Question 1

A patient is admitted into the ICU with the diagnosis of gunshot wound to the head, suicide attempt.While the patient is in the ICU the nurse's interventions should include&#10;A) limiting interaction with the patient due to antisocial behaviors exhibited by the suicidal attempt.&#10;B) ignoring the patient's need to talk about the incident.&#10;C) validating the patient's worth and self-esteem.&#10;D) discontinuing any psychotropic medications.

Accepted Answer

While the patient is in the unit, primary nursing interventions include validating the patient's worth and self-esteem and helping him or her regulate emotional states and behaviors.Patients who have attempted suicide are often stigmatized, and caregivers can resent caring for a person whose critical condition is self-inflicted.A suicide attempt indicates, however, that the patient was experiencing personal and spiritual distress to the point of wanting to end his or her life.The critical care team should make every effort to continue medications for mental health conditions during the critical care stay unless medically contraindicated.If the patient is unable to take oral medications, the team should attempt to find an alternative route if possible.

Question 2

Patients with an external locus of control&#10;A) believe that they can influence the outcome of their illness.&#10;B) should be forced to take control of their discharge planning.&#10;C) usually start out with an internal locus of control until a major illness occurs.&#10;D) believe that events are related to chance or fate.

Accepted Answer

People with an external locus of control tend to believe that events are related to chance or fate.Individuals who have an internal locus of control perceive themselves to be responsible for the outcome of events.People vary in the amount of control they prefer.

Question 3

Commonly used medications for withdrawal symptoms include&#10;A) chlordiazepoxide and folic acid.&#10;B) chlordiazepoxide and lorazepam.&#10;C) lorazepam and promethazine.&#10;D) promethazine and thiamine.

Accepted Answer

Commonly used medications include chlordiazepoxide and lorazepam for withdrawal symptoms and ondansetron and promethazine for nausea.Thiamine, folic acid, and multivitamins should be added to intravenous fluids.

Question 4

Interventions to help family members who are extremely upset include&#10;A) encouraging the family to visit as much as possible.&#10;B) conveying what the patient is experiencing to the family.&#10;C) supporting the family members away from the bedside.&#10;D) assuring the family that the staff will take care of the technical aspects of the patient's care.

Accepted Answer

Family members, themselves in a time of crisis, are particularly sensitive to a nurse's words and actions, making it essential that the nurse convey understanding and acceptance.Although the critical care nurse rarely has the time or opportunity to perform a full family assessment or give ongoing support to all family members, he or she can observe the quality of the patient-family interaction and formulate interventions that will aid the family in supporting the patient.

Question 5

Anxiety can cause emotional changes in the&#10;A) hypothalamus.&#10;B) limbic system.&#10;C) cerebral cortex.&#10;D) pituitary gland.

Accepted Answer

The neurotransmitters' complex and elusive integration of these responses within the central nervous system relies on communication among the cerebral cortex, limbic system, thalamus, hypothalamus, pituitary gland, and the reticular activating system.Whereas the cortex is involved with cognition, attention, and alertness, emotional responses to stress are located in the limbic system.

Question 6

Prolonged periods of anxious waiting, disrupted sleep patterns, witnessing emergency interventions, and financial concerns could put family members at risk for developing&#10;A) powerlessness.&#10;B) hopelessness.&#10;C) anxiety.&#10;D) PTSD.

Accepted Answer

Family members are at risk for developing post-traumatic stress reactions related to prolonged periods of uncertainty, anxious waiting, disrupted sleep patterns, financial concerns, witnessing emergency interventions, and confronting fears of loss and death.Anxiety is a normal and common subjective human response to a perceived or actual threat, which can range from a vague, generalized feeling of discomfort to a state of panic and loss of control.Conditions that increase a person's risk for feeling hopeless include a loss of dignity, long-term stress, loss of self-esteem, spiritual distress, and isolation, all of which can be present in a critical care experience.Patients who have a pervasive sense that they can do nothing to change or control their circumstances are at risk for feeling powerless.

Question 7

A patient has been admitted to the critical care unit with a severed spinal cord injury at the T2 level.The patient has been in halo traction with immobilization for the past week.The physician explains to the patient that the spinal cord has been severed and that the patient will not be able to walk again.The patient becomes overtly hostile to everyone.The patient is demonstrating

A) regression.
B) loss of autonomy.
C) ineffective coping.
D) hope.

Accepted Answer

Body image disturbances arise when disruption exists in the way individuals perceive their bodies.Self-esteem refers to how well one's behavior correlates with a sense of the ideal self and is most closely linked to one's sense of self-worth.Patients who have a pervasive sense that they can do nothing to change or control their circumstances are at risk for feeling powerless.

Question 8

A patient is in the critical care unit having undergone surgery a week ago for multiple fractures to the his right and left legs secondary to a fall from a rooftop.The patient refuses to participate in morning care activities such as brushing his own teeth or washing his face and hands.The patient yells at the nurse, "You do it! Can't you see that my legs are broken?" The patient is exhibiting a disturbance in

A) self-concept.
B) self-esteem.
C) body image.
D) personal identity.

Accepted Answer

Illness and trauma can rob the person of perspective and shrinks both the familiar world and the one of possibility, often leading to low self-esteem and feelings of powerlessness, helplessness, and depression.A low self-regard impairs one's ability to adapt.The person may refuse to participate in self-care, exhibit self-destructive behavior, or be too compliant.

Question 9

A patient with ineffective coping may manifest which of the following behaviors?&#10;A) Refusal to participate in care&#10;B) Feelings that his or her body has betrayed him or her&#10;C) Acceptance and ownership of problems&#10;D) Disruption in the perception of the body

Accepted Answer

Ineffective coping is defined as the impairment of a person's adaptive behaviors and problem-solving abilities when meeting life's demands and necessary roles.Manifestations of ineffective coping in critical illness include verbalization of an inability to cope, anxiety, and being unable to meet basic needs.The patient exhibits inappropriate use of defense mechanisms and has diminished problem-solving abilities.The patient may display apathy or destructive behavior toward self and others.

Question 10

According to the transactional theories on stress, what does a person do first when confronted by stress?&#10;A) Determines coping mechanisms to deal with the stress&#10;B) Determines the perceived degree of threat imposed&#10;C) Determines what the response will be to the stress&#10;D) Denies the stress exists

Accepted Answer

An alarm reaction is initiated by the hypothalamus, which, upon receiving sensory and chemical information regarding the presence of a stressor, signals the release of corticotrophin-releasing factor (CRF).During the resistance stage, the person's systems fight back, leading to adaptation and a return of normal functioning.If the stressors continue, exhaustion occurs, a stage in which reserves have been depleted.Reversal of stress exhaustion can be accomplished by restoration of one's reserves through the use of medications, nutrition, and other stress reduction measures.

Question 11

A subjective state in which an individual see extremely limited or not alternatives and is unable to mobilize energy on his or her behalf is known as?&#10;A) Hope&#10;B) Hopelessness&#10;C) Powerlessness&#10;D) Loss of Control

Accepted Answer

The answer of A subjective state in which an individual...

Question 12

Regression as a coping mechanism for critical care patients&#10;A) is necessary to some degree to allow staff to administer care.&#10;B) indicates deterioration of the physical state.&#10;C) is adaptive when the patient calls the nurse every 15 minutes, even for trivial matters.&#10;D) is best avoided to ensure successful recovery.

Accepted Answer

The answer of Regression as a coping mechanism for critical...

Question 13

Which of the following reactions to stress resulting from a failure of a person's will, strength, endurance, and courage?&#10;A) Disturbed self-esteem&#10;B) Regression&#10;C) Hopelessness&#10;D) PTSD

Accepted Answer

The answer of Which of the following reactions to stress...

Question 14

Which of the following concepts supports patients and helps them endure the physical and psychological insults of their critical illness?&#10;A) Regression&#10;B) Denial&#10;C) Hope&#10;D) Trust

Accepted Answer

The answer of Which of the following concepts supports patients...

Question 15

Which of the following techniques may be used to enhance coping?&#10;A) Encouraging the patient to let the staff have total control of the patient's care&#10;B) Encouraging denial of the illness&#10;C) Letting the patient know everything will be all right&#10;D) Fostering trust in the health care team

Accepted Answer

The answer of Which of the following techniques may be...

Question 16

_____ occurs when the critical illness is so severe that the patient or family becomes overwhelmed.&#10;A) Anxiety&#10;B) Spiritual distress&#10;C) Stress overload&#10;D) Hopelessness

Accepted Answer

The answer of _____ occurs when the critical illness is...

Question 17

A patient is admitted to the CCU complaining of pain from a femur fracture and is anxious and agitated.The patient is receiving steroids and theophylline for exacerbation of asthma.The nurse should assess the patient for

A) anxiety.
B) low self-esteem.
C) regression.
D) suicidal ideations.

Accepted Answer

The answer of A patient is admitted to the CCU...

Question 18

An adult patient sustains third- and fourth-degree burns to more than 70% of her body related to a house fire.The patient begins a pattern of behavior similar to that of a young child, in which she repeatedly whines and throws "temper tantrums" in an attempt to keep her nurse at the bedside.The patient's coping mechanism is consistent with

A) regression.
B) identity disturbance.
C) denial.
D) trust.

Accepted Answer

The answer of An adult patient sustains third- and fourth-degree...

Question 19

A patient has been admitted to the critical care unit with a severed spinal cord injury at the T2 level.The patient has been in halo traction with immobilization for the past week.The physician explains to the patient that the spinal cord has been severed and that the patient will not be able to walk again.The patient becomes overtly hostile to everyone.The patient is demonstrating

A) regression.
B) loss of autonomy.
C) ineffective coping.
D) hope.

Accepted Answer

The answer of A patient has been admitted to the...

Question 20

A patient has been admitted to the critical care unit with a severed spinal cord injury at the T2 level.The patient has been in halo traction with immobilization for the past week.The patient states, "I can't wait until I can get on my feet and walk again." Which defense mechanism is present in this statement?

A) Denial
B) PTSD
C) Regression
D) Trust

Accepted Answer

The answer of A patient has been admitted to the...

Question 21

A nurse can demonstrate caring and support to a patient through demonstration or expression of&#10;A) superior clinical skills.&#10;B) uncertainty with prognosis.&#10;C) empathy and physical contact.&#10;D) prioritizing care.

Accepted Answer

The answer of A nurse can demonstrate caring and support...

Question 22

Because the nature of the environment, _____ is a serious concern in the critical care environment.&#10;A) family involvement&#10;B) use of complementary therapies&#10;C) sleep deprivation&#10;D) calm environment

Accepted Answer

The answer of Because the nature of the environment, _____...

Question 23

Identify actions that a critical care nurse can take to decrease stressors at work.&#10;A) Request temporary assignments in a less stressful setting.&#10;B) Use self-reflection when feeling overwhelmed.&#10;C) Maintain good physical health.&#10;D) Ignore feelings of frustration and anger.&#10;E) Use stress management techniques.

Accepted Answer

The answer of Identify actions that a critical care nurse...

Question 24

Psychologic and spiritual interventions have the power to engage a patient's&#10;A) hope.&#10;B) fear.&#10;C) will to survive.&#10;D) energy.&#10;E) ability to meet life's challenges.

Accepted Answer

The answer of Psychologic and spiritual interventions have the power...

Question 25

A patient tells his family, &#34;I don't know why I was placed on this earth just to suffer from cancer all my life.I just want to die.&#34; The nurse realizes the patient&#10;A) has lost control of the situation.&#10;B) is expressing spiritual despair.&#10;C) is becoming anxious with the situation.&#10;D) will become withdrawn from his or her care.

Accepted Answer

The answer of A patient tells his family, &#34;I don't...

Deck 4: Psychosocial and Spiritual Alterations and Management