1After interacting with the partner of a client who has terminal cancer, the nurse anticipates that the client is experiencing denial. Which statement made by the caregiver supports the nurse’s conclusion?
- “My partner is blaming God for his condition.”
- “My partner wants to transfer to another hospital for a second opinion, even though it is obvious from his symptoms and diagnostic reports.”
- “My partner is not showing any interest in his favorite games and movies.”
- “My partner says he wants to spend as much time as possible with his family.”
2A client is retreating to an earlier level of development in response to stress. Which ego defense mechanism does the nurse suspect in this client?
- isolation
- projection
- regression
- displacement
3Which physiological activity occurs at the initial stage of stress during the “fight-or-flight” syndrome?
- Bronchioles constrict
- Decreased glycogenolysis
- Decreased respiration rate
- Bladder muscle constriction
4While communicating with a client, the nurse finds that the client is unable to remember anything about her sexual assault when she was 15 years old. Which ego defense mechanism does the nurse suspect in this client?
- isolation
- repression
- introjection
- suppression
5A client tells the nurse, “I drink because it’s the only way I can deal with my bad marriage and my worse job.” What does the nurse understand from the client’s statement?
- The client is showing a sublimation type of ego defense mechanism.
- The client is showing a repression type of ego defense mechanism.
- The client is showing the undoing type of ego defense mechanism.
- The client is showing the rationalization type of ego defense mechanism.
6Which emotional symptoms help the nurse to identify that a client is experiencing severe anxiety? Select all that apply.
- feeling of dread
- feeling of horror
- feeling of confusion
- feeling of being poisoned
- feeling of being plotted against
7A client who is depressed about a pending divorce proceeding tells the nurse, “I just don’t want to talk about the divorce. There’s nothing I can do about it anyway.” Which ego defense mechanism does the nurse suspect in this client?
- undoing
- repression
- sublimation
- suppression
8The nurse is teaching a group of student nurses about learning abilities in clients with different levels of anxiety. Which statement made by a student nurse indicates effective teaching?
- “Learning is enhanced in a client with mild anxiety levels.”
- “Learning still occurs in a client with panic anxiety levels.”
- "Effective learning cannot occur in a client with moderate anxiety levels.”
- “Learning cannot occur in a client with mild anxiety levels.”
9Which biological responses occur at the sustained response stage of stress during the “fight-or-flight” response? Select all that apply.
- decreased fluid retention
- decreased immune response
- decreased retention of sodium
- decreased inflammatory response
- decreased basal metabolic rate (BMR)
10Which response by the student indicates effective learning regarding the physiological response occurring during the initial stage of stress during “fight-or-flight” syndrome?
- “I can expect the patient’s heart rate to decrease to 53 during fight-or-flight syndrome."
- “During fight-or-flight syndrome, my patient may have a blood pressure of 92/54.”
- “When my patient is under stress, they will experience an increase in glycogenesis during fight-or-flight syndrome.”
- “My patient will have a decrease in gastric acid secretions during the stress experienced in fight-or-flight syndrome.”
11A client claims to be the messenger of God, drapes himself in a blanket, “performs miracles” on other clients, and integrates the beliefs and values of Jesus Christ into his own ego structure. Which type of ego defense mechanism would the nurse suspect in this client?
- introjection
- projection
- regression
- repression
12The nurse is teaching a group of student nurses about disorders in which the characteristic symptoms are manifested as physical symptoms. Which disorders should the nurse include in the teaching plan? Select all that apply.
- panic disorder
- factitious disorder
- conversion disorder
- seperation anxiety disorder
- dissociative identity disorder
13While caring for a client with anxiety, the nurse finds that the client is unable to comprehend even simple directions. On further evaluation, the nurse finds hyperactive nature and bizarre behavior in the client. Which type of anxiety does the nurse suspect in this client?
14Which hormone plays an important role in maintaining the basmetabolic rate?
- vasopressin
- growth hormone
- thyrotropic hormone
- adrenocorticotropic hormone
15What are the coping mechanisms adopted by a client to relieve mild anxiety? Select all that apply.
- sleeping
- isolation
- laughing
- projection
- supression
16Which biological response occurs at the initial stage of stress during “fight-or-flight” syndrome?
- lipogenesis
- constriction of pupils
- increased in intestinal motility
- contration of the bladder muscles
17To find relief from anxiety, a client tells the nurse, “Sorry, I did not take my medication today; my mother did not remind me to take it.” Which defense mechanism does the nurse suspect from the client’s statement?
- denial
- projection
- introjection
- rationalization
18Place the stages of Selye’s general adaptation syndrome in order.
a. Stage of exhaustion
b. Stage of resistance
c. Alarm reaction stage
1. c
2. b
3. a
19The nurse develops a plan of care for a client experiencing grief. Which intervention should the nurse include to assist the client in adaptation to the normal mourning process?
- Assess the patient to ensure safety and identify maladaptive behaviors
- Reuse a previous care plan used for a recent client, since all individuals experience grief in the same manner
- Provide mental health education to the client, as grief is considered a mental illness
- Respect the client’s privacy by allowing alone time to deal with grief.
20The registered nurse is teaching student nurses the various stages of general adaptation syndrome. Which statement by the registered nurse can be categorized under the alarm reaction stage?
- “The physiological responses of the ‘fight-or-flight’ syndrome are initiated.”
- “The individual attempts to adapt to the stressor.”
- "The body adjusts to the stressor due to prolonged exposure.”
- “Disease may occur due to adaptation to the stressor."
21Following a recent mastectomy, the female client states “I am upset that I feel less feminine than before the mastectomy.” Which statement by the nurse best explains the client’s experience and needs?
- “Any situation that creates change for an individual can be identified as a loss.”
- “This response is a form of a mental illness that requires medication.”
- “The client’s sense of loss is unique and is considered maladaptive.”
- “Since this is a normal grief response, the client does not require monitoring for increased risk of suicide
22The nurse provides care for a client who experiences decreased attention span and decreased ability to concentrate along with restlessness and increased muscular tension. Based on the current data, which stage of Peplau’s levels of anxiety does the nurse document?
23The nurse provides care for a client who is experiencing grief. Which client statement indicates a need for intervention by the nurse? Select all t
- “I am already so sad about my husband’s death, and I just don’t want to live without him.”
- “I just feel so helpless about my son’s broken arm.”
- “Sometimes my partner and I cry about my current diagnosis, but we try to support each other every day.”
- “Sometimes I feel so guilty that I was unhurt in the auto accident, and the other person was injured."
- “I am so frustrated that we cannot find a medication or treatment that helps manage my child’s chronic condition.”
24Which characteristic does the healthy or self-actualized individual exhibit, according to Maslow?
- creativeness
- encultration
- a degree of conformance
- desire for campanionship
25A client tells the nurse, “My family members hate me.” On further communication with the client, the nurse finds that the client shows no emotion while talking about their family; instead, the client tries to provide a rationale for their family members’ feelings. Which ego defense mechanism does the nurse suspect in this client?
- denial
- rationalization
- Intellectualization
- reaction formation
26Which psychotic response may the nurse observe in a client during the panic anxiety stage?
- obsessions
- compulsions
- schizophrenia
- hpochondriasis
27The nurse provides emergency care for a client who sustained injuries in a fire accident. The client reports palpitations and a headache. Based on this data, which stage of anxiety should the nurse include in the client’s plan of care?
28The nurse provides care for a client who experiences decreased attention span and decreased ability to concentrate along with restlessness and increased muscular tension. Based on the current data, which stage of Peplau’s levels of anxiety does the nurse document?
29Which physical characteristics may be noticed in a client with severe anxiety? Select all that apply.
- palpitations
- headaches
- diaphoresis
- insomnia
- inability to verbalize
30A client with mild anxiety tells the nurse, “I am disabled and unable to participate in sports. However, I am a great scholar.” Which ego defense mechanism does the nurse suspect in this client?
- compensation
- isolation
- identification
- intellectualization
31The nurse provides care to a client who was involved in an automobile accident in which the other passengers did not survive. The client is unable to remember anything about the traumatic event. Based on this data, which ego defense mechanism does the nurse include in the client’s plan of care?
- denial
- reaction formation
- displacement
- repression
32The nurse provides care for a client who is diagnosed with alcohol use disorder and blames the spouse for the excessive drinking. Which ego defense mechanism should the nurse include in the client’s plan of care?
- projection
- undoing
- introjection
- sublimation
33Which stage of anxiety is associated with incoherent speech and ineffective communication?
34The nurse anticipates that a client is showing the displacement type of ego defense mechanism. Which statement made by the client’s caregiver supports the nurse’s assumption?
- “My friend breaks things when he’s angry.”
- "My friend imitates the dressing style of his favorite athlete.”
- "My friend sleeps for a long period of time when experiencing stress.”
- “My friend ignores me and refuses to speak when I ask about an unpleasant memory.”
35Which symptoms are commonly observed in a client with psychosis? Select all that apply
- delusions
- obsessions
- hallucinations
- hypochondriasis
- disorganized speech
36A client tells the nurse, “My family members hate me.” On further communication with the client, the nurse finds that the client shows no emotion while talking about their family; instead, the client tries to provide a rationale for their family members’ feelings. Which ego defense mechanism does the nurse suspect in this client?
- denial
- rationalization
- intellectualization
- reaction formation
37A nurse is caring for a group of patients. Which patient would demonstrate a psychoneurotic response to severe anxiety?
- A patient with delusional disorder
- A patient with conversion disorder
- A patient with schizophrenic disorder
- A patient with schizoaffective disorder
38Which characteristic behavior does the nurse notice in a client with psychosis?
- minimal distress
- persistent contact with reality
- awareness of psychological problems
- awareness that their behavior is maladaptive
39A client’s partner complains to the nurse, “My husband continues to smoke even though he knows of the dangers to his health.” Which ego defense mechanism does the nurse suspect in the client?
- denial
- displacement
- rationalization
- introjection
40
Which are common responses that can be observed in a client with general adaptation syndrome? Select all that apply.
- alarm
- resistance
- exhaustion
- reflex pain response
- inflammatory response
41Which characteristics would the nurse expect to find in a patient with neurosis? Select all that apply.
- They feel helpless to change their situation
- They experience loss of contact with reality
- They are aware they are experiencing distress
- They are aware that their behaviors are maladaptive
- They are aware of possible psychological causes of the distress
42A client attempts to increase her self-worth by acquiring certain characteristics of an individual whom she admires. Which type of ego defense mechanism does the nurse suspect in this client?
- identification
- intellectualization
- suppression
- sublimation
43Which client statement indicates an appropriate understanding of grief response? Select all that apply.
- "When I feel anger, I’m experiencing an adaptive response to grief.”
- "Grief is considered a mental illness and should be treated with medication.”
- "Adaptive responses to grief may increase my risk of suicide.”
- “If I experience an adaptive grief response, I may experience an eating disorder.”
- “Saying that I feel hopeless indicates a normal response to grief.”
44The nurse is assessing coping mechanisms in the client who is experiencing stress. Which question does the nurse ask the client during the assessment? Select all that apply.
- “Do you feel stress-free after talking?”
- “Do you feel stress-free after pacing?”
- “Do you feel stress-free after smoking?”
- “Do you feel stress-free after cooking?”
- “Do you feel stress-free after reading?”