1. John, a veteran of the war in Iraq, is diagnosed with PTSD. He says to the nurse, "I can't figure out why God took my buddy instead of me." From this statement, the nurse assesses which of the following in John?
a. Repressed anger
b. Survivor's guilt
c. Intrusive thoughts
d. Spiritual dist...
i cant figure out why god took my buddy instead of me fr
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NSG 314 Test 4 Questions
1. John, a veteran of the war in Iraq, is diagnosed with PTSD. He says to the nurse, "I
can't figure out why God took my buddy instead of me." From this statement, the nurse
assesses which of the following in John?
a. Repressed anger
b. Survivor's guilt
c. Intrusive thoughts
d. Spiritual distress - Answer b.
2. John, a veteran of the war in Iraq, is diagnosed with PTSD. He experiences a
nightmare during his first night in the hospital. He explains to the nurse that he was
dreaming about gunfire all around and people being killed. The nurse's most
appropriate initial intervention?
a. administer alpralozam
b. call the physician and report the incident
c. stay with John and reassure him of his safety
d. have John listen to a tape of relaxation techniques - Answer c
3. John, a veteran of the war in Iraq, is diagnosed with PTSD. Which of the following
therapy regimens would most appropriately be ordered for John?
a. Paroxetine and group therapy
b. Diazepam and implosion therapy
c. Alprazolam and behavior therapy
d. Carbamazepine and cognitive therapy - Answer a
4. Which of the following may be influential in the predisposition to PTSD?
a. unsatisfactory parent-child relationship
b. excess of the neurotransmitter serotonin
c. distorted, negative cognitions
d. severity of the stressor and availability of support systems - Answer d
5. Nina recently left her husband of 10 years. She was very dependent on her husband
and is having difficulty adjusting to an independent lifestyle. She has been hospitalized
with a diagnosis of Adjustment disorder with Depressed Mood. The priority nursing
diagnosis for Nina would be
a. risk-prone health behavior related to loss of dependency
b. complicated grieving related to breakup of marriage
c. ineffective coping related to problems with dependency
d. social isolation related to depressed mood - Answer b
,6. Nina, who is depressed following the breakup of a very stormy marriage, says to the
nurse, "I feel so bad. I thought I would feel better once I left, but I feel worse!" Which is
the best response by the nurse?
a. "Cheer up, Nina. You have a lot to be happy about."
b. "You are grieving for the marriage you did not have. It's natural for you to feel badly."
c. "Try not to dwell on how you feel. If you don't think about it, you'll feel better."
d. "You did the right thing, Nina. Knowing that should make you feel better." - Answer b
7. Nina has been hospitalized with Adjustment Disorder with Depressed Mood following
the breakup of her marriage. Which of the following is true regarding the diagnosis of an
adjustment disorder?
a. Nina will require long-term psychotherapy to achieve relief
b. Nina likely inherited a genetic tendency for the disorder
c. Nina's symptoms will likely remit once she has accepted the change in her life
d. Nina probably would not have experienced an adjustment disorder is she had a
higher level of intelligence - Answer c
8. The physician orders sertraline (Zoloft) for a client who is hospitalized with
adjustment disorder with depressed mood. This medication is intended to:
a. increase energy and elevate mood
b. stimulate the central nervous system
c. prevent psychotic symptoms
d. produce a calming effect - Answer a
9. The category of adjustment disorder with disturbance of conduct identifies the
individual who:
a. violates the rights of others to feel better
b. expresses symptoms that reveal a high level of anxiety
c. exhibits severe social isolation and withdrawal
d. is experiencing a complicated grieving process - Answer a
10. Carol, age 16, has recently been diagnosed with diabetes mellitus. She must watch
her diet and take an oral hypoglycemic medication daily. She has become very
depressed and her mother reports that Carol refuses to change her diet and often skips
her medication. Carol has been hospitalized for stabilization of her blood sugar. The
psychiatric nurse practitioner has been called in as a consult. Which of the following
nursing diagnoses by the psychiatric nurse would be a priority for Carol at this time?
a. Anxiety related to hospitalization, evidenced by noncompliance
b. Low self-esteem related to feeling different form her peers, evidenced by social
isolation
,c. Risk for suicide related to new diagnosis of diabetes Mellitus
d. Risk-prone health behavior related to denial of seriousness of her illness, evidenced
by refusal to follow diet and take mediation - Answer d
11. Jared returned from active duty in the military and has been diagnosed with PTSD.
Which of the following interventions has been strongly advocated for as an effective
strategy in this population?
1) Group therapy with patients who have a variety of diagnoses
2) Group therapy with patients who have anger management issues
3) Group therapy with patients who have experienced similar traumas
4) Group therapy with patients who have experienced different types of trauma - Answer
3) Group therapy with patients who have experienced similar traumas
This type of group therapy is strongly recommended so that veterans may be able to
share experiences with other veterans (and therefore similar traumatic events) to
decrease feelings of isolation.
11. Trauma-informed care is a philosophical approach that includes which of the
following principles? Select all that apply.
a. Nurses need to be aware of the potential for trauma in any client and provide care
that minimizes the risk of revictimization or retraumatization.
b. Medications need to be given before any other interventions are considered.
c. Trauma-informed care highlights the importance of providing care that protects the
physical, psychological, and emotional safety of the client.
d. Trauma-informed care is based on the principle than traumas are not correlated with
depression or increased risk for suicide. - Answer a. Nurses need to be aware of the
potential for trauma in any client and provide care that minimizes the risk of
revictimization or retraumatization.
c. Trauma-informed care highlights the importance of providing care that protects the
physical, psychological, and emotional safety of the client.
Lorraine has been diagnosed with Somatic Symptom Disorder. Which of the following
symptom profiles would you expect when assessing Lorraine?
A. Multiple somatic symptoms in several body systems
B. Fear of having a serious disease
C. Loss of alteration in sensorimotor functioning
D. Belief that her body is deformed or defective in some way - Answer A. Multiple
somatic symptoms in several body systems
Which of the following ego defense mechanisms describes the underlying
psychodynamics of somatic symptom disorder?
A. Denial of Depression
B. Repression of anxiety
C. Suppression of grief
D. Displacement of anger - Answer b
, Nursing care for client with somatic symptom disorder would focus on helping the client
to
A. Eliminate the stress in his or her life
B. Discontinue his or her numerous physical complaints
C. Take his or her medication only as prescribed
D. learn more adaptive coping strategies. - Answer d
Lorraine, a client diagnosed with Somatic Symptom Disorder, states, "My doctor thinks I
should see a psychiatrist. I can't imagine why he would make such a suggestion?" What
is the basis for Lorraine's statement?
A. She thinks her doctor want to get rid of her a client
B. She does not understand the correlation of symptoms and stress
C. She thinks psychiatrists are only for "crazy" people
D. She thinks her doctor has made an error in diagnosis - Answer b
Lorraine, a client diagnosed with Somatic Symptom disorder, tells the nurse about a
pain in her side. She says she has not experienced it before. which is the most
appropriate response by the nurse?
A. "I don't want to hear about another physical complaint. You know they are all in your
head. It's time for group therapy now."
B. "Let's sit down here together and you can tell about his new pain you are
experiencing. You'll just have to miss group therapy today."
C. I will report this pain to you physician. In the meantime, group therapy starts in 5
minutes. You must leave now to be on time."
D. "I will call you physician and see if he will order a new pain medication for your side.
The one you have now doesn't seem to provide relief. Why don't you get some rest for
now?" - Answer c
Ellen has a history of childhood physical and sexual abuse. She was diagnosed with
Dissociative Identity Disorder (DID) 6 years ago. She has been admitted to the
psychiatric unit following a suicide attempt. The primary nursing diagnosis for Ellen
would be:
A. disturbed personal identity related to childhood abuse
B. disturbed sensory perception related to repressed anxiety
C. impaired memory related to disturbed thought processes
D. risk for suicide related to unresolved grief - Answer d
In establishing trust with Ellen, a client with the diagnosis of DID, the nurse must
A. try to relate to Ellen as though she did not have multiple personalities
B. establish a relationship with each of the personalities separately
C. ignore behaviors that Ellen attributes to the subpersonality, Beth
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