Signs/Symptoms
A person who feels unattractive repeatedly says, “Although I’m not beautiful, I am smart.” This is an example of
a. repression.
b. devaluation.
c. identification.
d. compensation.
d. compensation.
To assist patients diagnosed with somatic symptom disorders, nursing interventions of high priority
a. explain the pathophysiology of symptoms.
b. help these patients suppress feelings of anger.
c. shift focus from somatic symptoms to feelings.
d. investigate each physical symptom as it is reported
c. shift focus from somatic symptoms to feelings.
___ are most commonly used to treat anxiety disorders.
Benzodiazepines
Which mental health disorder can be a direct physiological result of hyperthyroidism?
A. Anxiety
B. Generalized anxiety disorder
C. Panic attacks
D. Obsessive-compulsive disorder
A. Anxiety
Which somatization disorder would the nurse consider highly treatment resistant?
A. Conversion disorder
B. Illness anxiety disorder
C. Somatic symptom disorder
D. Factitious disorder
D. Factitious disorder
When the nurse diagnoses that a client is experiencing panic-level anxiety, an intervention that should be immediately implemented is to:
A. teach relaxation techniques.
B. administer anxiolytic medication.
C. provide calm, brief, directive communication.
D. gather a show of force in preparation for physical control.
C. provide calm, brief, directive communication.
A patient experiencing moderate anxiety says, “I feel undone.” An appropriate response for the
nurse would be:
a. “What would you like me to do to help you?”
b. “Why do you suppose you are feeling anxious?”
c. “I’m not sure I understand. Give me an example.”
d. “You must get your feelings under control before we can continue.”
c. “I’m not sure I understand. Give me an example.”
A patient is experiencing moderate anxiety. The nurse encourages the patient to talk about feelings and concerns. What is the rationale for this intervention?
a. Offering hope allays and defuses the patient’s anxiety.
b. Concerns stated aloud become less overwhelming and help problem solving begin.
c. Anxiety is reduced by focusing on and validating what is occurring in the environment.
d. Encouraging patients to explore alternatives increases the sense of control and lessens anxiety
b. Concerns stated aloud become less overwhelming and help problem solving begin.
Which of the following drugs is approved by FDA for children aged 7 to 17 years for generalized anxiety disorder?
a. Venlafaxine
b. Clonazepam
c. Duloxetine
d. Fluoxetine
c. Duloxetine
Which other disorder is related to somatic symptom disorder?
A. Depersonalization
B. Dissociative fugue
C. Conversion disorder
D. Dissociative identity disorder
A. Depersonalization
Which statement made by the nurse demonstrates a need for education on the effective use of relaxation therapy for anxiety management?
A. “Relaxation therapy’s main goal is to prevent exhaustion by removing muscle tension.”
B. “Muscle relaxation promotes the relaxation response.”
C. “Show me how you learned to deep breathe in yesterday’s therapy session.”
D. “You’ve said that going to group makes you nervous, so let’s start relaxing now.”
A. “Relaxation therapy’s main goal is to prevent exhaustion by removing muscle tension.”
A client is seeking treatment for a specific phobia: fear of cats. The nurse in the anxiety disorders clinic has established the nursing diagnosis of anxiety related to exposure to phobic object (cats). A realistic indicator for the outcome anxiety self-control would be that within 10 days, the client will:
A. avoid the feared object whenever possible.
B. face the feared object without supportive assistance.
C. state that the fear of cats is unrealistic and inappropriate.
D. practice relaxation techniques and report decreased physiological sensations associated with thoughts of the feared object.
D. practice relaxation techniques and report decreased physiological sensations associated with thoughts of the feared object.
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 this event is not likely. This counseling demonstrates principles of
a. flooding.
b. desensitization.
c. relaxation technique.
d. cognitive restructuring
d. cognitive restructuring
A medical-surgical nurse works with a patient diagnosed with a somatic symptom disorder. Care planning is facilitated by understanding that the patient will probably
a. readily seek psychiatric counseling.
b. be resistant to accepting psychiatric help.
c. attend psychotherapy sessions without encouragement.
d. be eager to discover the true reasons for physical symptom
b. be resistant to accepting psychiatric help.
A nurse is going through the current medications list of a pregnant women during a clinic visit. Which medication will alert the nurse about the risk of floppy infant syndrome?
a. Fluoxetine
b. Buspirone
c. Lorazepam
d. Duloxetine
c. Lorazepam
A FCC nursing student changes study habits to earn better grades after initially failing a test. This behavioral change is likely a result of which factor?
A. Altruism
B. Trait anxiety
C. Normal anxiety
D. A rude awakening
C. Normal anxiety
A patient diagnosed with a somatic disorder asks what kind of psychotherapy will be prescribed. Which response would the nurse provide?
A. "A combination of antianxiety and antidepressant therapy is the most effective therapy."
B. "As you see desired behaviors modeled by the therapist, you also will be able to achieve the expected outcome."
C. "Cognitive-behavioral therapy (CBT) has been shown to consistently provide the best outcome for these types of disorders."
D. "As you see desired behaviors modeled by the therapist, you also will be able to achieve the expected outcome."
C. "Cognitive-behavioral therapy (CBT) has been shown to consistently provide the best outcome for these types of disorders."
When the psychiatrist prescribes alprazolam (Xanax) for the acute anxiety experienced by a client with agoraphobia, health teaching should include instructions to:
A. eat a tyramine-free diet.
B. report drowsiness.
C. avoid alcoholic beverages.
D. adjust dose and frequency of ingestion based on anxiety level.
C. avoid alcoholic beverages.
A patient with an abdominal mass is scheduled for a biopsy. The patient has difficulty understanding the nurse’s comments and asks, “What do you mean? What are they going to do?” Assessment findings include tremulous voice, respirations 28, and pulse 110. What is the patient’s level of anxiety?
a. Mild
b. Moderate
c. Severe
d. Panic
b. Moderate
A patient fearfully runs from chair to chair crying, “They’re coming! They’re coming!” The patient does not follow the staff’s directions or respond to verbal interventions. The initial nursing intervention of highest priority is to
a. provide for the patient’s safety.
b. encourage clarification of feelings.
c. respect the patient’s personal space.
d. offer an outlet for the patient’s energy.
a. provide for the patient’s safety.
The client is diagnosed with somatic symptom disorder. Which of the following are some common drugs to treat the disorder. Select All That Apply.
a. Amitriptyline
b. Fluoxetine
c. Lorazepam
d. Paroxetine
e. Duloxetine
a,b,d
Which datum is gathered routinely during assessment of a patient with a somatoform disorder?
A. Level of Confusion
B. Potential for violence
C. Dependance on medication
D. Personal identity disturbance
C. Dependance on medication
Which advantage does cognitive-behavioral therapy (CBT) have for patients with somatization disorders?
A. Provides a consistent supported treatment by a general medical nurse
B. Helps reframe the patient's thoughts and gain control of the situation
C. Builds a self-fulfilling cycle of pain, despair, and health-seeking behaviors
D. Initiates psychiatric consultation without need for the primary healthcare provider
B. Helps reframe the patient's thoughts and gain control of the situation
A client who has been unable to leave his home for more than a month because of symptoms of severe anxiety tells the nurse "I know it's probably crazy, but I just can't bring myself to leave my apartment alone." An appropriate nursing intervention for the nurse to include in the nursing care plan is to:
A. teach the client to use positive self-talk.
B. assist the client to apply for disability benefits.
C. reinforce the irrationality of the client's fears.
D. advise the client to accept the situation and use a companion
A. teach the client to use positive self-talk.
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?
a. Introjection
b. Conversion
c. Projection
d. Splitting
c. Projection
A patient preparing for surgery has moderate anxiety and is unable to understand preoperative information. Which nursing intervention is most appropriate?
a. Reassure the patient that all nurses are skilled in providing postoperative care.
b. Present the information again in a calm manner using simple language.
c. Tell the patient that staff is prepared to promote recovery.
d. Encourage the patient to express feelings to family.
b. Present the information again in a calm manner using simple language.
A patient is being treated for Obsessive-compulsive disorder. Which of the following medications can be prescribed to treat OCD. (Select All That Apply)
a. Clomipramine
b. Clorazepate
c. sertraline
d. aripirazole
e. risperidone
f. all of the above
a, c, d, e
The nurse is reviewing the assessment data of a client admitted to the mental health unit. The nurse notes that the admission nurse documented the client is experiencing anxiety as a result of a situational crisis. The nurse plans care for the client, determining that this type of crisis could be caused by which event?
A. Witnessing a murder
B. The death of a loved one
C. A fire that destroyed the client's home
D. A recent rape episode experienced by the client
B. The death of a loved one
Which strategy would the nurse incorporate in the plan of care to facilitate effective recovery for somatic symptoms? SATA
A. Provide continuity of care.
B. Avoid physical examination.
C. Set reasonable treatment goals.
D. Conduct a physical examination each time.
E. Conduct laboratory investigations related to each symptom.
A, C, E
A client who is a recovering alcoholic has been diagnosed as having panic attacks. The psychiatrist mentions plans to treat the client with daily doses of medication. Of the medications listed below, for which drug should the nurse plan client teaching?
A. Paroxetine (Paxil)
B. Alprazolam (Xanax)
C. Chlorpromazine (Thorazine)
D. Propranolol (Inderal)
A. Paroxetine (Paxil)
Which assessment data would help the health care team distinguish symptoms of conversion disorder from symptoms of illness anxiety disorder?
a. Voluntary control of symptoms
b. Patient’s style of presentation
c. Results of diagnostic testing
d. The role of secondary gains
b. Patient’s style of presentation
Which prescription medication would the nurse expect to be prescribed for a patient diagnosed with a somatic symptom disorder?
a. Narcotic analgesics for use as needed for acute pain
b. Antidepressant medications to treat co-morbid depression
c. Long-term use of benzodiazepines to support coping with anxiety
d. Conventional antipsychotic medications to correct cognitive distortions
b. Antidepressant medications to treat co-morbid depression
A female patient is diagnosed with anxiety disorder. The healthcare provider ordered Lorazepam 3mg PO daily in divided doses. Which information nurse should include in the teaching plan? (Select All That Apply)
a. Avoid alcohol, opioids and any other CNS depressant while taking this medication.
b. Do not stop taking it abruptly. Taper down slowly.
c. Take the dose in the morning empty stomach for better results.
d. Delirium, paranoia and anorexia are some common side-effects of the drug.
e. Avoid breastfeeding/pregnancy during therapy.
f. Store the drug in cool and dry place.
a, b, e
Which statement on cultural considerations for somatic symptoms is true? SATA
A. Patients from the Caribbean may have symptoms such as dizziness and fatigue.
B. In some cultures, physical symptoms are believed to have been caused by a spell.
C. Individuals who believe a spell has affected them may not show improvement until a traditional healer removes the spell.
D. Individuals who currently live in the United States are rarely affected by traumatic experiences before their move.
E. Immigrants must be assessed for a possible link between somatization symptoms and undisclosed traumatic experiences.
A, B, C, E
Which intervention demonstrates an understanding of the recommendations when working with patients exhibiting somatic disorder behaviors?
A. Scheduling the patient for short visits every 5 weeks
B. Arranging for uninterrupted therapy when the patient relocates
C. Recognizing that the patient's symptoms are real to that patient
D. Minimizing reinforcement of the patient's fears by avoiding routine physicals
E. Evaluating the patient's plan of care frequently for the reasonable goals directed toward main function
All of thee above; A, B, C, D, E
A nurse is counseling a client with an anxiety disorder by using cognitive therapy strategies. She gives the client a homework assignment to keep a diary in which he records the symptoms of anxiety he experiences and the events that transpired just before the onset of symptoms. The rationale for this strategy is:
A. to keep the client intellectually occupied to prevent dwelling on physiologic phenomena.
B. to link symptoms with precipitating events, which provides a basis for discussion and reframing.
C. that anxiety gives rise to automatic, negative cognitions that must be analyzed.
D. that antecedent events have less to do with the anxiety onset than internal events.
B. to link symptoms with precipitating events, which provides a basis for discussion and reframing.