Question 1

A person who feels unattractive repeatedly says,"Although I'm not beautiful,I am smart." This is an example of:

Accepted Answer

Compensation is an unconscious process that allows an individual to make up for deficits in one area by excelling in another area to raise self-esteem.Repression unconsciously puts an idea,event,or feeling out of awareness.Identification is an unconscious mechanism calling for an imitation of the mannerisms or behaviors of another.Devaluation occurs when the individual attributes negative qualities to self or to others.

Question 2

A nurse wishes to teach alternative coping strategies to a patient who is experiencing severe anxiety.The nurse will first need to:

Accepted Answer

A patient experiencing severe anxiety has a significantly narrowed perceptual field and difficulty attending to events in the environment.A patient experiencing severe anxiety will not learn readily.Determining preferred modes of learning,devising outcomes,and constructing teaching plans are relevant to the task but are not the priority measure.The nurse has already assessed the patient's anxiety level.Using defense mechanisms does not apply.

Question 3

A person who is speaking about a rival for a significant other's affection says in a gushy,syrupy voice,"What a lovely person.That's someone I simply adore." The individual is demonstrating:

Accepted Answer

Reaction formation is an unconscious mechanism that keeps unacceptable feelings out of awareness by using the opposite behavior.Instead of expressing hatred for the other person,the individual gives praise.Denial operates unconsciously to allow an anxiety-producing idea,feeling,or situation to be ignored.Projection involves unconsciously disowning an unacceptable idea,feeling,or behavior by attributing it to another.Repression involves unconsciously placing an idea,feeling,or event out of awareness.

Question 4

Which assessment question would be most appropriate to ask a patient who has possible generalized anxiety disorder?

Accepted Answer

Patients with generalized anxiety disorder frequently engage in excessive worrying.They are less likely to engage in ritualistic behavior,fear social situations,or have been involved in a highly traumatic event.

Question 5

A patient who is preparing for surgery has moderate anxiety and is unable to understand preoperative information.Which nursing intervention is appropriate?

Accepted Answer

Providing information in a calm,simple manner helps the patient grasp the important facts.Introducing extraneous topics as described in the remaining options will further scatter the patient's attention.

Question 6

A patient with a mass in the left upper lobe of the lung 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 a tremulous voice,respirations at 28 breaths per minute,and a pulse rate at 110 beats per minute.What is the patient's level of anxiety?

Accepted Answer

Moderate anxiety causes the individual to grasp less information and reduces his or her problem-solving ability to a less-than-optimal level.Mild anxiety heightens attention and enhances problem-solving abilities.Severe anxiety causes great reduction in the perceptual field.Panic-level anxiety results in disorganized behavior.

Question 7

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?

Accepted Answer

Projection is the hallmark of blaming,scapegoating,thinking prejudicially,and stigmatizing others.Conversion involves the unconscious transformation of anxiety into a physical symptom.Introjection involves intense,unconscious identification with another person.Splitting is the inability to integrate the positive and negative qualities of oneself or others into a cohesive image.

Question 8

A patient in the emergency department exhibits disorganized behavior and incoherence after a friend suggested a homosexual encounter.In which room should the nurse place the patient?

Accepted Answer

Individuals who are experiencing a severe-to-panic level of anxiety require a safe environment that is quiet,nonstimulating,structured,and simple.A room with a desk and two chairs provides simplicity,few objects with which the patient could cause self-harm,and a small floor space around which the patient can move.A small,empty storage room without windows or furniture would be like a jail cell.The nurse's office or a room with an examining table and instrument cabinets may be overstimulating and unsafe.

Question 9

A nurse encourages an anxious patient to talk about feelings and concerns.What is the rationale for this intervention?

Accepted Answer

All principles listed are valid,but the only rationale directly related to the intervention of assisting the patient to talk about feelings and concerns is the one that states that concerns spoken aloud become less overwhelming and help problem solving to begin.

Question 10

A patient approaches the nurse and impatiently blurts out,"You've got to help me! Something terrible is happening.My heart is pounding." The nurse responds,"It's almost time for visiting hours.Let's get your hair combed." Which approach has the nurse used?

Accepted Answer

The nurse has closed off patient-centered communication.The introduction of an irrelevant topic makes the nurse feel better.The nurse is uncomfortable dealing with the patient's severe anxiety.

Question 11

A patient who is experiencing moderate anxiety says,"I feel undone." An appropriate response for the nurse would be:

Accepted Answer

Increased anxiety results in scattered thoughts and an inability to articulate clearly.Clarification helps the patient identify his or her thoughts and feelings.Asking the patient why he or she feels anxious is nontherapeutic,and the patient will not likely have an answer.The patient may be unable to determine what he or she would like the nurse to do to help.Telling the patient to get his or her feelings under control is a directive the patient is probably unable to accomplish.

Question 12

A patient experiences an episode of severe anxiety.Of these medications in the patient's medical record,which is most appropriate to administer as an as-needed (prn)anxiolytic medication?

Accepted Answer

Lorazepam is a benzodiazepine medication used to treat anxiety;it may be administered as needed.Buspirone is long acting and not useful as an as-needed drug.Amitriptyline and desipramine are tricyclic antidepressants and considered second- or third-line agents.

Question 13

A patient with a high level of motor activity runs from chair to chair and cries,"They're coming! They're coming!" The patient is unable to follow staff direction or respond to verbal interventions.Which nursing diagnosis has the highest priority?

Accepted Answer

A patient who is experiencing panic-level anxiety is at high risk for injury,related to an increase in non-goal-directed motor activity,distorted perceptions,and disordered thoughts.Existing data do not support the nursing diagnoses of Self-care deficit or Disturbed energy field.This patient has disturbed thought processes,but the risk for injury has a higher priority.

Question 14

A person has minor physical injuries after an automobile accident.The person is unable to focus and says,"I feel like something awful is going to happen." This person has nausea,dizziness,tachycardia,and hyperventilation.What is this person's level of anxiety?

Accepted Answer

The person whose anxiety is severe is unable to solve problems and may have a poor grasp of what is happening in the environment.Somatic symptoms such as those described are usually present.The individual with mild anxiety is only mildly uncomfortable and may even find his or her performance enhanced.The individual with moderate anxiety grasps less information about a situation and has some difficulty with problem solving.The individual in a panic level of anxiety demonstrates significantly disturbed behavior and may lose touch with reality.

Question 15

A supervisor assigns a worker a new project.The worker initially agrees but feels resentful.The next day when asked about the project,the worker says,"I've been working on other things." When asked 4 hours later,the worker says,"Someone else was using the copier,so I couldn't finish it." The worker's behavior demonstrates:

Accepted Answer

A passive-aggressive person deals with emotional conflict by indirectly expressing aggression toward others.Compliance on the surface masks covert resistance.Resistance is expressed through procrastination,inefficiency,and stubbornness in response to assigned tasks.

Question 16

A patient is undergoing diagnostic tests.The patient says,"Nothing is wrong with me except a stubborn chest cold." The spouse reports that the patient smokes,coughs daily,has lost 15 pounds,and is easily fatigued.Which defense mechanism is the patient using?

Accepted Answer

Denial is an unconscious blocking of threatening or painful information or feelings.Regression involves using behaviors appropriate at an earlier stage of psychosexual development.Displacement shifts feelings to a more neutral person or object.Projection attributes one's own unacceptable thoughts or feelings to another.

Question 17

An individual experiences sexual dysfunction and blames it on a partner by calling the person unattractive and unromantic.Which defense mechanism is evident?

Accepted Answer

Rationalization involves unconsciously making excuses for one's behavior,inadequacies,or feelings.Regression involves the unconscious use of a behavior from an earlier stage of emotional development.Compensation involves making up for deficits in one area by excelling in another area.Introjection is an unconscious,intense identification with another person.

Question 18

A patient tells a nurse,"My new friend is the most perfect person one could imagine-kind,considerate,and good looking.I can't find a single flaw." This patient is demonstrating:

Accepted Answer

Idealization is an unconscious process that occurs when an individual attributes exaggerated positive qualities to another.Denial is an unconscious process that calls for the nurse to ignore the existence of the situation.Projection operates unconsciously and results in blaming behavior.Compensation results in the nurse unconsciously attempting to make up for a perceived weakness by emphasizing a strong point.

Question 19

Two staff nurses applied for promotion to nurse manager.The nurse not promoted initially had feelings of loss but then became supportive of the new manager by helping make the transition smooth and encouraging others.Which term best describes the nurse's response?

Accepted Answer

Altruism is the mechanism by which an individual deals with emotional conflict by meeting the needs of others and vicariously receiving gratification from the responses of others.The nurse's reaction is conscious,not unconscious.No evidence of aggression is exhibited,and no evidence of conscious denial of the situation exists.Passive aggression occurs when an individual deals with emotional conflict by indirectly and unassertively expressing aggression toward others.

Question 20

A patient with a high level of motor activity runs from chair to chair and cries,"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:

Accepted Answer

Safety is of highest priority;the patient who is experiencing panic is at high risk for self-injury related to an increase in non-goal-directed motor activity,distorted perceptions,and disordered thoughts.The goal should be to decrease the environmental stimuli.Respecting the patient's personal space is a lower priority than safety.The clarification of feelings cannot take place until the level of anxiety is lowered.

Quiz 11: Anxiety, anxiety Disorders, and Obsessive-Compulsive Disorders