Deck 24: Dissociative Disorders

Question 1

A client with the diagnosis of depersonalization disorder notices that he experiences periods of depersonalization when confronted with certain stressors.When developing the care plan,the nurse is aware that one of the most helpful activities in self-control for this client is for the client to:

A)Contact a treatment team member to discuss his thoughts and feelings every time he is confronted with a stressor
B)Keep a daily journal of his thoughts and feelings,paying special attention to thoughts and feelings during stressful times
C)Recall periods of stressful times in his life during his clinic visit
D)Join an exercise program that will help to decrease his stress level

Answer 1

Keep a daily journal of his thoughts and feelings,paying special attention to thoughts and feelings during stressful times

Question 2

A female client with a diagnosis of a dissociative disorder who attends group meetings at a community mental health clinic often voices that her boss at work frequently complains that she is working at a level below her capabilities.The client also states that she feels that she "never gets anything done." Which nursing diagnosis best addresses these issues?

A)Self-esteem,low
B)Social isolation
C)Body-image,disturbed
D)Memory,impaired

Answer 2

Self-esteem,low

Question 3

A "spell" is a culturally defined mental health disorder or a dissociative "state" seen in African Americans,Europeans,and Americans from southern U.S.cultures.This "state" is characterized by:

A)Sudden collapsing with eyes open and inability to see,while still hearing and understanding,without being able to move
B)Seizure activity and coma for up to 12 hours preceded by extreme excitement or irrational behavior
C)A state in which spirit possession interferes with daily activities
D)Communication with deceased relatives or spirits that occurs during a trancelike state

Answer 3

Communication with deceased relatives or spirits that occurs during a trancelike state

Question 4

A client with a dissociative disorder has the nursing diagnosis of disturbed body image.Which nursing interventions would address the nursing priority of determining the coping abilities and skills of this client? (Select all that apply. )

A)Assess the client's current level of adaptation
B)Help the client differentiate between isolation and loneliness
C)Note the use of addictive substances
D)Identify previously used coping strategies and their effectiveness

Question 5

When developing the nursing care plan for a client with dissociative identity disorder (DID),the nurse knows that one of the major goals of therapy is to assist the client in:

A)Naming all personalities for clarification
B)Integrating the personalities into one functional personality
C)Realizing when different personalities are about to emerge
D)Learning how to move from one personality to another

Question 6

The nurse witnesses different personalities emerging in the client with dissociative identity disorder (DID).The primary personality is referred to as the:

A)Host
B)Alter
C)Ego
D)Identity

Question 7

Which dissociative disorder is a result of a disturbance of identity?

A)Dissociative amnesia
B)Dissociative identity disorder
C)Dissociative fugue
D)Obsessive-compulsive disorder

Question 8

During assessment of a client with a dissociative disorder,the nurse notices that the client has been cutting herself on both arms.After talking with the client,the nurse,along with other members of the treatment team,decides that the best intervention at this time to prevent further self-destructive behavior would be:

A)Establishing a signed contract with the client to tell a team member when she is having self-destructive thoughts
B)Isolating the client from all other clients and activities until she is no longer having self-destructive thoughts
C)Administering medications that will reduce the client's anxiety levels
D)Involving the client in activities as a diversion from self-destructive thoughts

Question 9

The father of a 6-month-old and a 3-year-old discovers that his wife,who is the mother of the children,has abandoned the family and moved to another state.During this developmental stage,this abandonment will have the strongest negative effect on the children's:

A)Motor skills
B)Self-concept
C)Body image
D)Cognitive skills

Question 10

A family adopts a 7-year-old boy from an international adoption agency with little information on the child's history.They bring the child to a therapist because the child is withdrawn,destroys things in the house,and hits his adoptive siblings without provocation.As the therapist develops a trusting relationship with the child,what type of intervention would be initially used to gain input from the child?

A)Psychoeducation
B)Art therapy
C)Joint stabilization plan
D)Development of coping strategies

Question 11

The father of a 6-month-old and a 3-year-old discovers that his wife,who is the mother of the children,has abandoned the family and moved to another state.During this developmental stage,this abandonment will have the strongest negative effect on the children's:

A)Motor skills
B)Self-concept
C)Body image
D)Cognitive skills

Question 12

The 15-year-old son of a single,full-time working mother frequently is left at home alone to care for himself.According to Erikson's theory,the nurse is aware that this adolescent most likely would have difficulty in developing a comfortable:

A)Body image
B)Self-ideal
C)Self-concept
D)Role performance

Question 13

The hospice nurse notices that,following the death of his wife of 50 years,a surviving husband's affect is anxious,and he reports a feeling of detachment from his body,stating,"I feel like I am seeing myself from outside of my body." The caregiver knows that this client is displaying the characteristics of the dissociative disorder of:

A)Dissociative fugue
B)Dissociative amnesia
C)Dissociative identity disorder
D)Depersonalization disorder

Question 14

During a home visit,the client tells the nurse that she feels that her medication is no longer helping her dissociative diagnosis of depersonalization disorder because she has noticed that she is not thinking clearly,is having difficulty with her memory and judgment,and is often disoriented to the time.The nurse knows that the doctor must be contacted and that this client most likely will be:

A)Admitted to a long-term care agency because she is a threat to herself
B)Admitted to a state-psychiatric facility for an extended period for intense therapy
C)Referred to a group home setting for better supervision
D)Admitted to the hospital for evaluation and possible adjustment of her medications

Question 15

The care provider is aware that in addition to assessment,one of the first goals of therapy for the client with a dissociative disorder is:

A)Revisiting of past traumas
B)Pharmacological therapy
C)Stabilization
D)Family therapy

Question 16

Those who care for individuals with dissociative disorders must be aware that they often will try to __________ the staff members who are caring for them.

A)Manipulate
B)Harm
C)Date
D)Persecute

Question 17

The wife of a 70-year-old man is concerned that her husband refuses to participate in any activities with her since his retirement two years ago.He is often short tempered and sees any type of hobby as a "waste of time." Which intervention or activity would help him enhance his feelings of self-worth?

A)Begin taking antidepressant medication
B)Move with his wife to an assisted living community
C)Get involved in a retired businessmen's group providing assistance to new companies
D)Taking up a less strenuous activity to decrease stress and information overload

Question 18

Which of the following is considered a primary nursing diagnosis for a client with a dissociative disorder?

A)Self-esteem,low
B)Personal identity,disturbed
C)Role performance,ineffective
D)Anxiety

Question 19

What is the first nursing priority in a client with the nursing diagnosis of "Personal identity,disturbed"?

A)Promote wellness
B)Assist the client to manage any threatening feelings
C)Assess causative and/or contributing factors
D)Determine which medications will work most effectively

Question 20

A woman has had several episodes where she finds new clothes in her closet that are much more colorful than the style she usually buys.Today,a co-worker approached her to thank her for hosting a dinner party that she had no recollection of hosting.What is the most appropriate nursing diagnosis for this client?

A)Self-esteem,low
B)Personal identity,disturbed
C)Body image,disturbed
D)Anxiety

Question 21

A male client with a dissociative disorder copes with his low self-esteem by displaying behaviors associated with an exaggerated sense of self-importance.Which behaviors would this client most likely exhibit? (Select all that apply. )

A)Bragging about special abilities
B)Setting unrealistic goals
C)Having unrealistic dreams
D)Having a view of life that everything is either right or wrong

Question 22

Dissociative fugue is identified by which characteristics? (Select all that apply. )

A)Presence of two or more distinct personalities
B)Sudden travel with inability to recall the past
C)Behave normally during travel but confused by own identity
D)May assume a new life

Question 23

A person's self-concept,or how a person sees himself or herself,comprises which of the following? (Select all that apply. )

A)Body image
B)Self-esteem
C)Identity diffusion
D)Self-ideal
E)Personal identity

Question 24

Of the four types of dissociative disorders identified by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR),the disorder that formerly was called "multiple personality disorder" now is called __________.

Question 25

When a person is unable to bring his various childhood identifications into one effective adult personality,the individual is said to have identity _______________.