CARE FOR CLIENTS WITH PHYSIOLOGICAL AND PSYCHOSOCIAL ALTERATIONS

SITUATION 1: Technique of therapeutic communication should be utilized and incorporated into nursing practice.

1. When a nurse establishes a therapeutic relationship with a client, which of the following is the primary focus of the client’s care?a. The medical diagnosis c. The nursing diagnosis b. The client’s needs and problems d. The client’s social interaction

2. Which of the following is the overall purpose of therapeutic communication?a. To analyze client’s problemsb. To elicit cooperationc. To facilitate a helping relationshipd. To provide emotional support

3. In which of the following situations would communications be LEAST likely hindered?a. Mrs.L, 30 years old is admitted to the hospital for the first time for acute appendicitisb. Mrs. R, 50 years old, diabetic, is admitted to the hospital after a stroke. She has right hemiplegiac. Mrs. D, 45 years old, is admitted to the hospital for cervical cancerd. Mr. T, 70 years old, is admitted for fractured tibia. He speaks Spanish only

4. Which of the following communication technique is MOST effective in dealing with covert communication?a. Listening c. Clarificationb. Evaluation d. Validation

5. Which of the following is MOST important in fostering a positive relationship?a. The nurse recognizes that some patient regress when confronted with illnessb. The nurse functions as a positive role model to encourage health oriented patient behaviorc. Needs to understand that patients may test her before he can accept and trust herd. The nurse must fully share the patient’s feelings before she can develop her goal for her nursing care

SITUATION 2: Stress can bring about various human reactions that may result to illness or enhance one’s coping mechanism. Stress also triggers local and general adaptation syndrome.

6. Which of the following BEST describes the general adaptation syndrome. It is a:a. Psychological response to stress c. Behavioral response to stressb. Physiologic response to stress d. Sociocultural response to stress

7. Which of the following levels of anxiety is BEST for client’s learning?a. Moderate c. Severeb. Mild d. No anxiety

8. Which of the following defense mechanism is consciously used in coping mechanism with stress?a. Regression c. Repressionb. Suppression d. Projection

9. Which of the following models identifies ability to cope with stress, practice and norms of the peer group, effect of social environment and the resources used to deal with stress as determinants to stress and stress reactions?a. Stimulus based model c. Response based modelb. Adaptation based model d. Transaction based model

10. The purpose of the first stage of the General Adaptation Syndrome is which of the following?a. Determine the causes of the dangerb. Present the individual from having an unpleasant experiencec. Mobilize energy needed for adaptationd. Alert the individual to danger

SITUATION 3: Paul, 16 year old was committed to a mental health facility with diagnosis of personality disorder. He has a history of promiscuity and running away. He tells the staff “I can’t stand this place, I want to go away.”

11. How would the nurse deal effectively with Paul’s threat to run away?a. Tell him to stay in her roomb. Lock him in her roomc. Tell him firmly that if he does not control herself, the staff will help him control herselfd. Ignore the threat

12. The early experiences of Paul may indicate a history of:

a. Severe parental rejection c. Severe temper tantrumsb. Failure in interpersonal relationship d. Failure to identify positively with father

13. How would you describe parental rejection?a. Failure to identify positively with father c. Lack of recognition as a personb. Lack of parental love and discipline d. Lack of the capacity to trust others

14. What should the nurse do to prevent Paul from manipulating and dominating others?a. Ignore him demands c. Observe him closelyb. Isolate Paul d. Protect others from being manipulatedAnswer: D- Safety precautions must be posed to protect others, provide endorsement to other nurses

15. In dealing with manipulative behavior, the nurse should convey an attitude of:a. Active friendliness c. Love and understandingb. Permissiveness d. ConsistencyAnswer: D- Firmness, matter of fact and consistency is used to approach clients with antisocial personality

SITUATION 4: Mark was brought to the National Center for Mental Health for substance abuse.

16. Which of the following behaviors would indicate stimulant intoxication?a. Slurred speech, unsteady gait, impaired concentrationb. Hyperactivity, talkativeness, euphoriac. Relaxed inhibitions, increased appetite, distorted perceptionsd. Depersonalization, dilated pupils, visual hallucinations

17. Which of the following statements would indicate the teaching about Naltrexone (Revia) had been effective?a. “I’ll get sick if I use heroine on this medication.”b. “This medication will block the effects of any opioid substance I take.”c. “If I use opioid while taking naltrexone, I’ll become extremely ill.”d. “Using naltrexone may make me dizzy.”

18. Clonidine (Catapres) is prescribed for symptoms of opioid withdrawal. Which of the following nursing assessments is essential before giving a dose of this medication?a. Assessing the client’s blood pressureb. Determining when the client last use an opiatec. Monitoring the client for tremorsd. Completing a thorough physical assessment

19. The nurse has provided an in-service program on impaired professionals. She knows that teaching has been effective when staff identify the following as the greatest risk for substance abuse among professionals:a. Most nurses are codependent in their personal and professional relationshipsb. Most nurses come from dysfunctional families and are risk for developing addictionc. Most nurses are exposed to various substances and believe they are not risk to develop the diseased. Most nurses have preconceived ideas about what kind of people become addicted

20. The client tells the nurse that she takes a drink every morning to calm her nerves and stops her tremors. The nurse realizes the client is at risk for:a. An anxiety disorder c. Physical dependenceb. A neurological disorder d. Psychological addiction

SITUATION 5: A nurse must be aware of the latest issues on Child Abuse and Family Violence.

21. Marinel, a 16 years old young lady was left with her stepfather and with a mother who is working in the office the whole day. As a nurse, what would be your advice?a. Tell the mother to keep watching her daughterb. Tell the child get to her regular activitiesc. Ask the child to get away from her stepfatherd. Let the child stay with the relatives

22. Marinel’s high school friend made a visit and talked to her father. Marinel feels fidgety and continuously smoked while her friend is talking to her mother. Beth is experiencing:a. Worriesb. Angerc. Nervousnessd. Stress

23. The best way a nurse can advise an abused child is to call the:a. Police stationb. Schoolc. Parishd. Bantay Bata 163

24. When planning the care for a client who is abused, which of the following measures would be most important to include?a. Being compassionate and empatheticb. Teaching the client about abuse and the cycle of violencec. Explaining to the client his or her personal and legal rightsd. Helping the client develop a safety plan

25. During the session with the nurse, a client who is being abused states, “I don’t know what to do anymore. He doesn’t want me to go anywhere while he’s at work, not even to visit my friends.” Which of the following nursing diagnoses would the nurse formulate in respect to this information?a. Risk for violence related to abusive husband, as evidenced by victim’s statement of being batteredb. Low Self-Esteem related to victimization, as evidenced by not being able to leave the housec. Powerlessness related to abusive husband, as evidenced by inability to make decisionsd. Ineffective Coping related to victimization, as evidenced by cryingSITUATION 6: The following questions pertains to Musculoskeletal System of aging persons

26. Which of the following behaviors contribute to osteoporosis:

a. Smoking, and lack of exercise c. Drinking tea, deep breathing, and losing weightb. Physical activity, dancing, and swimming d. Knee bends, shopping, and weight lifting

27. As people gets older, they lose height (become shorter). This is due to:a. The fact that they don’t stand up straight c. Loss of bone mass in the vertebral discsb. The rest of the population has grown taller d. Inaccurate measurement

28. As one ages, muscle mass (that is muscle size):a. Decreases c. Stays about the sameb. Increases d. Can go either way

29. As a result of changes in long bones and the spinal column, the gait of older people:a. Becomes like a dancer c. Is more steadyb. Is less stable and balanced when walking d. Hardly changes at all

30. Changes in the bone of older people make which of the following a major danger?a. Infection c. Allergyb. Contagion d. Fractures

SITUATION 7: Sensory deprivation is experienced by most people in any setting whether they are patients confined in hospitals, workers assigned in mining industries or a family member assigned in far places.

31. Which of the following will LEAST likely result to sensory deprivation?a. Increased sensory input brought about by unlimited visitors from families and friendsb. Restriction of the environment in patients who are on absolute bed restc. Reduced sensory input in the case of patients who have just been operated on glaucomad. Elimination of order or “meaning” from input in the case of ICU patients or was in reverse isolation

32. Which of the following are observed in sensorially deprived adult and elderly people because of deafness?a. They prefer interaction with hearing adultsb. They show greater interdependence than hearing adultc. They become more flexible in daily routined. They show poor social judgment

33. Which nursing intervention would be appropriate for client with hyperthesia?a. Firm pressure when touching body parts c. Minimal use of direct touchb. Vigorous hair brushing d. Frequent back rubs

34. A post-operative blind patient needs to be assisted for ambulation. Which of the following should the nurse do in ambulating a client with visual impairment?a. Stand on the client’s nondominant side, approximately one step behind the client, grasping the client’s armb. Stand on the client’s dominant side and grasp the client’s armc. Stand on the client’s dominant aside slightly in front of the client, allowing the client to grasp the nurse’s armd. Stand slightly in front of the client’s nondominant side allowing the client to grasp the nurse’s arm

35. Which of the following is an appropriate communication method for client’s with hearing impairment?a. Talk side by side with the clientb. Use visual aide and gestures to enhance the spoken wordc. Restrict use of the client’s hands

d. Speak loud enough or shout if you may so that client will be able to hear you

SITUATION 8: Sexuality is one problem area that is often neglected by nurses in the care of elderly clients. The nurse however must be able to identify and address the sexual changes to provide nursing care.

36. Menopause is considered complete when:

a. Hot flashes cease c. A woman has been without periods for a yearb. Emotional stability ends d. Irritability goes away

37. Hormonal decline in women causes:a. Increased risk for atherosclerotic plaques c. No changes in risk for atherosclerotic plaquesb. Decreased risk for atherosclerotic plaques d. None of the above

38. Benefits of hormone replacement therapy (HRT) include:a. Protection against constipationb. Protection against osteoporosis and elimination of the unpleasant symptoms of menopausec. Protection against the flud. Protection against fever

39. Which of the following is NOT a known risk of hormone replacement therapy:a. Formation of blood clots and hypertensionb. Development of noncancerous fibroid tumors in the uterusc. Breast and endometrial cancersd. Lung cancer

SITUATION 9: The nurse is caring for an adult admitted with a diagnosis of brain tumor. He was scheduled for craniotomy.

40. A client has a supratentorial craniotomy for a tumor in the right frontal lobe of the cerebral cortex. Post operatively, the position that would be most appropriate for this client would be:a. High fowler’s with knee gatch raisedb. Flat with small pillow under the nape of the neckc. Head of the bed elevated 20 degrees with the head turned to the operative sided. Head of the bed elevated 45 degrees with a large pillow under the head and shoulders

41. A client is regaining consciousness after a craniotomy becomes restless and attempts to pull out her intravenous line. Which nursing intervention protects the client without increasing her ICP?a. Place her in a jacket restraintb. Wrap her hands in soft “mitten” restraintsc. Tuck her arms and hands under the draw sheetd. Apply a wrist restraint to each arm

42. Following 3 months of rehabilitation after craniotomy, a female client is still having some motor speech difficulty. To promote the client’s use of speech the nurse should:a. Correct her mistakes immediatelyb. Respond to her crude efforts of speakingc. Re-explain why she is having difficulty of speakingd. Speak to her in simple words and short sentences

43. A client undergoes a craniotomy for removal of her brain tumor. The nurse notes that her dressing is saturated with blood. Which of the following interventions is most appropriate?a. Replacing the dressingb. Marking the area of drainage on the dressingc. Reinforcing the dressing and notifying the doctor immediatelyd. Doing nothing because this is normal occurrence

44. After craniotomy, what is your primary goal?a. Prevent increased ICPb. Prevent infectionc. Prevent secondary surgeryd. Prevent hemorrhage

SITUATION 10: Dementing illness and changes in the brain

45. As one gets older, there is a loss of brain cells. The significance of this is:a. A cell transplant is indicatedb. The lost cells will regenerate on their ownc. The remaining cells are more than enough for learning and rememberingd. The significance is not known

46. ACUTE dementia is due to causes which can be reversed. A frequent cause of this type of dementia is:

a. Cerebrovascular accidentb. Alzheimer’s diseasec. Multiple Infarctsd. Electrolyte imbalance, especially hyponatremia (loss of sodium)

47. When assessing a client with dementia, which of the following behaviors would the nurse interpret as a manifestation of disinhibition?a. Wandering and getting lostb. Auditory and/or visual hallucinationsc. Decreased interest in bathing and hygiened. Inappropriate language and sexual behaviors

48. The brains of persons with Alzheimer’s disease are characterized by the presence of:a. Fatty deposits c. Calcium depositsb. Senile plaques and neurofibrillary tangles d. Lack of gray matter

SITUATION 11: A 23 year-old man was voluntarily admitted to the inpatient unit with a diagnosis of paranoid schizophrenia.

49. As the nurse approaches the client, he says, “If you come any closer, I’ll die.” This is an example of:a. Hallucinationb. Delusionc. Illusiond. Idea of reference

50. Delusion is:a. Psychomotor disturbanceb. Mood disturbancec. Disturbance of thoughtd. Disturbance of perception

51. When communicating with a paranoid client, the main principle is to:a. Use logic and be persistentb. Provide an anxiety-free environmentc. Express doubt and do not argued. Encourage ventilation of anger

52. The client tells his primary nurse that he’s scheduled to meet the President of the Philippines a special time, making it impossible for the client to leave his room for dinner. Which of the following responses by the nurse is most appropriate?a. “It’s meal time. Let’s go so you can eat.”b. “The President of the Philippines told me to take you to dinner.”c. “Your physician expects you to follow the unit’s schedule.”d. “People who don’t eat on this unit aren’t being cooperative.”

53. A schizophrenic patient who began taking haloperidol (Haloperidol) 1 week ago now exhibits jerking movements of the neck and mouth. These are signs of:a. Dystoniab. Psychosisc. Akathisiad. Parkinsonism

SITUATION 12: Nico, 27 yrs. old, is admitted for treatment of a major depression.

54. He is withdrawn, appears disheveled, and states, “No one could ever love me.” The nurse can expect the client to be placed ona. Antiparkinsonism medicationb. Suicide precautionsc. A low-salt dietd. Phototherapy

55. Which of the following behaviors indicates to the nurse that a client’s major depression is improving? The client:a. Displays a blunted effectb. Has lost an additional 2 poundsc. States one “good” thing about himselfd. Sleeps about 16 hours per day

56. Nico is scheduled for electroconvulsive therapy (ECT) tomorrow. The nurse would plan for which of the following activities?a. Force fluids 6 to 8 hours before treatmentb. Administer succinylcholine (Inestine, Anectine) during pretreatment carec. Encourage the client’s spouse to accompany himd. Reorient the client frequently during posttreatment care

57. Nico is recovering from a severe depression. Which of the following behaviors alerts the nurse to a risk for suicide?a. The client sleeps most of the dayb. The client has a plan to kill himselfc. The client loses 5 poundsd. The client does not attend unit activities

58. Nico has been depressed severely depressed for 2 weeks. He had mentioned “ending it all” prior to admission. Which of the following questions should the nurse ask during the prescreen assessment?a. “How long have you thought about harming yourself?”b. “What is it that makes you think about harming yourself?”c. “How has your concentration been?”d. “What specifically have you thought about doing to harm yourself?”

SITUATION 13: A client is admitted with a diagnosis of Alzheimer’s Disease.

59. When developing the plan of care for a client with Alzheimer’s disease who is experiencing moderate impairment, which of the following types of care would the nurse expect to include?a. Considerable assistance with activities of daily livingb. Managing complex medication schedulec. Constant supervision and total cared. Supervision of risky activities, such as shaving

60. Which of the following would be priority to include in the plan of care for a client with Alzheimer’s disease who is experiencing difficulty processing and completing complex tasks?a. Repeating the directions until the client follows themb. Asking the client to do one step of the task at a timec. Demonstrating for the client how to do the taskd. Maintaining routine and structure for the client

61. Clients with Alzheimer’s disease may have delusions about being harmed by staff and others. When the client expresses fear of being killed by staff, which of the following responses would be most appropriate?a. “What makes you think we want to kill you?”b. “We like you too much to want to kill you.”c. “You are in the hospital. We are nurses trying to help you.”

d. “Oh, don’t be so silly. No one wants to kill you here.”

62. When helping the families of clients with Alzheimer’s disease to cope with vulgar or sexual behaviors, which of the following suggestions would be most helpful?a. Ignore the behaviors, but try to identify the purposesb. Give feedback on the inappropriateness of the behaviorsc. Employ anger management strategiesd. Administer the prescribed risperidone (Risperdal)

63. The nurse determines that the son of the client with Alzheimer’s disease needs further education about the disease when he makes which of the following statements?a. “I didn’t realize the deterioration would be so incapacitating.”b. “The Alzheimer’s support group has so much good information.”c. “I get tired of the same old stories, but I know it’s important for Dad.”d. “I woke up this morning hoping that my old Dad would be back.”

SITUATION 14: A 34-year old is hospitalized with bipolar disorder.

64. The nurse knows that the major factor that distinguishes a bipolar from a unipolar disorder is the a. Higher incidence in womenb. Severity of the depressionc. Genetic etiologyd. Presence of mania

65. At 2 a.m. the nurse the nurse finds him phoning friends all across the country to discuss his new plan for eradicating world hunger. His excited explanations are keeping the entire unit awake, but he won’t quiet down. The nurse caring for him knows the drug most likely to be prescribed for this client is:a. A tricyclic depressantb. An MAOI-inhibitor antidepressantc. Lithium carbonate (Eskalith)d. An antianxiety drug

66. Supportive therapy for a client who is exhibiting manic behavior may include all of the following EXCEPT:a. Psychoanalysisb. Cognitive therapy

c. Interpersonal therapyd. Problem-solving therapy

67. The client is creating considerable chaos in a day treatment program with dominating and manipulative behavior. Which of the following nursing intervention is most appropriate?a. Allow the peer group to interveneb. Describe acceptable behavior and set realistic limits with the clientc. Recommend the client to be hospitalized for treatmentd. Tell client that his behavior is not appropriate

68. The client is skipping up and down the hallway practically running into other clients. Which of the following activities would the nurse expect to include in the client’s plan of care?a. Leading a group activityb. Watching televisionc. Reading the newspaperd. Cleaning the dayroom tables

SITUATION 15: A client is admitted to outpatient surgery for cataract extraction on the right eye.

69. The client asks, “What does the lens of my eye do?” The nurse should explain that the lens of the eye:a. Produces aqueous humorb. Holds the rods and conesc. Focuses light rays onto the retinad. Regulates the amount of light entering the eye

70. The client would most likely to complain of which symptoms?a. Halos and rainbows around lightsb. Eye pain and irritation that worsens at nightc. Blurred and hazy visiond. Eye strain and headache when doing close work

71. The nurse is to instill drops of phenylephrine hydrochloride (Neo-Synephrine) into a client’s right eye before cataract removal surgery. This preparation acts in the eye producea. Dilatation of the pupil and blood vesselsb. Dilatation of the pupil and constriction of blood vesselsc. Constriction of the pupil and constriction of blood vessels

d. Constriction of the pupil and dilatation of blood

72. A short time after cataract surgery, the client complains of nausea. Which of the following represents the nurse’s best course of action?a. Instruct the client to take a few deep breaths until the nausea subsidesb. Explain that this is a common feeling that will pass quicklyc. Tell the client to call the nurse promptly if vomiting occursd. Medicate the client with an antiemetic, as ordered73. Discharge planning would include:a. Wearing eye patches for the first 72 hoursb. Lifting light objects is acceptablec. Bending with the knees and keep the head straightd. Bending with the waist is acceptable if slowly done

SITUATION 16: A client is admitted with a diagnosis of Parkinson’s disease.

74. Which of the following is an initial sign of Parkinson’s disease?a. Rigidityb. Tremorc. Bradykinesiad. Akinesia

75. The nurse develops a teaching plan for a client newly diagnosed with Parkinson’s disease. Which of the following topics that the nurse plans to discuss is the most important?a. Maintaining a balanced nutritional dietb. Enhancing the immune systemc. Maintaining a safe environmentd. Engaging in diversional activity

76. When does the nurse encourage a client with Parkinson’s disease to schedule the most demanding physical activities to minimize the effects of hypokinesia?a. Early in the morning, when the client’s energy level is highb. To coincide with the peak action of drug therapyc. Immediately after a rest periodd. When family members will be available

77. Which goal is the most realistic and appropriate for a client diagnosed with Parkinson’s disease?a. To cure the disease

b. To stop the progression of the diseasec. To begin preparations for terminal cared. To maintain optimal body function

78. The client needs a long time to complete her morning hygiene, but she becomes annoyed when the nurse offers assistance and refuses all help. Which statement is the nurse’s best initial response in this situation?a. Tell the client firmly that she needs assistance and help her with her careb. Praise the client for her desire to be independent and give her extra time and encouragementc. Tell the client that she is being unrealistic about her abilities and accept that she needs helpd. Suggest to the client that if she insists on self care, she should at least modify her routine

SITUATION 17: A client is admitted to the hospital with Bell’s Palsy.

79. A client with Bell’s Palsy asks the nurse why artificial tears were ordered by the physician. Select the best reply by the nurse.a. “When your affected eye fails to make tears, the eye can become irritated and ulcerated.”b. “ Because your eye remains closed, foreign matter can be trapped beneath the lid.”c. “Artificial tears will remove the purulent drainage from your eye, which speeds healing.”d. “Because you cannot blink the affected eye, it can become dry and irritated.”

80. Which nursing diagnosis takes priority for the patient with Bell’s palsy?a. Risk for dysfunctional grievingb. Risk for injury related to corneal lacerationc. Risk for chronic low self-esteemd. Risk for impaired physical mobility

81. The nurse observes that the client’s right eye does not close completely. Based on this, which of the following nursing interventions would be most appropriate?a. Making sure the client wears her eyeglasses at all timesb. Placing an eye patch over her eyec. Instilling artificial tears once every shiftd. Cleansing the eye with a clean washcloth every shift

82. The client has a feeling of stiffness and a drawing sensation of the face. What would be an important teaching to the patient?a. Eye is susceptible to injury when eyelid does not close

b. Drooling from an increased saliva on the affected area may occurc. Cleaning the eye will prevent ulcerationd. All of the above

SITUATION 18: A 46-year old is admitted to the hospital because her family is unable to manage her constant hand washing rituals.

83. Her family reports she washes her hands at least 30 times each day. The nurse noticed the client’s hands are reddened, scaly, and cracked. The main nursing goal is to:a. Remind the client several times of her appointmentb. Limit the number of hand washingsc. Tell her it is her responsibility to be there on timed. Provide ample time for her to complete her rituals

84. Which of the following is an appropriate treatment for this client?a. An unstructured schedule of activitiesb. A structured schedule of activitiesc. Intense counselingd. Negative reinforcement every time she performs her rituals

85. The most effective way for the nurse to intervene with her hand and face washing is to:a. Allow her a certain amount of time each shift to engage in this behaviorb. Interrupt the activity briefly and frequently c. Lock the door to her room and restrict access to the bathroomd. Tell her to stop each time she is observed doing it

86. The client is also constipated and dehydrated. Which nursing intervention would the client be most likely to comply with?a. Drinking Ensure between mealsb. Drinking extra fluids with mealsc. Drinking 8 oz water every hour between mealsd. Drinking adequate amounts of fluid during the day

87. Upon admission she was also dehydrated and underweight. The nurse and the client will knowThat discharge planning is appropriate when the client:a. Regains her normal body weight

b. Expresses a desire to leave the hospitalc. Is able to start talking about her guilt and anxietyd. Limits her hand and face washing to a few times a day

SITUATION 19: The nurse is caring for a client who is experiencing panic attack.

88. Which intervention would be most appropriate?a. Tell the client he’s all right, and there is no need to panicb. Speak to the client in short, simple sentencesc. Explain to the client that there’s no need to worry because he’s safed. Give the client a detailed explanation of his panic reaction

89. The client reports that she often feels a choking sensation in her throat, a racing heart, dizziness and fearfulness. All of these symptoms have occurred almost daily for the past 3 months. Suspecting a psychological component to these symptoms, what would the nurse anticipate administering?a. Benzodiazepinesb. Proton pump inhibitorsc. Nitropussided. Lithium carbonate

90. The client has a generalized anxiety disorder. Which statement is true about this client?a. The client has regular obsessionsb. Relaxation techniques and psychotherapy are necessary for carec. Nightmares and flashbacks are common in individuals who suffer from generalized anxiety disorderd. Generalized anxiety disorder is characterized by anxiety that lasts longer than 6 months

91. The client is pacing and complains of racing thoughts. The nurse asks the client if something upsetting happens, and the client response is vague and not focused on nurse’s question. The nurse assesses the client’s level of anxiety as:a. Mildb. Moderatec. Severed. Panic

92. Which of the following is a behavior manifestation of anxiety, except:a. Panicb. Tachycardia

c. Hyperventilationd. Tachypnea

SITUATION 20: Defense Mechanisms

93. Sam is diagnosed with cancer does not talk about or acknowledge the diagnosis. Which of the following defense mechanism is Sam using?a. Denialb. Identificationc. Projectiond. Rationalization

94. Nathaniel, released from prison for selling narcotics has been rehabilitated and now works for a youth drug prevention agency. Darwin is reflecting which of the following defense mechanism?a. Denialb. Displacementc. Identificationd. Sublimation

95. Nina is admitted to the ICU with chest pain, an abnormal ECG, and elevated enzymes. When the significance of this is explained to her, she says, “I can’t be having a heart attack. No way. You must be mistaken.” The nurse suspects the client is using which defense mechanism?a. Sublimationb. Regressionc. Dissociationd. Denial96. In patients with dissociative disorders, the defense mechanism most often used to block traumatic experiences is:a. Passive-aggressionb. Reaction formationc. Deniald. Repression

97. The defense mechanism utilized by manic patients to cover up depression is:a. Displacementb. Denialc. Compensationd. Reaction formation

SITUATION 21: Psychosomatic disorders

98. A man’s family brought him onto the hospital because of his many somatic complaints. He has been seen by many medical specialists in the past without discovery of organic pathology. The nurse assesses that the client is probably experiencing which of the following problems?a. Conversion disorderb. Body dysmorphic disorderc. Malingeringd. Hypochondriasis

99. Amie is hospitalized for treatment of conversion disorder. She complained of paralysis of her right side after her husband threatened to leave her and their children. She seems unconcerned about her paralysis. An appropriate long term goal for the nurse to formulate is that client will:a. Cope effectively with stress without using conversionb. Identify stressorsc. Express feelings about conflictd. Develop an increased sense of relatedness to others

100. A patient who reports paralysis with no specific cause but has a history of a recent stressful event has a probable diagnosis of:a. Hypochondriasisb. Somatic illnessc. Conversion disorderd. Pain disorder