When the nurse detects that a client is using defense mechan
When the nurse detects that a client is using defense mechanisms,… When the nurse detects that a client is using defense mechanisms, the nurse should make which of these interpretations of the client’s behavior? 1. The client is attempting to reestablish emotional equilibrium. 2. The client is using self-defeating measures. 3. The client is demonstrating illness. 4. The client is asking for support from significant others. 2. To master his anxiety, the client must first: 1. Recognize that he is feeling anxious. 2. Identify the situations that precipitated his anxiety. 3. Understand the basis for his anxiety. 4. Select a strategy to cope with his anxiety. 3. A client says to the nurse, “I have something to tell you because I know you can keep a secret,” To respond to his statement, the nurse should make which of these remarks? 1. “It’s nice that you trust me to keep a secret.” 2. “I would like to hear your secret.” 3. “I cannot promise that I can keep your secret.” 4. “A secret is not a secret when it is repeated.” 4. Two nurses are discussing plans for their client group. What should be in the plan to promote group cohesiveness? 1. Make it clear to the group which clients are behaving in appropriate ways. 2. Seat the most talkative members close to the nurses. 3. Make group members aware of the decisions the nurses have made in advance of the group meeting. 4. Help the group identify group goals that are consistent with the individual members goals. 5. A young woman who is extremely fearful of dogs is being seen in clinic. Another client enters the waiting area with a service dog. The young woman begins to hyperventilate and starts screaming loudly. What is the best initial action for the nurse when caring for the frightened young woman? 1. Firmly insist that she sit quietly in the waiting area with the other clients. 2. Explain to her that the dog is a service dog and well trained and will not harm her. 3. Take her into an empty room and stay with her for a few minutes. 4. Reschedule her appointment and send her home. 6. A severely anxious client is admitted to the psychiatric unit. She experiences an anxiety attack immediately after her admission to the psychiatric unit. Which of the following actions would be most helpful to reduce anxiety at this time? 1. Encourage the client to talk about the anxiety. 2. Show the client the exercise room so she can express the anxiety physically. 3. Orient her to the unit and introduce her to a one or two of the other clients. 4. Take her to the room so she can be alone and get her bearings. 7. A client who is admitted with panic attacks begins to talk to the other clients and appears more relaxed. Which of the following behaviors would best indicate that she is improving? 1. She refuses to take her prescribed anti anxiety medication, saying she doesn’t need it anymore. 2. She requests that she be discharged. 3. She asks to see her husband and her parents. 4. She begins to participate in unit activities with the other clients. 8. The staff is concerned about a client who refuses to attend group therapy sessions at 9:00 a.m. because he says he has to wash his hands for at least 45 minutes from 9:00 a.m. to 9:45 a.m. At the team meeting, staff members discuss the problem. They feel it is important for the client to participate in group therapy sessions to learn more successful methods of interaction with others. Which concept does the staff need to keep in mind in planning nursing interventions for this client? 1. Fears and tensions are often expressed in disguised form through symbolic processes. 2. Unmet needs are discharged through ritualistic behavior. 3. Ritualistic behavior makes others uncomfortable. 4. Depression underlies ritualistic behavior. 9. Which nursing action would help to reduce stress and to aid an obsessive-compulsive client in using less maladaptive means of handling stress? 1. Provide varied activities on the unit, as change in routine can break a ritualistic pattern. 2. Give him unit assignments that do not require perfection. 3. Tell him of changes in routine at the last minute to avoid buildup of anxiety. 4. Provide an activity in which positive accomplishment can occur so he can gain recognition. 10. Which of the following is an example of limit setting as an effective nursing intervention in ritualistic behavior patterns? 1. “I don’t want you to wash your hands so often anymore.” 2. “If you continue to wash your hands so often, the skin on your hands will break down.” 3. “You may wash your hands before the group therapy meeting if you wish, but not during group therapy.” 4. “You will be punished if you wash your hands more than six times a day.” 11. Repetitive hand washing is probably an attempt by the client to: 1. Punish himself for guilt feelings. 2. Control unacceptable impulses or feelings. 3. Do what the voices tell him to do. 4. Seek attention from the staff. 12. A 34-year-old woman is admitted to the psychiatric unit of the hospital after extensive diagnostic tests established no physical basis for her persistent complaints of headache, fatigue, and difficulty in swallowing. During the first interview with the client, which of these assessments would be needed immediately to plan her nursing care 1. What is her level of anxiety? 2. When did she begin having these symptoms? 3. Does she have significant others? 4. What does she say to herself when under stress? 13. Each time an adult client is scheduled for a therapy session she develops a severe headache and nausea. The nurse best understands the client’s behavior as which of the following? 1. Conversion. 2. Reaction formation. 3. Projection. 4. Suppression. 14. A client with severe anxiety manifested by many somatic complaints starts psychotherapy. She becomes increasingly anxious, and her physical symptoms intensify. The nurse should make which of these interpretations of her observations? 1. The client needs to be involved in modifying the goals of therapy. 2. The client may be developing a physical illness unrelated to her emotional problems. 3. The client is responding to therapy as expected at this time. 4. The client is probably beginning to have insight into her behavior. 15. A young man was diagnosed with a conversion reaction. He was brought to the hospital blind after having seen his 3-day-old son breastfed. Which of the following is the best interpretation of this behavior? 1. “I don’t like this infant.”2. “I do not want my wife to have such close contact with the child.”3. “I don’t want to see this act of nursing.”4. “I wish I had never had a son.” 16. An adult who is admitted for elective surgery says to the nurse, “I hope I don’t die during the surgery. Does anyone ever die during this type of surgery?” How should the nurse reply initially? 1. “Don’t be worried, you will do well.” 2. “I have never seen anyone die during this kind of surgery.” 3. “You sound concerned about your surgery.” 4. “Why do you think you are going to die?” 17. An adult male is hospitalized for a bleeding ulcer. As is wife is leaving the intensive care unit, she says to the nurse, “Do you know what you are doing? He is bleeding so much.” What is the best initial response by the nurse? 1. “I am very well qualified to work in the ICU.” 2. “Why do you ask about my qualifications?” 3. “Everyone here is very well qualified to work you.” 4. “It must be scary to see your husband in here.” 18. The nurse is talking with a mother to assess her child. A positive response to whichwould indicate the child is in the oral stage of psychosexual development as described by Freud?”Does your child put everything in his mouth?””Does your child say ‘no’ to everything you say?””Does he seem jealous when you show affection to his father?””Does he vacillate from wanting to be treated like a child and wanting to be treated like an adult.” 19. An adult male walks in to the mental health center and says, “Help me. I can’t go on any longer.” After seating the client in a private room what should the nurse do next? 1. Determine what insurance the client has. 2. Talk with the client to find out more about what is happening. 3. Call the client’s family to come and take him home. 4. Reassure the client that someone will help him. 20. An adult male is admitted to the emergency department with substernal chest pain, elevated enzymes and an abnormal ECG. The doctor explains to him that he is probably having a heart attack and needs to be admitted immediately. The client responds by loudly proclaiming “It can’t be a heart attack. I’ve never had heart problems. I’m too healthy. The doctor has to be wrong.” The nurse understands the client is using which of these defense mechanisms? 1. Regression. 2. Suppression. 3. Rationalization. 4. Denial. Health Science Science Nursing MED SURG 200
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