ch 20-25 Flashcards
A client diagnosed with somatization disorder is most likely to exhibit which personality disorder characteristic?
A.
Experiences intense and chaotic relationships with fluctuating attitudes toward others.
B.
Socially irresponsible, exploitative, guiltless, and disregards rights of others.
C.
Self-dramatizing, attention seeking, overly gregarious, and seductive.
D.
Uncomfortable in social situations, perceived as timid, withdrawn, cold, and strange.
C
A nurse is working with a client diagnosed with somatization disorder. What criteria would differentiate this diagnosis from a somatoform pain disorder?
A.
The client diagnosed with somatization disorder experiences at least four pain symptoms in various body systems.
B.
The client diagnosed with somatization disorder experiences a change in the quality of self-awareness.
C.
The client diagnosed with somatization disorder has a perceived disturbance in body image or appearance.
D.
The client diagnosed with somatization disorder experiences severe and prolonged pain that’s etiology is psychological in nature.
A
Which would be considered an appropriate outcome when planning care for an inpatient client diagnosed with somatization disorder?
A.
The client will admit to fabricating physical symptoms to gain benefits by day 3.
B.
The client will list three potential adaptive coping strategies to deal with stress by day 2.
C.
The client will comply with medical treatments for physical symptoms by day 3.
D.
The client will openly discuss physical symptoms with staff by day 4.
B
Which are examples of primary and secondary gains that clients diagnosed with pain disorders may experience?
A.
Primary: chooses to seek a new doctor. Secondary: euphoric feeling from new medications.
B.
Primary: euphoric feeling from new medications. Secondary: chooses to seek a new doctor.
C.
Primary: receives get-well messages. Secondary: pain prevents attendance at family reunion.
D.
Primary: pain prevents attendance at family reunion. Secondary: receives get-well messages.
D
A nursing instructor is teaching about the etiology of hypochondriasis from a psychoanalytical perspective. What student statement about clients diagnosed with this disorder indicates that learning has occurred?
A.
“They express personal worthlessness through physical symptoms, because physical problems are more acceptable than psychological problems.”
B.
“When the sick role relieves them from stressful situations, their physical symptoms are reinforced.”
C.
“They misinterpret and cognitively distort their physical symptoms.”
D.
“They tend to have a familial predisposition to this disorder.”
A
An inpatient client is newly diagnosed with dissociative identity disorder (DID) stemming for severe childhood sexual abuse. Which nursing intervention takes priority?
A. Encourage exploration of sexual abuse. B. Encourage guided imagery. C. Establish trust and rapport. D. Administer antianxiety medications.
C
A client diagnosed with dissociative identity disorder (DID) switches personalities when confronted with destructive behavior. The nurse recognizes that this dissociation serves which function?
A.
It is a means to attain secondary gain.
B.
It is a means to explore feelings of excessive and inappropriate guilt.
C.
It serves to isolate painful events so that the primary self is protected.
D.
It serves to establish personality boundaries and limit inappropriate impulses.
C
A client is diagnosed with dissociative identity disorder (DID). What is the primary goal of therapy for this client?
A.
To recover memories and improve thinking patterns.
B.
To prevent social isolation.
C.
To decrease anxiety and need for secondary gain.
D.
To collaborate among sub-personalities to improve functioning.
D
What symptom differentiates dissociative fugue from dissociative amnesia?
A.
Clients diagnosed with dissociative fugue experience symptoms that are precipitated by extreme stress, and clients diagnosed with dissociative amnesia do not.
B.
Clients diagnosed with dissociative fugue are unaware of their memory loss, whereas clients diagnosed with dissociative amnesia are aware of their forgetfulness.
C.
Clients diagnosed with dissociative amnesia assume a new identity, and clients diagnosed with dissociative fugue do not.
D.
Clients diagnosed with dissociative amnesia usually recover completely, whereas clients diagnosed with dissociative fugue display residual effects.
B
Which is an example of systematized amnesia?
A.
A client cannot relate any lifetime memories, including personal identity.
B.
A client can relate family memories but has no recollection of a particular brother.
C.
A client cannot remember events surrounding a fatal car accident.
D.
A client whose home was destroyed by a tornado only remembers waking up in the hospital.
B
Neurological tests have ruled out pathology in a client’s sudden lower-extremity paralysis. Which nursing care should be included for this client?
A.
Deal with physical symptoms in a detached manner.
B.
Challenge the validity of physical symptoms.
C.
Meet dependency needs until the physical limitations subside.
D.
Encourage a discussion of feelings about the lower-extremity problem.
A
Which symptom exhibited by a client diagnosed with a conversion disorder would predict the poorest prognosis?
A. Seizures B. Blindness C. Aphonia D. Paralysis
A
Family dynamics are thought to be a major influence in the development of anorexia nervosa. Which statement regarding a client’s home environment should a nurse associate with the development of anorexia nervosa?
A.
The home environment maintains loose personal boundaries.
B.
The home environment places an overemphasis on food.
C.
The home environment is overprotective and demands perfection.
D.
The home environment condones corporal punishment.
C
A client’s altered body image is evidenced by claims of “feeling fat” even though the client is emaciated. Which is the appropriate outcome criterion for this client’s disorder?
A.
The client will consume adequate calories to sustain normal weight.
B.
The client will cease strenuous exercise programs.
C.
The client will perceive personal ideal body weight and shape as normal.
D.
The client will not express a preoccupation with food.
C
When counseling a client diagnosed with bulimia nervosa, a nurse explains that the client’s teeth will deteriorate because:
A.
The emesis produced during purging is acidic and corrodes the tooth enamel.
B.
Purging causes the depletion of dietary calcium.
C.
Food is rapidly ingested without proper mastication.
D.
Poor dental and oral hygiene leads to dental caries.
A
A nurse should explain to a client diagnosed with an eating disorder that behavior-modification programs are the treatment of choice because these programs:
A. Help the client correct a distorted body image. B. Address the underlying client anger. C. Manage the client’s uncontrollable behaviors. D. Allow clients to maintain control
D
A high school senior is diagnosed with anorexia nervosa and is hospitalized for severe malnutrition. Her treatment team is planning to use behavior modification. What rationale should a nurse identify as the reasoning behind this therapy choice?
A.
This therapy will increase the client’s motivation to gain weight.
B.
This therapy will reward the client for perfectionist achievements.
C.
This therapy will provide the client with control over behavioral choices.
D.
This therapy will protect the client from parental overindulgence.
C
A potential Olympic figure skater collapses during practice and is hospitalized for severe malnutrition. Anorexia nervosa is diagnosed. Which client statement best reflects insight related to this disorder?
A.
“Skaters need to be thin to improve their daily performance.”
B.
“All the skaters on the team are following an approved 1,200-calorie diet.”
C.
“The exercise of skating reduces my appetite but improves my energy level.”
D.
“I am angry at my mother. I can only get her approval when I win competitions.”
D
The family of a client diagnosed with anorexia nervosa becomes defensive when the treatment team calls for a family meeting. Which is the appropriate nursing response?
A.
“Tell me why this family meeting is causing you to be defensive. All clients are required to participate in two family sessions.”
B.
“Eating disorders have been correlated to certain familial patterns; without addressing these, your child’s condition will not improve.”
C.
“Family dynamics are not linked to eating disorders. The meeting is to provide your child with family support.”
D.
“Clients diagnosed with anorexia nervosa are part of the family system, and any alteration in family processes needs to be addressed.”
B
A client diagnosed with bulimia nervosa has been attending a mental health clinic for several months. Which factor should a nurse identify as an appropriate indicator of a positive client behavioral change?
A.
The client gained 2 pounds in 1 week.
B.
The client focused conversations on nutritious food.
C.
The client demonstrated healthy coping mechanisms that decreased anxiety.
D.
The client verbalized an understanding of the etiology of the disorder.
C
A morbidly obese client is prescribed an anorexiant medication. About which medication should a nurse teach the client?
A. Diazepam (Valium) B. Dexfenfluramine (Redux) C. Sibutramine (Meridia) D. Pemoline (Cylert)
C
A nurse is attempting to differentiate between the symptoms of anorexia nervosa and the symptoms of bulimia. Which statement should the nurse identify as correct?
A.
Clients diagnosed with anorexia nervosa experience extreme nutritional deficits, whereas clients diagnosed with bulimia nervosa do not.
B.
Clients diagnosed with bulimia nervosa experience amenorrhea, whereas clients diagnosed with anorexia nervosa do not.
C.
Clients diagnosed with bulimia nervosa experience hypotension, edema, and lanugo, whereas clients diagnosed with anorexia nervosa do not.
D.
Clients diagnosed with anorexia nervosa have eroded tooth enamel, whereas clients diagnosed with bulimia nervosa do not.
A
A client diagnosed with a history of anorexia nervosa comes to an outpatient clinic after being medically cleared. The client states, “My parents watch me like a hawk and never let me out of their sight.” Which nursing diagnosis would take priority at this time?
A. Altered nutrition less than body requirements B. Altered social interaction C. Impaired verbal communication D. Altered family processes
D
During an assessment interview, a client diagnosed with antisocial personality disorder spits, curses, and refuses to answer questions. Which is the appropriate nursing response to this behavior?
A.
“You are very disrespectful. You need to learn to control yourself.”
B.
“I understand that you are angry, but this behavior will not be tolerated.”
C.
“What behaviors could you modify to improve this situation?”
D.
“What anti-personality disorder medications have helped you in the past?
B