Deck 6: Psychosocial and Spiritual Alterations and Management

Question 1

A patient with low self-esteem may manifest which of the following behaviors?

A) Refusal to participate in care
B) Feelings that his or her body has betrayed him or her
C) Acceptance and ownership of problems
D) Disruption in the perception of the body

Answer 1

Refusal to participate in care

Question 2

Prolonged periods of anxious waiting,disrupted sleep patterns,witnessing emergency interventions,and financial concerns could put family members at risk for developing

A) powerlessness.
B) hopelessness.
C) anxiety.
D) PTSD.

Answer 2

PTSD.

Question 3

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

Answer 3

Denial

Question 4

Commonly used medications for withdrawal symptoms include

A) chlordiazepoxide and folic acid.
B) chlordiazepoxide and lorazepam.
C) lorazepam and promethazine.
D) promethazine and thiamine.

Question 5

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.

Question 6

According to the transactional theories on stress,what does a person do first when confronted by stress?

A) Determines coping mechanisms to deal with the stress
B) Determines the perceived degree of threat imposed
C) Determines what the response will be to the stress
D) Denies the stress exists

Question 7

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.

Question 8

Anxiety can cause emotional changes in the

A) hypothalamus.
B) limbic system.
C) cerebral cortex.
D) pituitary gland.

Question 9

Patients with an external locus of control

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

Question 10

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 continually tries to get out of bed and states,"My legs are only sleeping." Which of the following nursing diagnoses would be appropriate for the patient?

A) Disturbed body image
B) Powerlessness
C) Situational low self-esteem
D) Ineffective role performance

Question 11

Which of the following techniques may be used to enhance coping?

A) Encouraging the patient to let the staff have total control of the patient's care
B) Encouraging denial of the illness
C) Letting the patient know everything will be all right
D) Fostering trust in the health care team

Question 12

An intervention for a patient with learned helplessness is to

A) maintain control of the environment.
B) set limits on the behavior.
C) maintain a routine schedule so that the patient can anticipate activities.
D) prepare the patient for transfer to the medical floor.

Question 13

_____ occurs when the critical illness is so severe that the patient or family becomes overwhelmed.

A) Anxiety
B) Spiritual distress
C) Stress overload
D) Hopelessness

Question 14

A patient has recently been weaned off mechanical ventilation after 3 weeks of treatment.The patient is now refusing to have the ventilator removed from the room.What type of alteration is the patient experiencing?

A) Disturbed self-esteem
B) Regression
C) Hopelessness
D) Disturbed body image

Question 15

Interventions to help family members who are extremely upset include

A) encouraging the family to visit as much as possible.
B) conveying what the patient is experiencing to the family.
C) supporting the family members away from the bedside.
D) assuring the family that the staff will take care of the technical aspects of the patient's care.

Question 16

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.

Question 17

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

A) limiting interaction with the patient due to antisocial behaviors exhibited by the suicidal attempt.
B) ignoring the patient's need to talk about the incident.
C) validating the patient's worth and self-esteem.
D) discontinuing any psychotropic medications.

Question 18

Regression as a coping mechanism for critical care patients

A) is necessary to some degree to allow staff to administer care.
B) indicates deterioration of the physical state.
C) is adaptive when the patient calls the nurse every 15 minutes, even for trivial matters.
D) is best avoided to ensure successful recovery.

Question 19

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.

Question 20

Which of the following concepts supports patients and helps them endure the physical and psychological insults of their critical illness?

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

Question 21

A patient tells his family,"I don't know why I was placed on this earth just to suffer from cancer all my life.I just want to die." The nurse realizes the patient

A) has lost control of the situation.
B) is expressing spiritual despair.
C) is becoming anxious with the situation.
D) will become withdrawn from his or her care.

Question 22

Identify actions that a critical care nurse can take to decrease stressors at work.

A) Request temporary assignments in a less stressful setting.
B) Use self-reflection when feeling overwhelmed.
C) Maintain good physical health.
D) Ignore feelings of frustration and anger.
E) Use stress management techniques.

Question 23

Psychologic and spiritual interventions have the power to engage a patient's

A) hope.
B) fear.
C) will to survive.
D) energy.
E) ability to meet life's challenges.

Question 24

Because of the nature of the environment,_____ is a serious concern in the critical care environment.

A) family involvement
B) use of complementary therapies
C) sleep deprivation
D) calm environment

Question 25

A nurse can demonstrate caring and support to a patient through demonstration or expression of

A) superior clinical skills.
B) uncertainty with prognosis.
C) empathy and physical contact.
D) prioritizing care.