ARELLANO UNIVERSITY COURSE AUDIT 2 PSYCHIATRIC NURSING QUIZ 1 Set A/B 1/13. When planning the discharge of a client with chronic anxiety, the nurse directs the goal at promoting a safeenvironment at home. The appropriate maintenance goal should focus on which of the following? a. Ignoring feelings of anxiety c. ontinued contact with a crisis counselor!. Identifying anxiety"producing situations. d. #liminating all anxiety from daily situationsANSWER: B $ecogni%ing situations that produce anxiety allows the client to prepare to cope with anxiety or avoid specific stimulus. ounselors will not !e availa!le for all anxiety"producing situations, and this option does not encourage the development of internal strengths. Ignoring feelings will not resolve anxiety. #liminationof all anxiety from life is impossi!le. &/&1. ' woman comes into the emergency in a severe state of anxiety following a car accident. The appropriatenursing intervention is to( a. $emain with client. c. Teach the client deep !reathing.!. )ut a client in a *uiet room. d. #ncourage the client to tal+ a!out their feelings and concerns.ANSWER: A If a client with severe anxiety is left alone, the client may feel a!andoned and !ecome overwhelmed. )lacing the client ina *uiet room is also important, !ut nurse must stay with the client. Teaching the client deep !reathing or relaxation is not possi!le until the anxiety decreases. #ncouraging the client to discuss concerns and feelings would not ta+e place until the anxiety has decrease. 3/1,. The client is unwilling to go out of the house for fear of -doing something cra%y in pu!lic.. /ecause of this fear, the client remains home!ound, except when accompanied outside !y the spouse. /ased on this data, the nurse determines that the client is experiencing( a. 'gorapho!ia !. 0ocial pho!ia c. laustropho!ia d. 1ypochondriasisANSWER: A 'gorapho!ia is the fear of open spaces and the fear of !eing trapped in a situation from which there may not !e an escape. 'gorapho!ia includes the possi!ility of experiencing a sense of helplessness or em!arrassment if an attac+ occurs. 'voidance of such situations usually results in the reduction of social and professional interactions. 0ocial pho!ia focuses more on specific situations, such as fear of spea+ing, performing or eating in pu!lic. laustropho!ia is a fear of closed places. lients who have hypochondriacal symptoms focus their anxiety on physical complaints and preoccupied with their health. 2/12. ' client is admitted to a medical nursing unit with a diagnosis of acute !lindness. 3any tests are performed, and there seems to !e no organic reason why his client cannot see. The nurse later learns that the client !ecame !lind after witnessing a hit"and"run car accident, when a family of three was +illed. The nurse suspects that the client may !e experiencing a( a. )sychosis !. $epression c. onversion disorder d. 4issociative disorderANSWER: C ' conversion disorder is the alteration or loss of a physical function that cannot !e explained !y any +nown pathophysiological mechanism. ' conversion is thought to !e an expression of a physiological need or conflict. In this situation, the client witnessed an accident that was so physiologically painful that the client !ecame !lind. ' dissociative disorder is a distur!ance or alteration in the normally integrative functions of which identity, memory or consciousness. )sychosis is a state of which a person5s capacity to recogni%e reality, communicate, and relate to others is impaired, thus, interfering with the person5s a!ility to deal with life5s demands. $epression is coping mechanism in which unaccepta!le feelings are +ept out of awareness. 6/&&. ' client reports experiencing nightmares and constant worry a!out the weather since typhoon 7ndoy destroyedthe client5s house. The nurse assesses that this client is experiencing( a. 1allucinations !. )anic attac+s c. flash!ac+s d. delusionsANSWER: C ' client who repeatedly experiences nightmares and constantly worries a!out the weather since a typhoon destroyed his house is experiencing flash!ac+s. lients who have flash!ac+s have recurrent intrusive recollections of the traumatic event. lients with delusions, hallucinations, and panic attac+s wouldreexperience the traumatic event. Referene: !"r# Ann B$#%& P'#()"tr) N*r')n+& ,t( e%)t)$n& P"+e ,2-.,2/ ,/18. ' 39 year old male employee fre*uently complains of low !ac+ pain that leads to fre*uent a!sences from wor+.onsultation and tests reveal negative results. The client has which somatoform disorder? a. 0omati%ation 4isorder !. 1ypochondriaisis c. onversion 4isorder d. 0omatoform )ain 4isorderANSWER: D This is characteri%ed !y severe and prolonged pain that causes significant distress. 7ption '( This is a chronic syndrome of somatic symptoms that cannot !e explained medically and is associated with psychosocial distress. 7ption /( This is an unrealistic preoccupation with a fear of having a serious illness. 7ption ( haracteri%ed !y alteration or loss in sensory or motor function resulting from a psychological conflict. Referene: !"r# Ann B$#%& P'#()"tr) N*r')n+& ,t( e%)t)$n& P"+e ,/0 8/16. The nurse is assessing a parent who a!used her child. Which of the following ris+ factors would the nursesuspect to find in this case? a. :lexi!le role functioning !etween parents c. 0ingle parent home situation!. 1istory of parent having !een a!used as child d. )resence of parental mental illnessANSWER: B 7ne of the most important ris+ factors is history of childhood a!use in the parent who a!uses. :amily violence follows a multigenerational pattern. )arents who are flexi!le in their roles are characteristic of healthy functioning, not a!use. 0ingle parent households and a history of mental illness are not esta!lished ris+ factors for child a!use !y a parent. Referene: !"r# Ann B$#%& P'#()"tr) N*r')n+& ,t( e%)t)$n& P"+e -12.-11 ;/1