourage the client to avoid discussing any emotional or psychological issues
Correct Answer: B. To assist the client in recognizing the psychological factors contributing to their physical complaints
Explanation: The goal is to help the client understand the emotional and psychological factors underlying their physical complaints.
