Stress, Anxiety, And Mind-body Disorders | NCLEX Quiz 208

1. Mr. Johnson is newly admitted to a psychiatric unit because of severe obsessive-compulsive behavior. Which initial response by the nurse would be most therapeutic for him?

Accepting the client’s ritualistic behaviors

Challenging the client’s need for rituals

Expressing concern about the harmfulness of the client’s rituals

Limiting the client’s rituals that are excessive

It is important to accept the client’s need to perform ritualistic behaviors in this situation; admission to a psychiatric unit is stressful. and this client will tend to increase rituals when anxious. Other options are not appropriate for a newly admitted client.

Explanation

It is important to accept the client’s need to perform ritualistic behaviors in this situation; admission to a psychiatric unit is stressful. and this client will tend to increase rituals when anxious. Other options are not appropriate for a newly admitted client.

2. Nurse Wayne is planning a psychoeducational discussion for a group of adolescent clients with anorexia nervosa. Which of the following topics would Nurse Wayne select to enhance understanding about central issues in this disorder?

Anger management

Parental expectations

Peer pressure and substance abuse

Self-control and self-esteem

Self-control and self-esteem are central issues for clients with eating disorders. Such clients feel a loss of self-control over their life and experience diminished self-esteem and severe doubts about their self-worth.

Explanation

Self-control and self-esteem are central issues for clients with eating disorders. Such clients feel a loss of self-control over their life and experience diminished self-esteem and severe doubts about their self-worth.

3. Nurse Kerrick observes Toni who is hospitalized on an eating disorder unit during mealtimes and for 1 hour after eating. An explanation for this intervention is:

To develop a trusting relationship.

To maintain focus on the importance of nutrition.

To prevent purging behaviors.

To reinforce the behavioral contact.

Toni may experience increased anxiety during treatment and. therefore. may resume behaviors designed to prevent weight gain. such as vomiting or excessive exercise.

Explanation

Toni may experience increased anxiety during treatment and. therefore. may resume behaviors designed to prevent weight gain. such as vomiting or excessive exercise.

4. The nurse evaluates the treatment of Mrs. Montez with somatoform disorder as successful if:

Mrs. Montez practices self-medication rather than changing health care providers.

Mrs. Montez recognizes that physical symptoms increase anxiety level.

Mrs. Montez researches treatment protocols for various illnesses.

Mrs. Montez verbalizes anxiety directly rather than displacing it.

Mrs. Montez with somatoform disorder unconsciously displaces anxiety onto physical symptoms. The ability to recognize and verbalize anxious feelings directly rather than displacing them is a criterion of treatment success.Options A and C indicate the continuation of the problem.

Explanation

Mrs. Montez with somatoform disorder unconsciously displaces anxiety onto physical symptoms. The ability to recognize and verbalize anxious feelings directly rather than displacing them is a criterion of treatment success.Options A and C indicate the continuation of the problem.

5. Which of the following attitudes from a nurse would hinder a discussion with an adolescent client about sexuality?

Accepting

Matter-of-fact

Moralistic

Nonjudgemental

Adolescents are not likely to feel free to ask questions and participate in a discussion if the nurse has a moralistic attitude toward sexual issues. Having an accepting. matter-of-fact. or nonjudgmental attitude will be helpful in allowing adolescents to feel comfortable discussing sexual issues.

Explanation

Adolescents are not likely to feel free to ask questions and participate in a discussion if the nurse has a moralistic attitude toward sexual issues. Having an accepting. matter-of-fact. or nonjudgmental attitude will be helpful in allowing adolescents to feel comfortable discussing sexual issues.

6. Marlyn is diagnosed with anorexia nervosa and is admitted to the special eating disorder unit. The initial treatment priority for her is:

To determine her current body image.

To identify family interaction patterns.

To initiate a refeeding program.

To promote the client’s independence.

The physical need to reestablish near-normal weight takes priority because of the physiologic. life-threatening consequences of anorexia.

Explanation

The physical need to reestablish near-normal weight takes priority because of the physiologic. life-threatening consequences of anorexia.

7. Jordanne is a client with a fear of air travel. She is being treated in a mental institution for phobic disorder. The treatment method involves systematic desensitization. The nurse would consider the treatment successful if:

Jordanne plans a trip requiring air travel.

Jordanne takes a short trip in an airplane.

Jordanne recognizes the unrealistic nature of the fear of riding on airplanes.

Jordanne verbalizes a decreased fear about air travel.

Systematic desensitization is a behavioral technique in which the client with a specific phobia is gradually able to work through hierarchal fears until the most fearful situation is encountered. In this case. the most fearful is riding an airplane.The responses in options A and D may occur earlier in treatment. but not indicative of success. Generally. a phobic individual recognizes that his fear is disproportionate to the things he fears.

Explanation

Systematic desensitization is a behavioral technique in which the client with a specific phobia is gradually able to work through hierarchal fears until the most fearful situation is encountered. In this case. the most fearful is riding an airplane.The responses in options A and D may occur earlier in treatment. but not indicative of success. Generally. a phobic individual recognizes that his fear is disproportionate to the things he fears.

8. Nurse Ginia understands that her client Glenda who is bulimic feels shame and guilt over binge eating and purging. This disorder is therefore considered:

Ego-distorting.

Ego-dystonic.

Ego-enhancing.

Ego-syntonic.

An ego-dystonic disorder is one in which the client views behaviors or symptoms as incongruent with self-image and therefore feels guilt. shame. and distress about the symptoms. An ego-syntonic disorder is one which the client views behaviors as congruent with her self-image (as in anorexia nervosa).

Explanation

An ego-dystonic disorder is one in which the client views behaviors or symptoms as incongruent with self-image and therefore feels guilt. shame. and distress about the symptoms. An ego-syntonic disorder is one which the client views behaviors as congruent with her self-image (as in anorexia nervosa).

9. Nurse Vicky is assessing a newly admitted client for symptoms of post-traumatic stress disorder (PTSD). Which symptoms are typically seen with this diagnosis? Select all that apply.

Anger with numbing of other emotions

Exaggerated startle response

Feeling that one is having a heart attack

Frequent thoughts about contamination

Frequent nightmares

Survivor’s guilt

These are common symptoms of PTSD. Option C is common in panic disorder. and option D is characteristic of obsessive-compulsive disorder.

Explanation

These are common symptoms of PTSD. Option C is common in panic disorder. and option D is characteristic of obsessive-compulsive disorder.

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10. The psychoanalytic theory explains the etiology of anorexia nervosa as:

The achievement of secondary gain through control of eating.

A conflict between mother and child over separation and individualization.

Family dynamics that lead to enmeshment of members.

The incorporation of thinness as an ideal body image.

According to psychoanalytic theory. early mother-child dynamics lead to difficulty with a child establishing a sense of separateness from the mother. Control of eating becomes one area in which the child establishes a sense of independence.Option A is the behavioral view of anorexia nervosa.Option C reflects the family theory view of anorexia nervosa. which deals with the issue of lack of generational boundaries.Option D characterizes the sociocultural view of anorexia nervosa. which identifies thinness as being a culturally determined ideal.

Explanation

According to psychoanalytic theory. early mother-child dynamics lead to difficulty with a child establishing a sense of separateness from the mother. Control of eating becomes one area in which the child establishes a sense of independence.Option A is the behavioral view of anorexia nervosa.Option C reflects the family theory view of anorexia nervosa. which deals with the issue of lack of generational boundaries.Option D characterizes the sociocultural view of anorexia nervosa. which identifies thinness as being a culturally determined ideal.