Question: A patient performs ritualistic hand washing. What should the nurse do to help the patient develop more effective coping strategies?
Answer Choices: a. Allow the patient to set a hand-washing schedule. b. Encourage the patient to participate in social activities. c. Encourage the patient to discuss hand-washing routines. d. Focus on the patient’s symptoms rather than on the patient.
Answer: b
Question: For a patient experiencing panic, which nursing intervention should be implemented first?
Answer Choices: a. Teaching relaxation techniques b. Administering an anxiolytic medication c. Providing calm, brief, directive communication d. Gathering a show of force in preparation for gaining physical control
Answer: c
Question: Which assessment finding indicates that a patient with moderate-to-severe anxiety has successfully lowered the anxiety level to mild?
Answer Choices: a. Patient asks, “What’s the matter with me?” b. Patient stays in a room alone and paces rapidly. c. Patient successfully concentrates on what the nurse is saying. d. Patient states, “I don’t want anything to eat. My stomach is upset.”
Answer: c
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 which mental health diagnosis?
Answer Choices: a. Acrophobia b. Agoraphobia c. Social anxiety disorder
Answer: c
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 which cognitive-based therapy?
Answer Choices: a. Flooding b. Desensitization c. Controlled relaxation d. Thought restructuring
Answer: d
Question: Anxiety disorders (social phobias) are often treated with which type of medication?
Answer Choices: a. Beta blockers b. Antipsychotic medications c. Tricyclic antidepressant agents d. Monoamine oxidase inhibitors
Answer: a
Question: A patient tells the nurse, “I wanted my health care provider to prescribe diazepam for my anxiety disorder, but buspirone was prescribed instead. Why?” The nurse’s reply should be based on the knowledge of which characteristic of buspirone?
Answer Choices: a. It does not produce blood dyscrasias. b. It is not known to cause dependence. c. It can be administered as needed. d. It is faster acting than diazepam.
Answer: b
Question: A child is placed in a foster home after being removed from parental contact because of both physical and verbal abuse. The child is apprehensive and overreacts to environmental stimuli. The foster parents ask the nurse how to help minimize the child’s anxious behaviors. What should the nurse recommend? (Select all that apply.)
Answer Choices: a. Use a calm manner and low voice. b. Maintain simplicity in the environment. c. Avoid repetition in what is said to the child. d. Minimize opportunities for exercise and play. e. Explain and reinforce reality to avoid distortions.
Answer: a, b, e
Question: A nurse plans health teaching for a patient diagnosed with generalized anxiety disorder (GAD) who takes lorazepam. What information should be included? (Select all that apply.)
Answer Choices: a. Use caution when operating machinery. b. Allow only tyramine-free foods in diet. c. Restrict intake of caffeine. d. Avoid using alcohol and other sedatives. e. Take the medication on an empty stomach.
Answer: a, c, d
Question: Which assessment questions are most relevant to ask a patient with possible obsessive-compulsive disorder? (Select all that apply.)
Answer Choices: a. “Have you been a victim of a crime or seen someone badly injured or killed?” b. “Are there certain social situations that cause you to feel especially uncomfortable?” c. “Do you have to do things in a certain way to feel comfortable?” d. “Is it difficult to keep certain thoughts out of awareness?” e. “Do you do certain things over and over again?”
Answer: c, d, e
Question: A medical-surgical nurse works with a patient diagnosed with a somatic system disorder. Care planning is facilitated by understanding that the patient will probably present what behavior?
Answer Choices: a. Readily seek psychiatric counseling. b. Being resistant to accepting psychiatric help. c. Attending psychotherapy sessions without encouragement. d. Being eager to discover the true reasons for physical symptoms.
Answer: b
Question: A patient whose blindness is related to a functional neurological (conversion) disorder appears to be unconcerned about this problem. Which understanding should guide the nurse’s planning for this patient?
Answer Choices: a. Suppressing accurate feelings regarding the problem. b. Experiencing a high level of anxiety that is reduced through the physical symptom. c. Exhibiting an intentional lack of concern about the disability to manipulate others. d. Using the blindness to deflect attention from another problem.
Answer: b
Question: A patient’s blindness is related to a functional neurological (conversion) disorder. To help the patient eat, the nurse should implement what intervention?
Answer Choices: a. Establishing a “buddy” system with other patients who can feed the patient at each meal b. Expecting the patient to self-feed after explaining the arrangement of the food on the tray c. Directing the patient to locate items on the tray independently with feeding being unassisted d. Addressing the needs of other patients in the dining room, and then feeding this patient
Answer: b
Question: A patient with blindness related to a functional neurological (conversion) disorder states, “All the doctors and nurses in this hospital stop by often to check on me. Too bad people outside the hospital don’t find me interesting.” Which nursing diagnosis is most relevant?
Answer Choices: a. Social isolation b. Chronic low self-esteem c. Interrupted family processes d. Ineffective health maintenance
Answer: b
Question: To assist a patient diagnosed with a somatic system disorder, which nursing intervention is of highest priority?
Answer Choices: a. Pointing out that symptoms are not real b. Helping the patient suppress feelings of anger c. Shifting the focus from somatic symptoms to feelings d. Investigating each physical symptom as soon as it is reported
Answer: c
Question: A patient who fears serious heart disease was referred to the mental health center by a cardiologist after diagnostic evaluation showed no physical illness. The patient says, “My heart misses beats. I’m frequently absent from work. I don’t go out much because I need to rest.” Which health problem is most likely?
Answer Choices: a. Depersonalization disorder b. Antisocial personality disorder c. Illness anxiety disorder d. Persistent depressive disorder
Answer: c
Question: A nurse assessing a patient diagnosed with a somatic system disorder is most likely to note what patient characteristic?
Answer Choices: a. Readily sees a relationship between symptoms and interpersonal conflicts. b. Rarely derives personal benefit from the symptoms. c. Has little difficulty communicating emotional needs. d. Has unmet needs related to comfort and activity.
Answer: d
Question: To plan effective care for patients diagnosed with somatic system disorders, the nurse should understand that patients have difficulty giving up the symptoms because of what characteristic?
Answer Choices: a. They are generally chronic in nature. b. They have a physiological basis. c. They can be voluntarily controlled. d. They provide relief from health anxiety.
Answer: d
Question: A patient diagnosed with a somatic symptom disorder has the nursing diagnosis: Interrupted family processes, related to patient’s disabling symptoms as evidenced by the spouse and children assuming roles and tasks that previously belonged to the patient. What is an appropriate outcome for this patient?
Answer Choices: a. Assumes roles and functions of the other family members. b. Demonstrate a resumption of former roles and tasks. c. Focuses energy on problems occurring in the family. d. Relies on family members to meet personal needs.
Answer: b
Question: Which medication would the nurse expect to be prescribed for a patient diagnosed with a somatic symptom disorder?
Answer Choices: a. Narcotic analgesics for use as needed for acute pain b. Antidepressant medications to treat underlying depression c. Long-term use of benzodiazepines to support coping with anxiety d. Conventional antipsychotic medications to correct cognitive distortions
Answer: b