Pyschiatric Nursing Pt. 4

1. Which of the following should be included in the health teachings among clients receiving Valium:

Avoid taking CNS depressant like alcohol.

There are no restrictions in activities.

Limit fluid intake.

Any beverage like coffee may be taken

Valium is a CNS depressant. Taking it with other CNS depressants like alcohol; potentiates its effect. B. The client should be taught to avoid activities that require alertness. C. Valium causes dry mouth so the client must increase her fluid intake. D. Stimulants must not be taken by the client because it can decrease the effect of Valium.

Explanation

Valium is a CNS depressant. Taking it with other CNS depressants like alcohol; potentiates its effect. B. The client should be taught to avoid activities that require alertness. C. Valium causes dry mouth so the client must increase her fluid intake. D. Stimulants must not be taken by the client because it can decrease the effect of Valium.

2. Situation: A 35 year old male has intense fear of riding an elevator. He claims " As if I will die inside." This has affected his studies The client is suffering from:

Agoraphobia

Social phobia

Claustrophobia

Xenophobia

Claustrophobia is fear of closed space. A. Agoraphobia is fear of open space or being a situation where escape is difficult. B. Social phobia is fear of performing in the presence of others in a way that will be humiliating or embarrassing. D. Xenophobia is fear of strangers.

Explanation

Claustrophobia is fear of closed space. A. Agoraphobia is fear of open space or being a situation where escape is difficult. B. Social phobia is fear of performing in the presence of others in a way that will be humiliating or embarrassing. D. Xenophobia is fear of strangers.

3. Nina reveals that the boyfriend has been pressuring her to engage in premarital sex. The most therapeutic response by the nurse is:

“I can refer you to a spiritual counselor if you like.”

“You shouldn’t allow anyone to pressure you into sex.”

“It sounds like this problem is related to your paralysis.”

“How do you feel about being pressured into sex by your boyfriend?”

Focusing on expression of feelings is therapeutic. The central force of the client’s condition is anxiety. A. This is not therapeutic because the nurse passes the responsibility to the counselor. B. Giving advice is not therapeutic. C. This is not therapeutic because it confronts the underlying cause.

Explanation

Focusing on expression of feelings is therapeutic. The central force of the client’s condition is anxiety. A. This is not therapeutic because the nurse passes the responsibility to the counselor. B. Giving advice is not therapeutic. C. This is not therapeutic because it confronts the underlying cause.

4. In the management of bulimic patients, the following nursing interventions will promote a therapeutic relationship EXCEPT:

Establish an atmosphere of trust

Discuss their eating behavior.

Help patients identify feelings associated with binge-purge behavior

Teach patient about bulimia nervosa

The client is often ashamed of her eating behavior. Discussion should focus on feelings. A,C and D promote a therapeutic relationship

Explanation

The client is often ashamed of her eating behavior. Discussion should focus on feelings. A,C and D promote a therapeutic relationship

5. Which is the desired outcome in conducting desensitization:

The client verbalize his fears about the situation

The client will voluntarily attend group therapy in the social hall.

The client will socialize with others willingly

The client will be able to overcome his disabling fear.

The client will overcome his disabling fear by gradual exposure to the feared object. A,B and C are not the desired outcome of desensitization.

Explanation

The client will overcome his disabling fear by gradual exposure to the feared object. A,B and C are not the desired outcome of desensitization.

6. Unlike psychophysiologic disorder Linda may be best managed with:

Medical regimen

Milieu therapy

Stress management techniques

Psychotherapy

Stree management techniques is the best management of somatoform disorder because the disorder is related to stress and it does not have a medical basis. A. This disorder is not supported by organic pathology so no medical regimen is required. B and D. Milieu therapy and psychotherapy may be used a therapeutic modalities but these are not the best.

Explanation

Stree management techniques is the best management of somatoform disorder because the disorder is related to stress and it does not have a medical basis. A. This disorder is not supported by organic pathology so no medical regimen is required. B and D. Milieu therapy and psychotherapy may be used a therapeutic modalities but these are not the best.

7. The nurse develops a countertransference reaction. This is evidenced by:

Revealing personal information to the client

Focusing on the feelings of the client.

Confronting the client about discrepancies in verbal or non-verbal behavior

The client feels angry towards the nurse who resembles his mother.

Countertransference is an emotional reaction of the nurse on the client based on her unconscious needs and conflicts. B and C. These are therapeutic approaches. D. This is transference reaction where a client has an emotional reaction towards the nurse based on her past.

Explanation

Countertransference is an emotional reaction of the nurse on the client based on her unconscious needs and conflicts. B and C. These are therapeutic approaches. D. This is transference reaction where a client has an emotional reaction towards the nurse based on her past.

8. Initial intervention for the client should be to:

Encourage to verbalize his fears as much as he wants.

Assist him to find meaning to his feelings in relation to his past.

Establish trust through a consistent approach.

Accept her fears without criticizing.

The client cannot control her fears although the client knows its silly and can joke about it. A. Allow expression of the client’s fears but he should focus on other productive activities as well. B and C. These are not the initial interventions.

Explanation

The client cannot control her fears although the client knows its silly and can joke about it. A. Allow expression of the client’s fears but he should focus on other productive activities as well. B and C. These are not the initial interventions.

9. Malingering is different from somatoform disorder because the former:

Has evidence of an organic basis

It is a deliberate effort to handle upsetting events

Gratification from the environment are obtained.

Stress is expressed through physical symptoms.

Malingering is a conscious simulation of an illness while somatoform disorder occurs unconscious. A. Both disorders do not have an organic or structural basis. C. Both have primary gains. D. This is a characteristic of somatoform disorder.

Explanation

Malingering is a conscious simulation of an illness while somatoform disorder occurs unconscious. A. Both disorders do not have an organic or structural basis. C. Both have primary gains. D. This is a characteristic of somatoform disorder.

10. Situation: A 20 year old college student is admitted to the medical ward because of sudden onset of paralysis of both legs. Extensive examination revealed no physical basis for the complaint. The nurse plans intervention based on which correct statement about conversion disorder?

The symptoms are conscious effort to control anxiety

The client will experience high level of anxiety in response to the paralysis.

The conversion symptom has symbolic meaning to the client

A confrontational approach will be beneficial for the client.

the client uses body symptoms to relieve anxiety. A. The condition occurs unconsciously. B. The client is not distressed by the lost or altered body function. D. The client should not be confronted by the underlying cause of his condition because this can aggravate the client’s anxiety.

Explanation

the client uses body symptoms to relieve anxiety. A. The condition occurs unconsciously. B. The client is not distressed by the lost or altered body function. D. The client should not be confronted by the underlying cause of his condition because this can aggravate the client’s anxiety.