Deck 27: Anxiety-Related, Obsessive-Compulsive, Trauma- and Stressor-Related, Somatic, and Dissociative Disorders

Question 1

A patient diagnosed with obsessive-compulsive disorder ( OCD ) experiences improvement after beginning treatment with a selective serotonin reuptake inhibitor ( SSRI ). This phenomenon supports the theory that OCD is associated with:

A) norepinephrine deficiency.
B) serotonin dysregulation.
C) dopamine excess.
D) GABA deficiency.

Answer 1

serotonin dysregulation.

Question 2

A priority focus of milieu management for a patient diagnosed with dissociative identity disorder ( DID ) should be:

A) ensuring safety.
B) stimulating memory return.
C) insight-oriented group therapy.
D) gathering data about family relationships.

Answer 2

ensuring safety.

Question 3

A patient diagnosed with OCD paces up and down the corridor counting every tile. Select the nurse's best action.

A) Offer to play cards with the patient in the dayroom.
B) Ask the patient, "Why are you pacing and counting?"
C) Take the patient's arm and escort the patient to a quiet area.
D) Permit the patient to pace and count until feeling more comfortable.

Answer 3

Permit the patient to pace and count until feeling more comfortable.

Question 4

A patient with panic attacks awakens from sleep complaining of chest pain. The patient is diaphoretic and breathlessly says, "I feel like I'm going to die." Select the nurse's priority action.

A) Have the patient lie flat and relax.
B) Bring the crash cart to the patient's room.
C) Shake the patient and shout, "Are you okay?"
D) Instruct the patient to breathe into a paper bag.

Question 5

When working with a patient diagnosed with dissociative amnesia, the nurse should begin by:

A) setting mutual goals for behavioral changes.
B) instituting measures to prevent identity diffusion.
C) identifying and supporting the patient's strengths.
D) helping the patient develop a realistic self-concept.

Question 6

What is the nurse's initial action when working with a patient with PTSD?

A) Develop trust.
B) Promote problem solving.
C) Encourage verbalization of anger.
D) Have the patient evaluate past behaviors.

Question 7

Which statement by an individual with PTSD best indicates that treatment was effective?

A) "I'm drinking less now that I've faced my problems."
B) "I feel like the accident happened to someone else."
C) "I sleep for 3 to 4 hours a night without nightmares."
D) "My artwork distracts me and eases my anxiety."

Question 8

After a mass transit disaster many injured patients are expected at the emergency room. The nurse expects victims to have which assessment findings?

A) Dissociative symptoms, numbing, detachment, and derealization
B) Auditory hallucinations and other perceptual distortions
C) Physical symptoms that mimic neurologic disorders
D) Exaggerated mood (either depression or elation)

Question 9

Which intervention should the nurse use first when caring for a patient experiencing anxiety?

A) Assist the patient to problem solve.
B) Provide support and understanding.
C) Reorient the patient.
D) Provide privacy.

Question 10

Which symptom would the nurse expect in a patient diagnosed with dissociative fugue?

A) Worry about having a serious disease
B) A feeling of detachment from one's body
C) Belief that part of the body is ugly or disproportionate
D) Travel away from home and assumption of a new identity

Question 11

A patient is hospitalized with blindness of sudden onset. According to the spouse, the patient entered a room and found the spouse in a romantic embrace with a neighbor. The patient is unconcerned about the blindness and says, "I'm sure things will turn out all right." Which term best describes this reaction?

A) La belle indifference
B) Agoraphobia
C) Dissociation
D) Fugue

Question 12

The nurse would expect which comment from a patient diagnosed with depersonalization disorder?

A) "I feel like I'm outside my body, watching what's happening."
B) "I feel as though someone is reading thoughts in my mind."
C) "I know I have cancer, but the doctors can't find it."
D) "When I woke up, my legs were paralyzed."

Question 13

The effects of stress can be seen by measurement of clinical changes of the body. This statement is a tenet of which theorist?

A) Freud
B) Selye
C) Peplau
D) Sullivan

Question 14

Which statement by a patient diagnosed with somatic symptom disorder indicates that goals for treatment are being achieved?

A) "I need to be very careful about what I eat."
B) "I can focus on things other than my symptoms."
C) "I understand that my doctor is not an expert in everything."
D) "I try to figure out my diagnosis by reading articles on the Internet."

Question 15

Select the most important assessment question to ask a patient suspected of having a dissociative disorder.

A) "Do any members of your family have problems with drugs or alcohol?"
B) "Do you ever find yourself in places with no idea how you got there?"
C) "How would you describe your current level of anxiety?"
D) "How do you think we can be of help to you?"

Question 16

A driver was trapped in a car for several hours after an earthquake caused a bridge to collapse. A year later this person still has nightmares and reexperiences feelings of fear associated with being trapped in the car. The assessment findings are consistent with symptoms of:

A) agoraphobia.
B) panic attacks.
C) generalized anxiety disorder.
D) posttraumatic stress disorder ( PTSD ).

Question 17

Which principle best applies to care of a patient diagnosed with conversion disorder?

A) Structure care to provide time for rituals.
B) Facilitate progressive review of the trauma.
C) Give attention to the patient, not the symptom.
D) Permit dependence while the symptoms are acute.

Question 18

A patient's family member died in the 9/11 World Trade Center explosion. The patient says, "I can't go into tall buildings because I get sweaty, my heart races, and I can't breathe. I get terrifying feelings the building will explode." These symptoms suggest which diagnosis?

A) OCD
B) Generalized anxiety disorder
C) Acute stress disorder
D) Specific phobia

Question 19

Which term describes the final stage in the normal process of anxiety?

A) Panic
B) Crisis
C) Disorganization
D) Coping

Question 20

A patient says, "I have the same continuous and intrusive thoughts that my house is contaminated with lethal bacteria. I spend hours cleaning the walls, floors, and furniture." These symptoms are most consistent with which diagnosis?

A) Social phobia
B) Panic disorder
C) Somatoform disorder
D) OCD

Question 21

A patient diagnosed with PTSD has frequent flashbacks and persistent hyperarousal symptoms. Which nursing interventions should be planned? Select all that apply.

A) Offer empathy and support.
B) Encourage relaxation activities.
C) Encourage verbalization of anger.
D) Set limits when the patient begins to tell of the story of the traumatic incident.
E) Help the patient associate current feelings and behaviors with trauma experience.

Question 22

The nurse is assigned to care for a patient with moderate anxiety (+2). The most effective nursing intervention will be:

A) use of time-out.
B) initiation of problem solving.
C) providing firm guidance and control.
D) administering a parenteral antianxiety drug.

Question 23

A patient is demonstrating severe (+3) anxiety. Nursing interventions will center around:

A) encouraging ventilation and refocusing attention.
B) discussing possible sources of anxiety.
C) taking control to guide the patient.
D) decreasing stimuli and pressure.

Question 24

If a patient's threshold set point for anxiety is lowered, the nurse can expect subsequent stressors to:

A) have a lesser effect.
B) easily reactivate the anxiety response.
C) produce marked personality disorganization.
D) be easily managed using familiar coping strategies.

Question 25

An anxious patient has distorted perceptions and ineffective reasoning. On an anxiety rating scale, the nurse would expect to record the patient's level of anxiety as:

A) mild, +1.
B) moderate, +2.
C) severe, +3.
D) panic, +4.

Question 26

A nurse is assigned to care for a patient diagnosed with moderate (+2) anxiety. Which assessment findings are most likely?

A) Distorted perceptions, disorientation, and defensiveness.
B) Poor concentration, narrow perceptions, and irritability.
C) Irrational reasoning and loss of contact with reality.
D) Alertness, attentiveness, and accurate perceptions.