NURSING 326 Mental Health Exam 4

NURSING 326 Mental Health Exam 4 1. A 40-year-old client experiences intense fear for approximately 15 minutes and reports chest pain, palpitations, and nausea. The client's symptoms indicate which of the following? a ...

NURSING 326 Mental Health Exam 4 1. A 40-year-old client experiences intense fear for approximately 15 minutes and reports chest pain, palpitations, and nausea. The client's symptoms indicate which of the following? a. panic attack b. overanxious disorder c. ptsd d. signal anxiety 2. Which type of phobia is associated with avoidance of people, places, or events from which escape would be difficult? A. Macrophobia B. Logophobia C. Agoraphobia D. Zelophobia 3. a client appears tense and expresses feelings of dread regarding test results. This client is demonstrating – anxiety 4. A client describes flashbacks of a terrifying car crash in which he saw his best friend die. Which disorder should the nurse suspect in this situation? A. Agoraphobia B. Panic disorder C. Obsessive-compulsive disorder D. Posttraumatic stress disorder 5. A client continually reports physical symptoms in the absence of objective clinical findings. The nurse should suspect which of the following disorders? a. body dysmorphic disorder b. dysthymia c. major depressive disorder d. somatoform disorder 6. A nurse should suspect which disorder when a client is able to move his arm in private but states to others that his arm is paralyzed? A. conversion disorder b. hypochonriasis c. personality disorder d. cyclothymic disorder 7. A man who develops an illness to avoid military service is – malingering 8. A 6-year-old is preparing to have a dental procedure. His anxious mother is in the room with him. When the child asks if everything will be okay, she assures him it will but continues to pace and wring her hands. What is the most appropriate action for the dentist to take? A. Give the mother a seat near the child and continue to assure the mother. b. Request that the mother wait in the waiting room.c. Allow the mother to verbalize what her concerns are. d. Tell the child to ignore his mother. 9. An adolescent caught stealing a classmate’s laptop says that he needed it to write his paper and that the classmate “has enough money to buy another one anyway.” This adolescent is demonstrating which of the following defense mechanisms? a.Denial b.Restitution c.Rationalization d. Conversion 10. A client has constant thoughts about locking his front door every time he leaves his house. This client is experiencing a/an: a. obsession b. compulsion c. phobia d. anxiety 11. A client tells the nurse that exercising in the gym helps him keep his stress level reduced. Which type of coping mechanism best describes this situation? a. spiritual b. emotional c. intellectual d. physical 12. The charge nurse is angry with another nurse who has arrived one hour after the shift begins. Rather than expressing her anger, the nurse avoids confrontation by denying approval of the nurse’s requested vacation day. What does this behavior demonstrate? a. Substitution b. Restitution c. Suppression d. Rationalization 13. A mother brings her 9-month-old son to the emergency department because he stopped breathing at home. She demands that he receive a full diagnostic work-up. When asked for the name of her pediatrician, she states she has not found one she is satisfied with. The nurse suspects: a. Projection b, Malingering c. Conversion disorder d. Munchausen’s syndrome by proxy 14. A soldier arrives at the airport after completing a combat assignment. He reports a new-onset blindness but was able to identify his wife in the crowd awaiting passenger arrivals. He is likely experiencing symptoms of: a. Somatization b. Hypochondriasis c. Conversion Disorder d. Malingering15. A woman arrives at the hospital complaining of chest pains and shortness of breath. She has come in several times over the past two weeks, and the staff is doubtful that her symptoms are real. What is the first action for the health care team to implement? a. Complete a history, physical, and diagnostics b. Arrange for a psychiatric consult c. Provide discharge instructions and arrange for a follow-up visit d. Obtain a prescription for an antianxiety agent 16. The client recently witnessed a horrific auto accident. Now she is complaining of double vision, loss of balance, and a constant “lump in her throat.” She is exhibiting the signs and symptoms of: Anxiety reaction Behavioral disorder Conversion disorder Posttraumatic stress reaction 17. The client complains of severe back pain and is excused from work. Later, he is seen water skiing and jogging. These behaviors describe: Malingering Somatization Hypochondriasis A factitious disorder 18. A female client frequently complains of chest pain, has had extensive physiological testing with negative results, and sees several different medical doctors. This client is exhibiting signs and symptoms characteristic of: Hypochondriasis Conversion disorder Body dysmorphic disorder Factitious disorder 19. A 2-year-old child cries and protests when her mother leaves for work. This child's behavior is consistent with what condition? Generalized anxiety disorder Situational anxiety disorder Overanxious disorder Separation anxiety disorder 20. A client with generalized anxiety disorder (GAD) is prescribed buspirone (BuSpar). Which information should be given to the client? The risk of sedation is increased with this medication. It treats the worry associated with GAD. The medication begins to work in 7 days. The medication is taken 3 days per week. 21. A client is given the diagnosis of generalized anxiety disorder and is prescribed a benzodiazepine. The client should be instructed on which of the following? Monthly laboatory tests are needed to monitor drug level. Benzodiazepines do not cause physical dependence. Benzodiazepines and alcohol can be dangerous.Foods that contain tyramine should be avoided. 22. A teenager reacts with anxiety in relatively low-stress situations and gives reasons for the behavior, even when not requested. What is the teenager exhibiting? Signal anxiety Anxiety trait Anxiety state Mild anxiety 23. A child develops anxiety when his father continually disapproves of his friends and interests. This situation is consistent with which model related to anxiety? Interpersonal model Behavioral model Psychodynamic model Biological model 24. Which of the following activities are examples of addictive behaviors? (Select all that apply.) Gambling Shopping Working Excessive sexual activity Flashbacks Coping 25. Which symptoms may be seen in a person who is having a panic attack? (Select all that apply.) Shortness of breath Fear of dying Recurrent persistent thoughts Palpitations Chills Feelings of depersonalization 26. Which term best describes an individual’s feelings of anxiety that are broad, long-lasting, and excessive? Generalized anxiety disorder Panic attack Phobic disorder Obsessive-compulsive disorder 27. A female college student is seeking help from the counseling center for test anxiety. She reports that during an exam, she “freezes,” and says, “It feels like the time I have to take the exam is racing by, and I can’t answer any of the questions when I know the answers.” Which level of anxiety is the client experiencing? Mild Moderate Severe Panic28. On the morning of a final exam, a student is feeling tense and excited, with her heart rate and breathing slightly increased. She is feeling energized and alert, with her attention focused on the exam. Based on these findings what advice can the student be given? Practice deep breathing and do some exercise to stabilize vital signs. Request to take the exam at a later date when anxiety decreases. Take the exam more seriously and treat it with more concern. The level of anxiety described should allow for a positive outcome. 29. A female client is taking a benzodiazepine for her anxiety disorder. She complains of anorexia and nausea since she started taking the medication a few days ago. What is the nurse’s best response? “Be sure to take the medicine on an empty stomach to avoid these symptoms.” “It takes a while to get used to the medicine. Give it a couple of weeks.” “Try taking the medication with food or milk, and see if the symptoms improve.” “Stop taking the medication immediately, and I will notify your doctor.” 30. is a defense mechanism that is characterized by redirecting one’s energy to another person or object. - displacement 31. When an individual uses psychological strategies to cope with stressors in an attempt to decrease anxiety, this person is using a - Defense mechanism 32. Adolescents who ineffectively cope with anxiety often express their anxiety through: Inappropriate behaviors Calm behavior Psychotic behavior Suicide 33. refers to a vague, uneasy feeling of uncertainty and helplessness. - anxiety 34. Which statements best describe an anxiety disorder? (Select all that apply.) Anxiety is expressed in ineffective ways. Coping mechanisms are used to deal with anxiety. Coping mechanisms do not relieve anxiety. Defense mechanisms are used occasionally. 35. A male client has had agoraphobia for several years. In the past 2 years, he has not left his home, and he only speaks to people on the phone occasionally. Which nursing diagnosis has the highest priority in this situation? Social isolation Thought processes, disturbed Coping, ineffective individual Powerlessness 36. Which is a typical symptom of posttraumatic stress disorder? Constant use of defense mechanisms Flashbacks Distressing persistent thoughts Irrational fear37. The treatment team and a male client in whom obsessive-compulsive disorder associated with hand washing has been diagnosed decide on a treatment plan for the disorder. The nurse begins to implement the plan by having the client gradually extend the time between hand washes. This intervention is an example of which type of therapy? Behavior modification Desensitization Flooding Pharmacological therapy 38. experiences nausea and sweaty palms before boarding an airplane, is best described as: A normal anxiety response Signal anxiety An anxiety state An anxiety trait 39. When a client has a mild level of anxiety, his or her emotional response is: Relaxed and calm Energized Feeling overloaded Helplessness with loss of control 40. What is the term for physical expression of anxiety by an individual in ways such as nausea or headaches? Compensation Somatization Denial Fantasy 41. Which intervention by the nurse would be therapeutic for a client with hypochondriasis? Administer antipsychotic medication for client’s delusions. Challenge the client’s beliefs about the symptoms. Respond to the client’s complaints with acceptance and understanding. Engage the client in conversation about the physical symptoms. 42. Misinterpretation of bodily symptoms is a distinctive feature of which of the following? Body dysmorphic disorder (BDD) Hypochondriasis Somatization disorder Conversion disorder 43. After instructing a class on factitious disorders, the instructor asks students for a brief description of a factitious disorder. Which of the following statements is accurate? Symptoms are purposefully produced to assume the sick role. Factitious disorders are a form of malingering. If confronted by the behavior, the person will confess the truth about the symptoms The person descriptively and consistently describes his/her medical history 44. A client with a somatic illness was born in another country and believes that his body is the property of his ancestors. This belief is consistent with which cultural group?Southeast Asians Hispanics Koreans Japanese 45. Which of the following theories of psychophysical disorders states that individuals are biochemically patterned to react to stress? Eric Fromm’s theory Stress response theory Carl Jung’s theory Theory of organic weakness 46. Epinephrine is produced and released by which of the following? Hypothalamus Thyroid gland Pituitary gland Adrenal glands 47. is the biochemical fight-or-flight response that is a survival tool against stressors. - General adaptation syndrome 48. A client is admitted every month for the past four months to the psychiatric hospital with complaints of suicidal thoughts and a plan when his monthly disability income has been spent. This client is exhibiting signs of: Factitious Disorder Conversion Disorder Hypochondriasis Malingering 49. In the __________ culture, mental and emotional disorders are expressed as somatoform complaints on the basis of the belief that the body is the property of the ancestors. Japanese Hispanic Southeast Asian Korean 50. The main feature of a factitious disorder is that symptoms are purposefully produced to allow the individual to: Get out of work Assume the sick role Assume control of treatment Get the attention of health care providers 51. Which of the following are characteristics of somatoform disorders? (Select all that apply.) Relieve anxiety Decrease depression Have no organic medical sourceAre related to a medical condition Significantly impair one’s level of functioning Often occur in those who must cope with illness Occur in clients who are unaware of or unable to express emotional distress 52. Your client is a wife and mother who, in addition to doing most of the household tasks, has a difficult time saying no to helping out with functions at school and church. Based on Fromm’s psychodynamic theory, what illness is she more prone to develop? Cardiac problems High blood pressure Alcoholism Gastric ulcer 53. The human physiological stress response mechanism is also called the ____ response. Startle Neuroleptic Homeostasis Fight-or-flight 54. La belle indifference is a characteristic that most often is associated with: Anxiety reaction Conversion disorder Depressive disorder Posttraumatic stress reaction 55. Which of the following are indicative of hypochondriasis? (Select all that apply.) Symptoms most commonly appear in early childhood First diagnosed following a severe stressor More frequent in person exposed to a serious illness in childhood Sufferers usually have strained interpersonal relationships 56. In the past, disorders that were emotionally related to physical problems were called __________ illnesses. - Psychosomatic 57. Which are the essential features of conversion disorders? (Select all that apply.) Preoccupation with fears of disease Deficits in motor function Long history of vague complaints Deficits in sensory function 58. People who are able to recognize and defuse their stressors early ____ suffer from the physical effects of stress. Never Often Always Seldom 59. Once the acute feelings of illness are resolved, what is an appropriate intervention when treating a client with a psychosocial problem?Avoid expression of feelings as this will provide a relapse of acute symptoms Minimize secondary gains Convey an attitude that such behavior is not acceptable Assist the client to limit social network to avoid additional stress 60. Several studies have demonstrated that significant ____ changes occur in people who display hostile or negative behaviors. Attitudinal Behavioral Gastrointestinal Immune-mediated 61. The physiological stress response has an effect on: Many body systems Only the nervous system The gastrointestinal system The cardiovascular and respiratory systems 62. Most psychosomatic problems and somatoform disorders begin in: Puberty Adulthood Childhood Adolescence 63. Somatization disorder is a polysymptomatic disorder, which means that the disorder is associated with ____ symptoms. Few signs and Polymorphic Many signs and Specific signs and 64. The client can acknowledge the possibility that she exaggerates her symptoms, but she continues to hold on to the belief that something is physically wrong, in the face of evidence to the contrary. What is the client’s diagnosis most likely to be? Malingering Hypochondriasis A conversion reaction Body dysmorphic disorder