Question 1

A patient experiencing panic suddenly began running and shouting, "I'm going to explode!" Select the nurse's best action.

Accepted Answer

A)  Ask, "I'm not sure what you mean. Give me an example." 
B)  Capture the patient in a basket-hold to increase feelings of control. 
C)  Tell the patient, "Stop running and take a deep breath. I will help you." 
D)  Assemble several staff members and say, "We will take you to seclusion to help you regain control."

Question 2

Two staff nurses applied for a charge nurse position. After the promotion was announced, the nurse who was not promoted said, "The nurse manager had a headache the day I was interviewed." Which defence mechanism is evident?

Accepted Answer

A)  Introjection 
B)  Conversion 
C)  Projection 
D)  Splitting

Question 3

A nurse assesses a patient suspected of having somatic symptom disorder. Which assessment findings regarding this patient support the suspected diagnosis?

Accepted Answer

A)  Female 
B)  Reports frequent syncope 
C)  Rates pain as "1" on a scale of "10" 
D)  First diagnosed with psoriasis at age 12 
E)  Reports insomnia often results from back pain

Question 4

A person speaking about a rival for a significant other's affection says in an emotional, syrupy voice, "What a lovely person. That's someone I simply adore." The individual is demonstrating which of the following?

Accepted Answer

A)  Reaction formation 
B)  Repression 
C)  Projection 
D)  Denial

Question 5

Which assessment questions would be most appropriate for the nurse to ask a patient with possible obsessive-compulsive disorder?

Accepted Answer

A)  "Are there certain social situations that cause you to feel especially uncomfortable?" 
B)  "Are there others in your family who must do things in a certain way to feel comfortable?" 
C)  "Have you been a victim of a crime or seen someone badly injured or killed?" 
D)  "Is it difficult to keep certain thoughts out of your awareness?" 
E)  "Do you do certain things over and over again?"

Question 6

A patient with an abdominal mass is scheduled for a biopsy. The patient has difficulty understanding the nurse's comments and asks, "What do you mean? What are they going to do?" Assessment findings include tremulous voice, respirations 28, and pulse 110. What is the patient's level of anxiety?

Accepted Answer

A)  Mild 
B)  Moderate 
C)  Severe 
D)  Panic

Question 7

Which assessment data would help the health care team distinguish symptoms of conversion (functional neurological) disorder from symptoms of illness anxiety disorder (hypochondriasis)?

Accepted Answer

A)  Voluntary control of symptoms 
B)  Patient's style of presentation 
C)  Results of diagnostic testing 
D)  The role of secondary gains

Question 8

A patient fearfully runs from chair to chair, crying, "They're coming! They're coming!" The patient does not follow the staff's directions or respond to verbal interventions. The initial nursing intervention of highest priority is to do which of the following?

Accepted Answer

A)  Provide for the patient's safety 
B)  Encourage clarification of feelings 
C)  Respect the patient's personal space 
D)  Offer an outlet for the patient's energy

Question 9

A patient diagnosed with a somatic symptom disorder says, "My pain is from an undiagnosed injury. I can't take care of myself. I need pain medicine six or seven times a day. I feel like a baby because my family has to help me so much." It is important for the nurse to assess which of the following?

Accepted Answer

A)  Mood 
B)  Cognitive style 
C)  Secondary gains 
D)  Identity and memory

Question 10

What is an essential difference between somatic symptom disorders and factitious disorders?

Accepted Answer

A)  Somatic symptom disorders are under voluntary control, whereas factitious disorders are unconscious and automatic. 
B)  Factitious disorders are precipitated by psychological factors, whereas somatic symptom disorders are related to stress. 
C)  Factitious disorders are individually determined and related to childhood sexual abuse, whereas somatic symptom disorders are culture bound. 
D)  Factitious disorders are under voluntary control, whereas somatic symptom disorders involve expression of psychological stress through somatization.

Question 11

A patient preparing for surgery has moderate anxiety and is unable to understand preoperative information. Which nursing intervention is most appropriate?

Accepted Answer

A)  Reassure the patient that all nurses are skilled in providing postoperative care. 
B)  Present the information again in a calm manner using simple language. 
C)  Tell the patient that staff is prepared to promote recovery. 
D)  Encourage the patient to express feelings to family.

Question 12

A child was placed in a foster home after being removed from abusive parents. The child is apprehensive and overreacts to environmental stimuli. The foster parents ask the nurse how to help the child. Which interventions should the nurse suggest?

Accepted Answer

A)  Use a calm manner and low voice. 
B)  Maintain simplicity in the environment. 
C)  Avoid repetition in what is said to the child. 
D)  Minimize opportunities for exercise and play. 
E)  Explain and reinforce reality to avoid distortions.

Question 13

A patient has blindness related to conversion (functional neurological) disorder, but is unconcerned about this problem. Which understanding should guide the nurse's planning for this patient?

Accepted Answer

A)  The patient is suppressing accurate feelings regarding the problem. 
B)  The patient's anxiety is relieved through the physical symptom. 
C)  The patient's optic nerve transmission has been impaired. 
D)  The patient will not disclose genuine fears.

Question 14

A patient fearfully runs from chair to chair, crying, "They're coming! They're coming!" The patient does not follow the staff's directions or respond to verbal interventions. Which nursing diagnosis has the highest priority?

Accepted Answer

A)  Fear 
B)  Risk for injury 
C)  Self-care deficit 
D)  Disturbed thought processes

Question 15

A patient who experienced a myocardial infarction was transferred from critical care to a step-down unit. The patient then used the call bell every 15 minutes for minor requests and complaints. Staff nurses reported feeling inadequate and unable to satisfy the patient's needs. When the nurse manager intervenes directly with this patient, which comment would be most therapeutic?

Accepted Answer

A)  "I'm wondering if you're feeling anxious about your illness and being left alone." 
B)  "The staff are concerned that you are not satisfied with the care you are receiving." 
C)  "Let's talk about why you use your call bell so frequently. It is a problem." 
D)  "You frustrate the staff by calling them so often. Why are you doing that?"

Question 16

A patient with blindness related to conversion (functional neurological) disorder says, "All the doctors and nurses in the hospital stop by often to check on me. Too bad people outside the hospital don't find me as interesting." Which nursing diagnosis is most relevant?

Accepted Answer

A)  Social isolation 
B)  Chronic low self-esteem 
C)  Interrupted family processes 
D)  Ineffective health maintenance

Question 17

A patient diagnosed with a factitious disorder says, "Why has God chosen me to be sick all the time and unable to provide for my family? The burden on my family is worse than the pain I bear." Which nursing diagnoses apply to this patient?

Accepted Answer

A)  Spiritual distress 
B)  Decisional conflict 
C)  Adult failure to thrive 
D)  Impaired social interaction 
E)  Ineffective role performance

Question 18

A patient with a somatic symptom disorder has the nursing diagnosis Interrupted family processes related to patient's disabling symptoms as evidenced by spouse and children assuming roles and tasks that previously belonged to the patient. An appropriate outcome is that the patient will do which of the following?

Accepted Answer

A)  Assume roles and functions of other family members 
B)  Demonstrate performance of former roles and tasks 
C)  Focus energy on problems occurring in the family 
D)  Rely on family members to meet personal needs

Question 19

A nurse assessing a patient diagnosed with a somatic symptom disorder is most likely to note which of the following?

Accepted Answer

A)  The patient sees a relationship between symptoms and interpersonal conflicts. 
B)  The patient has little difficulty communicating emotional needs to others. 
C)  The patient rarely derives personal benefit from the symptoms. 
D)  The patient has altered comfort and activity needs.

Exam 12: Anxiety and Related Disorders