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exam 1 chapter 11

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PSYCH EXAM 1 ch.7-12 Quiz on exam 1 chapter 11, created by Stephanie Werner on 09/09/2018.
Stephanie Werner
Quiz by Stephanie Werner, updated more than 1 year ago
Stephanie Werner
Created by Stephanie Werner about 6 years ago
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Resource summary

Question 1

Question
A nurse wishes to teach alternative coping strategies to a patient experiencing severe anxiety. The nurse will first need to:
Answer
  • Lower the patient’s current anxiety level.
  • Create outcomes and a teaching plan.
  • Verify the patient’s learning style.

Question 2

Question
A patient approaches the nurse and impatiently blurts out, “You’ve got to help me! Something terrible is happening. My heart is pounding.” The nurse responds, “It’s almost time for visiting hours. Let’s get your hair combed.” Which approach has the nurse used?
Answer
  • Bringing up an irrelevant topic
  • Responding to physical needs
  • Addressing false cognitions

Question 3

Question
A patient experiencing moderate anxiety says, “I feel undone.” An appropriate response for the nurse would be:
Answer
  • “I’m not sure I understand. Give me an example.”
  • “What would you like me to do to help you?”
  • “Why do you suppose you are feeling anxious?”

Question 4

Question
A patient with a high level of motor activity runs from chair to chair and cries, “They’re coming! They’re coming!” The patient does not follow instructions or respond to verbal interventions from staff. The initial nursing intervention of highest priority is to:
Answer
  • provide for patient safety.
  • increase environmental stimuli.
  • respect the patient’s personal space.

Question 5

Question
A patient with a high level of motor activity runs from chair to chair and cries, “They’re coming! They’re coming!” The patient is unable to follow instructions or respond to verbal interventions from staff. Which nursing diagnosis has the highest priority?
Answer
  • Risk for injury
  • Self-care deficit
  • Disturbed energy field

Question 6

Question
A supervisor assigns a worker a new project. The worker initially agrees but feels resentful. The next day, when asked about the project, the worker says, “I’ve been working on other things.” When asked 4 hours later, the worker says, “Someone else was using the copier, so I couldn’t finish it.” The worker’s behavior demonstrates:
Answer
  • passive aggression.
  • suppression.
  • projection.

Question 7

Question
A patient is undergoing diagnostic tests. The patient says, “Nothing is wrong with me except a stubborn chest cold.” The spouse reports that the patient smokes, coughs daily, has recently lost 15 pounds, and is easily fatigued. Which defense mechanism is the patient using?
Answer
  • Denial
  • Projection
  • Regression

Question 8

Question
A patient with a mass in the left upper lobe of the lung is scheduled for a biopsy. The patient has difficulty understanding the nurse’s comments and asks, “What are they going to do?” Assessment findings include a tremulous voice, respirations 28 breaths per minute, and pulse rate 110 beats per minute. What is the patient’s level of anxiety?
Answer
  • Moderate
  • Severe
  • Panic

Question 9

Question
A patient who is preparing for surgery has moderate anxiety and is unable to understand preoperative information. Which nursing intervention is appropriate?
Answer
  • Describe the procedure again in a calm manner, using simple language.
  • Reassure the patient that all nurses are skilled in providing postoperative care.
  • Tell the patient that the staff is prepared to promote recovery.

Question 10

Question
A nurse encourages an anxious patient to talk about feelings and concerns. What is the rationale for this intervention?
Answer
  • Concerns stated aloud become less overwhelming and help problem solving to begin.
  • Offering hope allays and defuses the patient’s anxiety.
  • Anxiety is reduced by focusing on and validating what is occurring in the environment.

Question 11

Question
Which assessment question would be most appropriate for the nurse to ask a patient who has possible generalized anxiety disorder (GAD)?
Answer
  • “Do you find it difficult to control your worrying?”
  • “Do you repeatedly do certain things over and over again?”
  • “Do you feel especially uncomfortable in social situations involving people?

Question 12

Question
A patient in the emergency department has no physical injuries but exhibits disorganized behavior and incoherence after minor traffic accident. In which room should the nurse place the patient?
Answer
  • Interview room furnished with a desk and two chairs
  • Small, empty storage room with no windows or furniture
  • Room with an examining table, instrument cabinets, desk, and chair

Question 13

Question
A person has minor physical injuries after an automobile accident. The person is unable to focus and says, “I feel like something awful is going to happen.” This person has nausea, dizziness, tachycardia, and hyperventilation. What is this person’s level of anxiety?
Answer
  • Severe
  • moderate
  • mild

Question 14

Question
Two staff nurses applied for a charge nurse position. After the promotion was announced, the nurse who was not promoted said, “The nurse manager had a headache the day I was interviewed.” Which defense mechanism is evident?
Answer
  • Projection
  • conversion
  • introversion

Question 15

Question
A patient tells a nurse, “My new friend is the most perfect person one could imagine—kind, considerate, and good looking. I can’t find a single flaw.” This patient is demonstrating:
Answer
  • idealization.
  • projection
  • denial

Question 16

Question
A patient experiences an episode of severe anxiety. Of these medications in the patient’s medical record, which is most appropriate to administer as an as-needed (PRN) anxiolytic medication?
Answer
  • lorazepam (Ativan)
  • buspirone (BuSpar)
  • amitriptyline (Elavil)

Question 17

Question
Two staff nurses applied for promotion to nurse manager. Initially, the nurse not promoted had feelings of loss but then became supportive of the new manager by helping make the transition smooth and encouraging others. Which term best describes the nurse’s response?
Answer
  • Altruism
  • sublimation
  • supression

Question 18

Question
A person who feels unattractive repeatedly says, “Although I’m not beautiful, I am smart.” This is an example of:
Answer
  • compensation.
  • identification
  • repression

Question 19

Question
A person who is speaking about a contender for a significant other’s affection says in a gushy, syrupy voice, “What a lovely person. That’s someone I simply adore.” The individual is demonstrating:
Answer
  • reaction formation.
  • repression
  • rejection

Question 20

Question
An individual experiences sexual dysfunction and blames it on a partner by calling the person unattractive and unromantic. Which defense mechanism is evident?
Answer
  • Rationalization
  • compensation
  • introjection

Question 21

Question
A student says, “Before taking a test, I feel a heightened sense of awareness and restlessness.” The nurse can correctly assess the student’s experience as:
Answer
  • mild anxiety.
  • trait anxiety
  • displacement

Question 22

Question
A student says, “Before taking a test, I feel a heightened sense of awareness and restlessness.” The nursing intervention most suitable for assisting the student is to:
Answer
  • explain that the symptoms are the result of mild anxiety, and discuss the helpful aspects.
  • advise the student to discuss this experience with a health care provider.
  • encourage the student to begin antioxidant vitamin supplements.

Question 23

Question
If a cruel and abusive person rationalizes this behavior, which comment is most characteristic of this person?
Answer
  • “That person should not have provoked me.”
  • “I have always had poor impulse control.”
  • “I don’t know why it happens.”

Question 24

Question
A patient experiencing severe anxiety suddenly begins running and shouting, “I’m going to explode!” The nurse should:
Answer
  • assemble several staff members and state, “We will help you regain control.”
  • capture the patient in a basket-hold to increase feelings of control.
  • chase after the patient, and give instructions to stop running.

Question 25

Question
A person who has been unable to leave home for more than a week because of severe anxiety says, “I know it does not make sense, but I just can’t bring myself to leave my apartment alone.” Which nursing intervention is appropriate?
Answer
  • Teach the person to use positive self-talk.
  • Assist the person to apply for disability benefits.
  • Advise the person to accept the situation and use a companion.

Question 26

Question
Which comment by a person experiencing severe anxiety indicates the possibility of obsessive-compulsive disorder?
Answer
  • “I check where my car keys are eight times.”
  • “My legs often feel weak and spastic.”
  • . “I’m embarrassed to go out in public.”

Question 27

Question
Alprazolam (Xanax) is prescribed for a patient experiencing acute anxiety. Health teaching should include instructions to:
Answer
  • avoid alcoholic beverages.
  • . eat a tyramine-free diet.
  • report drowsiness.

Question 28

Question
Which statement is mostly likely to be made by a patient diagnosed with agoraphobia?
Answer
  • “Being afraid to go out seems ridiculous, but I can’t go out the door.”
  • “I’m sure I’ll get over not wanting to leave home soon. It takes time.”
  • When I have a good incentive to go out, I can do it.”

Question 29

Question
A patient has the nursing diagnosis Anxiety, related to __________, as evidenced by an inability to control compulsive cleaning. Which phrase correctly completes the etiologic portion of the diagnosis?
Answer
  • having persistent thoughts about bacteria, germs, and dirt
  • attempting to avoid interactions with others
  • ensuring the health of household members

Question 30

Question
A patient performs ritualistic hand washing. What should the nurse do to help the patient develop more effective coping strategies?
Answer
  • Encourage the patient to participate in social activities
  • Allow the patient to set a hand-washing schedule.
  • Encourage the patient to discuss hand-washing routines.

Question 31

Question
For a patient experiencing panic, which nursing intervention should be implemented first?
Answer
  • Provide calm, brief, directive communication.
  • Administer an anxiolytic medication.
  • Teach relaxation techniques.

Question 32

Question
Which finding indicates that a patient with moderate-to-severe anxiety has successfully lowered the anxiety level to mild? The patient:
Answer
  • can concentrate on what the nurse is saying.
  • . stays in a room alone and paces rapidly.
  • asks, “What’s the matter with me?”

Question 33

Question
A patient tells the nurse, “I don’t go to restaurants because people might laugh at the way I eat, or I could spill food and be laughed at.” The nurse assesses this behavior as consistent with:
Answer
  • social anxiety disorder (social phobia).
  • agoraphobia.
  • acrophobia.

Question 34

Question
A patient checks and rechecks electrical cords related to an obsessive thought that the house may burn down. The nurse and patient explore the likelihood of an actual fire. The patient states that a house fire is not likely. This counseling demonstrates the principles of:
Answer
  • cognitive restructuring.
  • relaxation technique.
  • desensitization.

Question 35

Question
A patient has a fear of public speaking. The nurse should be aware that social anxiety disorders (social phobias) are often treated with which type of medication?
Answer
  • Beta-blockers
  • Antipsychotic medications
  • . Tricyclic antidepressant agents

Question 36

Question
A patient tells the nurse, “I wanted my health care provider to prescribe diazepam (Valium) for my anxiety disorder, but buspirone (BuSpar) was prescribed instead. Why?” The nurse’s reply should be based on the knowledge that buspirone:
Answer
  • does not cause dependence.
  • does not produce blood dyscrasias.
  • can be administered as needed.
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