Deck 13: Psychosocial Health Illness

Question 1

A 13-year-old patient is admitted to the hospital.There is no medical restriction on visitation.To help maintain the patient's social identity while hospitalized,it is most important for the nurse to encourage visits by:

A) Peers
B) Grandparents
C) Siblings
D) Parents

Answer 1

Peers

Question 2

A 17-year-old patient sustained facial fractures and a 6-inch laceration on the left side of her face in a motor vehicle accident.The patient tells the nurse that she does not want anyone to see her "looking this way." Which statement by the nurse is most appropriate?

A) "Tell me what you mean by 'looking this way.'"
B) "Okay, I'll restrict your visitors until your face heals."
C) "Your friends and family love you no matter what."
D) "You're young; your face will heal quickly."

Answer 2

"Tell me what you mean by 'looking this way.'"

Question 3

Which of the following explanations by the nurse would be the best description of personal identity?

A) A continually evolving sense of individuality and uniqueness
B) The same as demographic data
C) A person's genetic and cultural heritage
D) Individual information guarded to avoid identity theft

Answer 3

A continually evolving sense of individuality and uniqueness

Question 4

Which statement best describes self-esteem?

A) View of oneself as a unique human being
B) One's mental image of one's physical self
C) One's overall view of oneself
D) How well one likes oneself

Question 5

A 35-year-old patient diagnosed with testicular cancer is undergoing chemotherapy,which leaves him unable to help care for his young children.As a result,his wife misses work whenever the children are ill.She has become increasingly distressed over her situation.Her experience best demonstrates which of the following?

A) Role strain
B) Interpersonal role conflict
C) Role performance
D) Interrole conflict

Question 6

The nurse is updating a care plan for a patient who has a nursing diagnosis of Anxiety.Which patient behavior might suggest that the problem is resolving?

A) Pacing in the hallway at intervals
B) Using relaxation techniques
C) Speaking rapidly when spoken to
D) Avoiding eye contact

Question 7

A patient undergoing fertility treatments for the past 9 months learns that despite in vitro fertilization she still is not pregnant.This patient is at risk for experiencing a crisis in which component of self-concept?

A) Body image
B) Self-esteem
C) Personal identity
D) Role performance

Question 8

Which outcome is most realistic and appropriate in planning care for any newly diagnosed client with anxiety?

A) Plans coping strategies for anxious situations
B) Discusses the reasons for episodes with significant others
C) Establishes two new social relationships
D) Verbalizes that he is episode free

Question 9

The nurse is assessing a patient admitted with a newly diagnosed bleeding duodenal ulcer.He is exhibiting physiological signs of anxiety and seems to have difficulty concentrating.During the interview,the patient tells the nurse that he is often "short of breath" and says,"I lie awake nights worrying about everything." He has been unable to work or care for his family for the past 6 months.What is the nurse's priority after documenting this information in the nurses' notes?

A) Provide emotional support for the patient using reflective listening technique.
B) Do nothing; people with duodenal ulcers typically cannot work.
C) Question the patient's family about the information received from the patient.
D) Notify the primary care provider and ask for a referral to a mental health professional.

Question 10

Which of the following is considered a strength of the nursing profession?

A) Biomedical focus
B) Psychosocial focus
C) Biopsychosocial focus
D) Physical focus

Question 11

A patient comes to the emergency department complaining of headache,palpitations,nausea,and dizziness.After determining that the patient is anxious,the nurse notes tachycardia and trembling.Which level of anxiety is this patient exhibiting?

A) Mild
B) Moderate
C) Severe
D) Panic

Question 12

A patient who lost his job last month has now been told that his wife wants a divorce.He says,"I know I don't have much to offer a woman.She wants more than what I am,and now I'm not even bringing home any money." Which nursing diagnosis is most appropriate?

A) Chronic Low Self-Esteem
B) Situational Low Self-Esteem
C) Disturbed Personal Identity
D) Disturbed Body Image

Question 13

The nursing diagnosis Disturbed Personal Identity is identified for a newly admitted patient.Which of the following is an example of an individualized goal for that patient?

A) Distorted Thought Control
B) Anxiety Level
C) Self-Mutilation Restraint
D) No Self-Injury, Consistently Demonstrated

Question 14

The nurse is updating the care plan of a patient who must undergo a right mastectomy for breast cancer.Which nursing diagnosis should the nurse anticipate in expectation of the body changes associated with the upcoming surgery?

A) Deficient Knowledge
B) Impaired Adjustment
C) Hopelessness
D) Grieving

Question 15

A female client tells the nurse,"I see how people look at me with my crooked back and short leg.No one has to tell me that I'm not pretty." The nurse realizes this client is exhibiting:

A) An overinflated sense of self-esteem
B) A well-developed self-concept
C) An overactive imagination
D) A low self-concept

Question 16

Which statement by the nurse is best when communicating with a patient with clinical depression?

A) "It's a beautiful day today; you'll feel better if you look out the window."
B) "You're having a bad day; I'm sure you'll feel better soon."
C) "Life seems overwhelming at times; would you like to discuss how you're feeling?"
D) "You are very lucky to have such a supportive family."

Question 17

The nurse is caring for a patient with cancer who has been receiving chemotherapy.Based on Maslow's Hierarchy of Needs,which nursing intervention is your first priority?

A) Assess for and treat pain.
B) Determine whether the patient is hungry or thirsty.
C) Explore feelings about dying.
D) Observe client's self-care abilities.

Question 18

A patient admitted with depression has a nursing diagnosis of Chronic Low Self-Esteem.Which NOC outcome is essential for this nursing diagnosis?

A) Decision Making
B) Distorted Thought Content
C) Role Performance
D) Depression Level

Question 19

Which response by the patient demonstrates an internal locus of control?

A) "My blood sugar wouldn't be out of control if my wife prepared better foods."
B) "I knew I shouldn't have come to this hospital; I'd be better if I hadn't."
C) "God must be getting even with me for my past behavior."
D) "I'm just glad to be alive; the accident could've been a lot worse."

Question 20

The nurse is developing a plan of care for a mother of three small children who has been admitted with a serious acute illness,which is likely to continue long term.The nurse writes the following intervention: "Facilitate communication between patient and significant other regarding the sharing of responsibilities to accommodate changes brought on by illness." The purpose of this intervention is to help:

A) Promote self-esteem
B) Promote positive body image
C) Facilitate role enhancement
D) Prevent depersonalization

Question 21

The nurse is seeing a home-care client with a history of mental illness.The client has just been discharged from the hospital after undergoing a mastectomy for breast cancer.As the nurse begins to perform a dressing change over the left breast area,the client states,"Every time I have a nurse come here,they do this dressing differently.I can't seem to have a nurse that does it right." What is the best response by the nurse?

A) "I don't know how other nurses do your dressing change, but I will do it correctly."
B) "I have done this type of dressing many times, so you don't need to worry."
C) "How would you like this dressing change done? Tell me how you do it."
D) "It seems you have some concerns with our agency. You may need to talk to the supervisor."

Question 22

The nurse is caring for a patient with a history of depression and hypertension.The patient states,"Sometimes I just don't believe in using all the medications the doctor orders for me,so I use a lot of over-the-counter herbal medications." What is the most appropriate response by the nurse?

A) "Yes, there are many good herbal therapies, but you'll want to let your doctor know about these therapies in addition to the medications he has ordered for you."
B) "Some over-the-counter medications work very well for depression; however, you cannot take them without your doctor's permission."
C) "You shouldn't be treating yourself, as you don't know how these medications work with your depression."
D) "I think it's a great idea! If they make you feel better, then continue doing what you're doing."

Question 23

The nurse is assessing a patient for depression.Which of the following sets of behavioral symptoms may indicate depression?

A) Preoccupation with loss, self-blame, and ambivalence
B) Anger, helplessness, guilt, and sadness
C) Anorexia, insomnia, headache, and constipation
D) Tearfulness, withdrawal, and present substance abuse

Question 24

A 45-year-old man with a history of anxiety comes into the emergency department and is diagnosed with a myocardial infarction (MI).He says to the nurse,"This is the most ridiculous thing I've ever heard of.I eat well,exercise,and am too young to have a heart attack." The nurse recognizes that this man is most likely experiencing:

A) Fear related to the diagnosis
B) Anxiety related to the diagnosis
C) Ineffective denial
D) Overreaction

Question 25

The nurse is caring for several patients on a medical-surgical unit.To which patient statement is the nurse most alerted for making a mental health referral?

A) "Since finding out I have cancer, I feel nervous and uneasy all the time."
B) "Sometimes I feel very down about my job, but if I get to the gym and do some exercising, I feel better."
C) "When things really bother me, I just put them right out of my head and go on."
D) "Things at home are just piling up. I just feel so alone and empty inside of me."

Question 26

A frail,elderly patient admitted with dehydration to a medical-surgical unit is exhibiting confusion,distractibility,memory loss,and irritability.What is most important for the nurse to do?

A) Recognize these symptoms as signs of normal, physiologic aging.
B) Obtain a urine specimen before notifying the primary care provider.
C) Be sure she is placed in a room occupied with another patient.
D) Interview the patient to screen for clinical depression.

Question 27

The nurse caring for a patient admitted with severe depression identifies a nursing diagnosis of Hopelessness on the care plan.Which outcome is appropriate for this diagnosis?

A) Displays stabilization and control of mood
B) Sleeps 6 to 8 hours per night with report of feeling rested
C) Does not engage in risky, self-injurious behavior
D) Eats a well-balanced diet to prevent weight change

Question 28

The school nurse at the elementary school is preparing a presentation for parents on promoting self-esteem in children.What are some self-esteem promotion strategies she will teach at the presentation? Select all that apply.

A) Treat children with respect.
B) Be firm and consistent in applying rules.
C) Do not allow children to make decisions independently.
D) Provide frequent positive and negative criticism.

Question 29

A client presents in the clinic and tells the nurse,"I was taking my blood pressure medications and watching my diet,but that didn't help my blood pressure.So now I have stopped the medication and will just eat whatever I want." What is the most appropriate nursing diagnosis for this client?

A) Anxiety
B) Risk for Hopelessness
C) Ineffective health maintenance
D) Depression

Question 30

Which assessment finding(s)might suggest that the patient has low self-esteem and requires more in-depth assessment? Select all that apply.

A) Infrequent eye contact
B) Straight posture
C) Overly critical of others
D) Careful grooming

Question 31

The nurse is developing a plan of care for a client with anxiety.What are appropriate nursing interventions the nurse can use for assisting the client in reducing anxiety? Select all that apply.

A) Assist the client to identify triggers and situations that create anxiety.
B) Be vague in answering questions because you can't know how the client will react.
C) Develop coping strategies and behavior modification techniques with the client.
D) Remind the patient that he must not engage in any negative thinking.

Question 32

What are the best communication strategies that a nurse can use to encourage patients to share personal and sensitive information? Select all that apply.

A) Be aware of your own biases and personal opinions with regard to the patient's information.
B) Use very specific yes and no questions during the interview to keep the patient focused and attentive.
C) Start an interview by asking very broad questions and then proceed to more specific questions.
D) Avoid any questions related to cultural and gender-specific details about the person of family members.

Question 33

Which nursing intervention specifically helps reduce a patient's anxiety?

A) Teaching the importance of adequate nutrition and hydration
B) Giving clear facts pertaining to the patient's circumstances
C) Promoting small-group activities to improve self-esteem
D) Monitoring the patient for the risk of suicide

Question 34

A client is admitted to the psychiatric unit of a local hospital.During the nursing assessment,the nurse finds the client is poorly groomed,wearing dirty clothes,tearful,and reports weight loss with poor appetite.The nurse formulates a nursing diagnosis of Depressed Mood.What are the most appropriate nursing outcomes for this client? Select all that apply.

A) Eats a well-balanced diet
B) Depressed mood resolves by discharge
C) Bathes, washes, and maintains grooming and hygiene
D) Develops a spiritual belief system or engages in a religious affiliation

Question 35

An elderly patient admitted from a skilled nursing residence to a medical-surgical unit is exhibiting confusion,distractibility,memory loss,and irritability.She has a medical diagnosis of Dehydration.Which of the following should lead the nurse to suspect that dementia,rather than depression or dehydration,is the source of the symptoms?

A) Rambles, speaks incoherently, answers questions inappropriately
B) Speaks slowly with delayed response to questions, but responds appropriately
C) Awakens early in the day yet sleeps almost constantly during the day
D) Sometimes has difficulty concentrating on details of the present situation

Question 36

The nurse on a psychiatric unit is caring for a client with severe depression.The client states,"I just cannot go on.It is hopeless for me and there is no end in sight.My family would be better off without me burdening them." The nurse recognizes that this client is most at risk for:

A) Ineffective coping
B) Denial
C) Impaired recovery
D) Suicide

Question 37

An adult patient is diagnosed with lung cancer,and surgery to remove the right lung is recommended.The patient is uncertain about whether he should consent to the surgery because of the risks involved.Which nursing diagnosis is most appropriate for this patient?

A) Decisional Conflict
B) Death Anxiety
C) Powerlessness
D) Ineffective Denial

Question 38

Which intervention(s)by the nurse might help the patient maintain a sense of personhood during hospitalization? Assume that all are culturally appropriate.Select all that apply.

A) Addressing the patient by his first name
B) Making eye contact if it is comfortable for the patient
C) Always offering an explanation before beginning a procedure
D) Speaking to others about the patient so that the patient can hear you

Question 39

There are many theories and treatments for depression.Based on current research,which of the following is considered to be the most effective treatment for serious depression?

A) Psychotherapy
B) Antidepressant medications
C) Education
D) Social support networks