psych_final_20160315212353 Flashcards
You are caring for Vanessa, a 38-year-old patient with major depression. She has just met with her provider. She states to you, “my provider said something about the medicine she is ordering working on my neurotransmitters. What exactly are neurotransmitters?” Your best response is:
a. ) “Neurotransmitters are chemical messengers in the brain that help regulate specific functions.”
b. ) “Neurotransmitters are too complicated to explain easily. Just know that the medication will help your mood.”
c. ) “Neurotransmitters are the reason you are depressed.”
d. ) “I will ask your provider to give you a more in-depth explanation.”
a.) “Neurotransmitters are chemical messengers in the brain that help regulate specific functions.”
Neurotransmitters are chemicals released from neurons that function as a neuromessenger and influence brain functions.
Telling the patient that the answer is too complicated belittles the patient by implying she cannot understand, while stating that neurotransmitters are the reason she is depressed is too simplistic.
Asking the provider to give the education abdicates your responsibility to provide patient education.
Vanessa’s provider writes orders including medication to treat her depression. Based on current understanding of brain physiology, which of the following neurotransmitters would you expect to see targeted with the medication ordered?
a. ) dopamine
b. ) GABA
c. ) serotonin/norepinephrine
d. ) Acetylcholine
c.) serotonin/norepinephrine
Antidepressant medication targets serotonin and norepinephrine.
Dopamine is implicated in schizophrenia (increase) and Parkinson’s disease (decrease).
GABA is implicated in anxiety disorders.
Acetylcholine is implicated in Alzheimer’s disease as well as Huntington’s disease and Parkinson’s disease.
The term pharmacodynamics refers to the effect of the drug on the body, while pharmacokinetics refers to:
a. ) the effect of the drug specifically on the brain and movement.
b. ) the effect of the person on the drug.
c. ) the effect of the drug on children and adolescents.
d. ) the effect of the drug on the half-life and ability of the liver to excrete.
b.) the effect of the person on the drug.
Pharmacokinetics refers to the effect of the person on the drug and helps to guide dosing. The other options are incorrect.
Which of the following patients would need monitoring for potential development of the side effect of hypothyroidism?
a. ) Janelle, who is taking Prozac
b. ) Travis, who is taking Depakote
c. ) Shelly, who is taking lithium
d. ) Anna, who is taking Risperdal
c.) Shelly, who is taking lithium
Long-term use of lithium may cause hypothyroidism. The other options refer to drugs whose long-term use do not cause hypothyroidism.
Julie, a 49-year-old patient diagnosed with schizophrenia at 22 years old, is taking risperidone (Risperdal). Which of the following nursing assessments is the priority assessment with Julie?
a. ) Monitoring blood levels to avoid toxicity
b. ) Monitoring for abnormal involuntary movements
c. ) Observing for secondary mania
d. ) Observing for memory changes
b.) Monitoring for abnormal involuntary movements
Risperidone has the highest rate of extrapyramidal side effects (EPSs) of the second-generation antipsychotic medications, thus making it imperative to monitor for EPSs. Risperidone is not monitored with blood levels and does not cause mania or memory changes.
The basic functional unit of the nervous system is called a
a. ) neuron.
b. ) synapse.
c. ) receptor.
d. ) neurotransmitter.
a.) neuron.
Neurons are nerve cells. Cells are the basic unit of function. A neurotransmitter is a chemical substance that functions as a neuromessenger. This neurotransmitter then diffuses across a space, or synapse, to an adjacent postsynaptic neuron, where it attaches to receptors on the neuron’s surface.
The incoherent thought and speech patterns of the client with schizophrenia are related to the brain’s inability to
a. ) regulate conscious mental activity.
b. ) retain and recall past experience.
c. ) regulate social behavior.
d. ) maintain homeostasis.
a.) regulate conscious mental activity.
When the brain cannot regulate conscious mental activity, the individual’s speech patterns demonstrate incoherence and lack of reality orientation.
Homeostasis is promoted by interaction between the brain and internal organs mediated by
a. ) conscious behavior.
b. ) the autonomic nervous system.
c. ) the sympathetic nervous system.
d. ) the parasympathetic nervous system.
b.) the autonomic nervous system.
The function of the autonomic nervous system is to transmit messages between the brain and the internal organs. This linkage promotes the maintenance of homeostasis.
Cells that respond to stimuli, conduct electrical impulses, and release neurotransmitters are called
a. ) neurons.
b. ) synapses.
c. ) dendrites.
d. ) receptors.
a.) neurons.
Neurons are the basic functional unit of the nervous system responsible for sending and receiving messages as electrochemical events.
Which imaging technique can provide information about brain function?
a. ) Computed tomography (CT) scan
b. ) Positron emission tomography (PET) scan
c. ) Magnetic resonance imaging (MRI) scan
d. ) Skull radiograph
b.) Positron emission tomography (PET) scan
The positron emission tomography scan provides information about function; the other imaging techniques provide information about structure.
When a tumor of the cerebellum is present, the nurse should expect that the client would initially demonstrate
a. ) disequilibrium.
b. ) abnormal eye movement.
c. ) impaired social judgment.
d. ) blood pressure irregularities.
a.) disequilibrium.
The cerebellum is the organ primarily responsible for symptoms of equilibrium or imbalance.
Which organs secrete hormones that are a normal component of the body’s general response to stress?
a. ) Brain, thyroid gland, pancreas
b. ) Brain, pituitary gland, adrenal glands
c. ) Pituitary gland, pancreas, thyroid gland
d. ) Adrenal glands, parathyroid glands
b.) Brain, pituitary gland, adrenal glands
The hypothalamus, pituitary, and adrenal glands act as a system that responds to mental and physical stress. The three hormones secreted—corticotropin-releasing hormone, corticotropin, and cortisol—influence the function of nerve cells of the brain.
The behavior of an individual who seems unable to learn right from wrong and who repeatedly violates laws and lies demonstrates problems related to the brain’s inability to
a. ) regulate conscious mental activity.
b. ) retain and recall past experience.
c. ) regulate social behavior.
d. ) maintain homeostasis.
c.) regulate social behavior.
The inability to regulate social behavior usually results in antisocial behaviors such as lying, cheating, taking advantage of others, and breaking laws.
A client being medicated for both hallucinations and delusions reports being drowsy. The nurse will correctly interpret this symptom as related to the drug’s effect on the brain’s ability to regulate
a. ) mood.
b. ) thought.
c. ) memory.
d. ) sleep.
d.) sleep.
A number of psychotropic drugs have side effects that interfere with the brain’s ability to regulate sleep alertness. These side effects range from lethargy to extreme drowsiness. As the client’s body becomes accustomed to the drug, the drowsiness should dissipate.
A client’s communication is marked by loose associations and word salad. Dysfunction of which portion of the brain is responsible for these symptoms?
a. ) Cerebrum
b. ) Cerebellum
c. ) Brainstem
d. ) Basal ganglia
a.) Cerebrum
The ability to think and speak logically is controlled by the cerebrum.
A nursing assistant shares with the nurse that a client with schizophrenia is as difficult to communicate with as “someone with Alzheimer’s.” The nurse offers the following advice:
a. ) “Try talking to him early in the day to get the best results. Fatigue disorganizes his thinking.”
b. ) “Schizophrenia and Alzheimer’s disease both cause irreversible brain damage, so keep your conversations short when you talk to a client with either disorder.”
c. ) “His medication targets his disturbed thought and speech patterns. To maximize improvement he will need positive interactions and support.”
d. ) “Make sure he eats the comfort foods he is served because they increase serotonin production and will help normalize his thoughts and speech.”
c.) “His medication targets his disturbed thought and speech patterns. To maximize improvement he will need positive interactions and support.”
This response will help the nursing assistant understand that improvement can be expected in the client’s condition and that this improvement can be maximized by therapeutic interactions with staff. It establishes the expectation that the nursing assistant will interact in a therapeutic manner.
The nurse caring for a client taking risperidone (Risperidal) observes the client carefully for
a. ) napping during the day, a weight gain, and reports of dizziness.
b. ) reports of falls, heartburn, and nausea.
c. ) a rapid heartbeat, red rash, and hives.
d. ) dry mouth, poor urinary output, and constipation.
a.) napping during the day, a weight gain, and reports of dizziness.
H1 blockade has the potential to produce sedation, weight gain, and hypotension.
The medication prescribed for a client acts by blocking reuptake of both serotonin and norepinephrine. The nurse evaluates the treatment as successful when observing
a. ) laughing at a joke.
b. ) exercising a sore shoulder.
c. ) writing down his telephone number.
d. ) going to his room to “calm down.”
a.) laughing at a joke.
Depression is thought to be at least in part caused by lowered levels of serotonin and norepinephrine. Increasing the amount of these transmitters in the brain by blocking reuptake may result in mood elevation.
The first-line drug used to treat mania is
a. ) lithium carbonate (Lithium).
b. ) carbamazepine (Tegretol).
c. ) lamotrigine (Lamictal).
d. ) clonazepam (Klonopin).
a.) lithium carbonate (Lithium).
Lithium, a mood stabilizer, is the first-line drug for use in treating bipolar disorder.
A person who has numerous hypomanic and dysthymic episodes can be assessed as demonstrating characteristics of
a. ) bipolar II disorder.
b. ) bipolar I disorder.
c. ) cyclothymia.
d. ) seasonal affective disorder.
c.) cyclothymia.
Cyclothymia refers to mood swings involving hypomania and dysthymia of 2 years’ duration.
The mood swings are not severe enough to prompt hospitalization.
A bipolar client tells the nurse, “I have the finest tenor voice in the world. The three tenors who do all those TV concerts are going to retire because they can’t compete with me.” The nurse would make the assessment that the client is displaying
a. ) flight of ideas.
b. ) distractibility.
c. ) limit testing.
d. ) grandiosity.
d.) grandiosity.
Exaggerated belief in one’s own importance, identity, or capabilities is seen with grandiosity.
Which behavior would be most characteristic of a client during a manic episode?
a. ) Going rapidly from one activity to another
b. ) Taking frequent rest periods and naps during the day
c. ) Being unwilling to leave home to see other people
d. ) Watching others intently and talking little
a.) Going rapidly from one activity to another
Hyperactivity and distractibility are basic to manic episodes.
The nurse can expect a client demonstrating typical manic behavior to be attired in clothing that is
a. ) dark colored and modest.
b. ) colorful and outlandish.
c. ) compulsively neat and clean.
d. ) ill-fitted and ragged.
b.) colorful and outlandish.
Manic clients often manage to dress and apply makeup in ways that create a colorful, even bizarre, appearance.
An outcome for a manic client during the acute phase that would indicate that the treatment plan was successful would be that the client
a. ) reports racing thoughts.
b. ) is free of injury.
c. ) is highly distractible.
d. ) ignores food and fluid.
b.) is free of injury.
Risk for injury is a diagnosis of high priority for manic clients because of their hyperactivity.
Lack of injury is a highly desirable outcome.
When a client experiences four or more mood episodes in a 12-month period, the client is said to be
a. ) dyssynchronous.
b. ) incongruent.
c. ) cyclothymic.
d. ) rapid cycling.
d.) rapid cycling.
Rapid cycling implies four or more mood episodes in a 12-month period, as well as more severe symptomatology.
Which room placement would be best for a client experiencing a manic episode?
a. ) A shared room with a client with dementia
b. ) A single room near the unit activities area
c. ) A single room near the nurses’ station
d. ) A shared room away from the unit entrance
c.) A single room near the nurses’ station
The room placement that provides a nonstimulating environment is best.
Nearness to the nurses’ station means close supervision can be provided.
When a hyperactive manic client expresses the intent to strike another client, the initial nursing intervention would be to
a. ) question the client’s motive.
b. ) set verbal limits.
c. ) initiate physical confrontation.
d. ) prepare the client for seclusion.
b.) set verbal limits.
Verbal limit setting should always precede more restrictive measures.
When a client reports that lithium causes an upset stomach, the nurse suggests taking the medication:
a. ) with meals
b. ) with an antacid
c. ) 30 minutes before meals
d. ) 2 hours after meals
a.) with meals
Many clients find that taking lithium with or shortly after meals minimizes gastric distress.
The priority nursing diagnosis for a hyperactive manic client during the acute phase is
a. ) risk for injury.
b. ) ineffective role performance.
c. ) risk for other-directed violence.
d. ) impaired verbal communication.
a.) risk for injury.
Risk for injury is high, related to the client’s hyperactivity and poor judgment.
An acute phase nursing intervention aimed at reducing hyperactivity is redirecting the client to
a. ) write in a diary.
b. ) exercise in the gym.
c. ) direct unit activities.
d. ) orient a new client to the unit.
a.) write in a diary.
Manic clients often respond well to the invitation to write.
They will fill reams of paper.
While writing they are less physically active.
A bipolar client whose continuing phase treatment consists of lithium therapy and cognitive-behavioral therapy may become noncompliant with medication. Which factor would be of least concern to the nurse developing a psychoeducation plan to foster compliance?
a. ) The side-effects are unpleasant.
b. ) The voices tell the client to stop taking it.
c. ) The client prefers to feel “high” and energetic.
d. ) The client feels well and denies the possibility of recurrence.
b.) The voices tell the client to stop taking it.
Manic clients may hallucinate during the delirious state but generally do not hear voices.
Psychoeducation would not be going on during the time the client is delirious.
A manic client tells a nurse “Bud. Crud. Dud. I’m a real stud! You’d like what I have to offer. Let’s go to my room.” The best approach for the nurse to use would be
a. ) “What an offensive thing to suggest!”
b. ) “I don’t have sex with clients.”
c. ) “It’s time to work on your art project.”
d. ) “Let’s walk down to the seclusion room.”
c.) “It’s time to work on your art project.”
Distractibility works as the nurse’s friend.
Rather than discuss the invitation, the nurse may be more effective by redirecting the client.
A desired outcome for the maintenance phase of treatment for a manic client would be that the client will
a. ) exhibit optimistic, energetic, playful behavior.
b. ) adhere to follow-up medical appointments.
c. ) take medication more than 50% of the time.
d. ) use alcohol to moderate occasional mood “highs.”
b.) adhere to follow-up medical appointments.
The client would be living in the community during the maintenance phase.
Keeping follow-up appointments is highly desirable.
What action should the nurse take on learning that a manic client’s serum lithium level is 1.8 mEq/L?
a. ) Withhold medication and notify the physician.
b. ) Continue to administer medication as ordered.
c. ) Advise the client to limit fluids for 12 hours.
d. ) Advise the client to curtail salt intake for 24 hours.
a.) Withhold medication and notify the physician.
The client’s lithium level has exceeded desirable limits.
Additional doses of the medication should be withheld and the physician notified.
To plan care for a manic client the nurse must consider that lithium cannot be started until
a. ) the physical examination and laboratory tests are analyzed.
b. ) the initial doses of antipsychotic medication have brought behavior under control.
c. ) seclusion has proven ineffective as a means of controlling assaultive behavior.
d. ) electroconvulsive therapy can be scheduled to coincide with lithium administration.
a.) the physical examination and laboratory tests are analyzed.
Lithium should not be given to clients with impaired renal or thyroid function.
A thorough physical examination and various laboratory tests are necessary to rule out other organic causes for the behavior and to ensure that the lithium can be excreted normally.
A desirable short-term goal for the nursing diagnosis Defensive coping related to biochemical changes as evidenced by aggressive verbal and physical behaviors would be
a. ) making no attempts at self-harm within 12 hours of admission.
b. ) sleeping soundly for 12 of the next 24 hours.
c. ) willingly taking prescribed medication as offered by staff within 24 hours of admission.
d. ) demonstrating psychomotor retardation associated with sedation from prescribed medication within 6 hours of admission.
a.) making no attempts at self-harm within 12 hours of admission.
Whenever aggressive verbal or physical behaviors are demonstrated, a desirable goal is cessation of those behaviors.
Verbal and physical aggression are most apt to occur when staff are trying to structure the client’s behavior for his or her own safety or the safety of others.
Which side effects of lithium can be expected at therapeutic levels?
a. ) Fine hand tremor and polyuria
b. ) Nausea and thirst
c. ) Coarse hand tremor and gastrointestinal upset
d. ) Ataxia and hypotension
a.) Fine hand tremor and polyuria
The fact that fine hand tremor and polyuria are present at therapeutic levels is quite annoying to some clients.
These and other side effects are factors in noncompliance.
When the wife of a manic client asks about genetic transmission of bipolar disorder, the nurse’s answer should be predicated on the knowledge that
a. ) no research exists to suggest genetic transmission.
b. ) much depends on the socioeconomic class of the individuals.
c. ) highly creative people tend toward development of the disorder.
d. ) the rate of bipolar disorder is higher in relatives of people with bipolar disorder.
d.) the rate of bipolar disorder is higher in relatives of people with bipolar disorder.
This understanding will allow the nurse to directly address the question.
Responses based on the other statements would be tangential or untrue.
Which of the following is true of the relationship between bipolar disorder and suicide?
a. ) Patients need to be monitored only in the depressed phase because this is when suicides occur.
b. ) Suicide is a serious risk because nearly 20% of those diagnosed with bipolar disorder commit suicide.
c. ) Patients with bipolar disorder are not considered high risk for suicide.
d. ) As long as patients with bipolar disorder adhere to their medication regimen, there is little risk for suicide.
b.) Suicide is a serious risk because nearly 20% of those diagnosed with bipolar disorder commit suicide.
Mortality rates for bipolar disorder are severe because 25% to 60% of individuals with bipolar disorder will make a suicide attempt at least once in their lifetime, and nearly 20% of all deaths among this population are from suicide.
Suicides occur in both the depressed and the manic phase.
Bipolar patients are always considered high risk for suicide because of impulsivity while in the manic phase and hopelessness when in the depressed phase.
Although staying on medications may decrease risk, there is no evidence to suggest that only patients who stop medications commit suicide.
Tyler is a 31-year-old patient admitted with acute mania. He tells the staff and the other patients that he is on a secret mission given to him by the President of the United States to monitor citizens for terrorist activity. He states, “I am the only one he trusts, because I am the best!” For documentation purposes you know that this behavior is referred to as:
a. ) unpredictability.
b. ) rapid cycling.
c. ) grandiosity.
d. ) flight of ideas.
c.) grandiosity.
Grandiosity is inflated self-regard.
People with mania may exaggerate their achievements or importance, state that they know famous people, or believe they have great powers.
Although patients with mania are unpredictable, the scenario does not describe unpredictability: Rapid cycling is switching between mania and depression in a given time period.
The scenario does not describe flight of ideas, which means a continuous flow of speech with abrupt topic changes.
Tyler is being discharged home to his family. Which of the following is important teaching to include for the patient and the family to recognize possible signs of impending mania?
a. ) Increased appetite
b. ) Decreased social interaction
c. ) Increased attention to bodily functions
d. ) Decreased sleep
d.) Decreased sleep
Changes in sleep patterns are especially important because they usually precede mania.
Even a single night of unexplainable sleep loss can be taken as an early warning of impending mania.
The other options do not indicate impending mania.
Which of the following describe the symptoms of the manic phase of bipolar disorder? (select all that apply):
a. ) Excessive energy
b. ) Fatigue and increased sleep
c. ) Low self-esteem
d. ) Pressured speech
e. ) Purposeless movement
f. ) Racing thoughts
g. ) Withdrawal from environment
h. ) Distractibility
a.) Excessive energy
d.) Pressured speech
e.) Purposeless movement
f.) Racing thoughts
h.) Distractibility
All these options describe mania. The other options more aptly describe the opposite of what happens in mania.
Tyler’s nursing care plan has several nursing diagnoses listed. Match the nursing diagnosis to the level of priority (1 to 4):
a. ) Knowledge, deficient
b. ) Nonadherence
c. ) Risk for injury
d. ) Self-care deficit, bathing and hygiene
1 = Risk for injury
2 = Self-care deficit, bathing and hygiene
3 = Knowledge, deficient
4 = Nonadherence
A major principle the nurse should observe when communicating with a patient experiencing elated mood is to:
a. ) Use a calm, firm approach.
b. ) Give expanded explanations.
c. ) Make use of abstract concepts.
d. ) Encourage lightheartedness and joking.
a.) Use a calm, firm approach.
Nadia has been diagnosed with bipolar disorder. Which is an outcome for Nadia in the continuation of treatment phase of bipolar disorder?
a. ) Patient will avoid involvement in self-help groups.
b. ) Patient will adhere to medication regimen.
c. ) Patient will demonstrate euphoric mood.
d. ) Patient will maintain normal weight.
b.) Patient will adhere to medication regimen.
A medication teaching plan for a patient receiving lithium should include:
a. ) Periodic monitoring of renal and thyroid function.
b. ) Dietary teaching to restrict daily sodium intake.
c. ) The importance of blood draws to monitor serum potassium level.
d. ) Discontinuing the drug if weight gain and fine hand tremors are noticed.
a.) Periodic monitoring of renal and thyroid function.
Which symptom related to communication is most likely to be present in a patient experiencing mania?
a. ) Mutism
b. ) Verbosity
c. ) Poverty of ideas
d. ) Confabulation
b.) Verbosity
For assessment purposes, the nurse should identify the body system most at risk for decompensation during a severe manic episode as:
a. ) Renal
b. ) Cardiac
c. ) Endocrine
d. ) Pulmonary
b.) Cardiac
Crises that occur as an individual moves from one developmental level to another are called
a. ) reactive crises.
b. ) recurring crises.
c. ) situational crises.
d. ) maturational crises.
d.) maturational crises.
Maturational crises are normal states in growth and development in which specific new maturational tasks must be learned when old coping mechanisms are no longer effective.
When a person becomes unemployed, he is likely to experience a(n)
a. ) reactive crisis.
b. ) situational crisis.
c. ) adventitious crisis.
d. ) substance abuse crisis.
b.) situational crisis.
Situational crises arise from external sources.
Examples are death of a loved one, divorce, marriage, or a change in health status.
When a tornado results in the loss of homes, businesses, and life, the town residents are likely to experience a(n)
a. ) maturational crisis.
b. ) situational crisis.
c. ) adventitious crisis.
d. ) endogenous crisis.
c.) adventitious crisis.
An adventitious crisis is unplanned, accidental, and not part of everyday life.
Examples are disasters and crimes of violence.
A crisis is so acutely uncomfortable to the individual that it is likely to self-resolve in
a. ) 1 to 10 days.
b. ) 1 to 3 weeks.
c. ) 4 to 6 weeks.
d. ) 3 to 4 months.
c.) 4 to 6 weeks.
At 4 to 6 weeks, the individual is making accommodations and adjustments to relieve anxiety, and the crisis is no longer a crisis.
The expected outcome at the conclusion of crisis intervention therapy is that the client will function
a. ) at a higher level than before the crisis.
b. ) at the precrisis level.
c. ) only marginally below the precrisis level.
d. ) without aid from identified support systems.
b.) at the precrisis level.
The intent of crisis intervention is to return the individual to the precrisis level of functioning.
In the event of an adventitious crisis, which age group would be least in need of crisis intervention?
a. ) Children
b. ) Such crises seldom require intervention
c. ) The elderly
d. ) A distinction cannot be made
d.) A distinction cannot be made
The need for psychological first aid (crisis intervention) and debriefing after any crisis situation cannot be overstressed for all age groups (children, adolescents, adults, and the elderly).
The nurse caring for a client in crisis shows signs of a problematic nurse-client relationship by
a. ) offering to change the time of the counseling session for the second time in 3 weeks.
b. ) experiencing frustration about the decisions the client is making.
c. ) giving the client permission to call him or her at home when the client “needs to talk.”
d. ) suggesting that the client attend an extra counseling session each month.
c.) giving the client permission to call him or her at home when the client “needs to talk.”
The behavior in option C is a reaction to the nurse’s need to be needed and undermines the client’s sense of self-reliance.
When a stressful event occurs and the individual is unable to resolve the situation by using his or her usual coping strategies, the individual
a. ) becomes disorganized and uses trial-and-error problem solving.
b. ) withdraws and acts as though the problem does not exist.
c. ) develops severe personality disorganization.
d. ) resorts to planning suicide.
a.) becomes disorganized and uses trial-and-error problem solving.
This is the second stage of crisis, according to accepted crisis theory.
A client is treated in the emergency department for injuries sustained while vacationing hundreds of miles away from home. To best meet the client’s emotional needs, the nurse should
a. ) arrange to hospitalize the client.
b. ) refer the client for traditional psychotherapy for posttraumatic stress disorder.
c. ) provide temporary support by arranging shelter and contacting the client’s friends.
d. ) suggest that contacting a victim support group would be more appropriate than crisis intervention.
c.) provide temporary support by arranging shelter and contacting the client’s friends.
When a client has no support system, the nurse may assume that role for a short time.
Which statement would suggest to the crisis intervention nurse the need to arrange for hospitalization of a client?
a. ) “I’m feeling overwhelmed by all that has happened, and I need help sorting it out.”
b. ) “I see no solution for this situation if nothing changes by tomorrow.”
c. ) “There are three possibilities that might help, but I can’t decide what to do.”
d. ) “I feel a little calmer than yesterday at this time, but things are still very difficult.”
b.) “I see no solution for this situation if nothing changes by tomorrow.”
Whenever the client presents a danger to himself or herself or others, hospitalization must be considered.
To assess the client’s perception of the event precipitating a crisis, the nurse would initially ask
a. ) “What was happening just before you began feeling this way?”
b. ) “During difficult times in the past, what has helped you?”
c. ) “Can you give me the name of someone you trust?”
d. ) “Who is available to help you?”
a.) “What was happening just before you began feeling this way?”
Option A is the only query that is directed at the client’s perception of the precipitating event.
The other options ask important questions but are not related to perception of the precipitating event.
Which assumption serves as a foundation for the use of crisis intervention?
a. ) The individual is mentally healthy but in a state of disequilibrium.
b. ) Long-term dysfunctional adjustment can be addressed by crisis intervention.
c. ) An anxious person is unlikely to be willing to try new problem-solving strategies.
d. ) Crisis intervention nurses need to remain passive as the client deals with the crisis.
a.) The individual is mentally healthy but in a state of disequilibrium.
Only statement A is true.
The priority concern of the crisis intervention nurse is
a. ) client safety.
b. ) setting up future contacts.
c. ) brainstorming possible solutions.
d. ) working through termination issues.
a.) client safety.
Client safety is always the priority concern in crisis intervention therapy.
The disequilibrium of crisis predisposes the client to suicidal thinking.
Which situation has the potential for early crisis intervention to occur?
a. ) Mrs. R tells the nurse in the well-baby clinic that she’s feeling uptight and has arranged to see a primary care therapist.
b. ) Ms. T is hospitalized after an unsuccessful suicide attempt that she states, “was a mistake.”
c. ) Mr. W asks for reassurance that he will be welcome at the day hospital after his hospital discharge.
d. ) Ms. G enters the emergency department with a strong smell of alcohol on his person, stating he is anxious and depressed.
a.) Mrs. R tells the nurse in the well-baby clinic that she’s feeling uptight and has arranged to see a primary care therapist.
Phase I intervention is when a person confronted by a conflict or problem that threatens the self-concept responds with increased feelings of anxiety.
The increase in anxiety stimulates the use of problem-solving techniques and defense mechanisms in an effort to solve the problem and lower anxiety.
Option B indicates a phase 4 response to a crisis; option C would be a phase 3 response.
In option D the client is using inappropriate coping mechanisms, which are not effective to treat depression and anxiety.
A 12-year-old finds herself feeling anxious and overwhelmed and seeks out the school nurse to report that “Everything is changing . . . my body, the way the boys who were my friends are treating me, everything is so different.” It is likely the child is
a. ) describing personal identity disorder.
b. ) experiencing a maturational crisis.
c. ) potentially suicidal.
d. ) mildly neurotic.
b.) experiencing a maturational crisis.
The maturational crisis of moving from childhood into adolescence may be difficult because many new coping skills are necessary.
The nurse working with a client in crisis must initially assess for the client’s
a. ) self-report of feeling depressed.
b. ) unrealistic report of a crisis-precipitating event.
c. ) report of a high level of anxiety.
d. ) admission that he or she is abusing drugs.
b.) unrealistic report of a crisis-precipitating event.
A person’s equilibrium may be adversely affected by one or more of the following: an unrealistic perception of the precipitating event, inadequate situational supports, and inadequate coping mechanisms.
These factors must be assessed when a crisis situation is evaluated because data gained from the assessment are used as guides for both the nurse and the client to set realistic and meaningful goals as well as to plan possible solutions to the problem situation.
A woman comes to the crisis intervention clinic and reports that her 16-year-old son uses drugs in the home and often assaults her. The nurse tells the client,
a. ) “This is not an uncommon problem. Don’t worry.”
b. ) “Together we will be able to work on this problem.”
c. ) “Now that you are asking for help, everything will be all right.”
d. ) “I have friends in law enforcement who can help us choose a solution.”
b.) “Together we will be able to work on this problem.”
The nurse takes an active collaborative role in problem resolution beginning with telling the client that a solution will be found.
A woman comes to the crisis intervention clinic expressing concern that her 16-year-old is using illegal drugs in their home.The nurse will
a. ) encourage the mother to call the police when her son brings drugs home.
b. ) inform her of the obligation to report this information to the police.
c. ) work with the client to set goals that are mutually acceptable.
d. ) refer the client to the police for consultation.
c.) work with the client to set goals that are mutually acceptable.
Goal setting is a collaborative task. Goals must be acceptable to the client and seen by the nurse as safe and appropriate.
A client comes to the crisis intervention clinic and tearfully tells the nurse, “It is so painful! I have thought about it, and I cannot see how I can go on without my partner.” The nurse states, “You have resilience and will look back on this as a crisis you were able to manage.” Analysis of this interaction reveals that the nurse
a. ) has a good understanding of the effect of time on perception of a crisis.
b. ) is offering a statement of positive outcome based on client coping ability.
c. ) has not followed up on the client’s verbal clues to suicidal thoughts.
d. ) has stepped into the territory of traditional psychotherapy.
c.) has not followed up on the client’s verbal clues to suicidal thoughts.
Nurses who are uncomfortable with the idea of suicide may fail to pick up on a client’s clues.
This client clearly was open to discussing her suicidal thoughts, or she would not have said, “I cannot see how I can go on.”
When the client begins to sob uncontrollably and her speech becomes so incoherent that she is unable to give the nurse any information, the immediate interventions will focus on
a. ) securing hospital admission.
b. ) contacting a family member or close friend.
c. ) lowering her anxiety level from severe to moderate.
d. ) assisting the client to identify new effective coping strategies.
c.) lowering her anxiety level from severe to moderate.
Individuals with severe anxiety are not able to collaborate in problem solving.
The nurse must assist the client to lower anxiety from severe to moderate or lower.
Mason and Charlie, both 16 years old, were involved in a bad car accident in which they were both passengers. Mason spoke with a counselor about the incident once and has been able to move forward with little dysfunction. Charlie has been experiencing anxiety and an inability to concentrate in school even after numerous counseling sessions. The difference in the way the accident affected both boys may be explained by:
a. ) perception of the event.
b. ) Mason’s more laid-back personality.
c. ) the possibility that Charlie may have experienced previous trauma from which he did not fully recover.
d. ) the possibility that counseling Charlie received may have been inadequate.
a.) perception of the event.
People vary in the way they absorb, process, and use information from the environment.
Some people may respond to a minor event as if it were life-threatening.
Conversely, others may experience a major event and look at it in a calmer fashion.
The other options may be true but are not the primary reason two people respond differently to the same event.
Carter, aged 36 years, comes to the crisis clinic for his first visit with complaints of not sleeping, anxiety, and excessive crying. He recently was fired suddenly from his job and 3 days later lost his home to a tornado that devastated the town he lives in. Which of the following statements regarding crisis accurately describes Carter’s situation?
a. ) He is experiencing low self-esteem from the job loss, as well as anger because of the loss of his home.
b. ) He is experiencing both a situational and an adventitious crisis.
c. ) He is experiencing ineffective coping and should be hospitalized for intensive therapy.
d. ) He is experiencing a situational crisis with the added stress of financial burden.
b.) He is experiencing both a situational and an adventitious crisis.
It is possible to experience more than one type of crisis situation simultaneously, and as expected, the presence of more than one crisis further taxes individual coping skills.
Carter lost his job (situational crisis) and also experienced the devastating effects of a tornado (adventitious crisis).
The first option may be true but doesn’t accurately describe the crisis criteria. There is nothing in the scenario suggesting he needs acute hospitalization at this time.
He is experiencing not only a situational crisis, but an adventitious one as well, which makes coping more difficult.
Tori is the nurse working with Carter and other members of the community after the tornado. As the weeks go by, she begins to feel anxious and distressed. She speaks to her nurse mentor about her feelings. Which of the following may Tori be experiencing?
a. ) Reactionary grief
b. ) Maturational crisis
c. ) Vicarious traumatization
d. ) Transference
c.) Vicarious traumatization
Even experienced nurses working in disaster situations can become overwhelmed when witnessing catastrophes such as loss of human life or mass destruction of people’s homes and belongings (e.g., floods, fires, tornadoes).
Researchers have found that mental health care providers may experience psychological distress from working with traumatized populations, a phenomenon of secondary traumatic stress or “vicarious traumatization.”
Reactionary grief does not describe secondary stress from working with such populations.
A maturational crisis arises from disruption of a developmental stage.
Transference describes feelings displaced onto the nurse or therapist by the patient.
Tori knows that Carter needs assistance with many aspects of getting through the crisis. Tori’s highest priority in Carter’s care is:
a. ) reduction of Carter’s anxiety.
b. ) development of new coping skills.
c. ) prevention of boundary blurring.
d. ) keeping Carter safe.
d.) keeping Carter safe.
The nurse’s initial task is to promote safety by assessing the patient’s potential for suicide or homicide.
The other options are all important components of the care plan, but safety of the patient takes the highest priority.
Carter experiences each of the following during his crisis. Which of the following describes phase IV of Caplan’s phases of crisis?
a. ) Carter experiences increased anxiety and feelings of extreme discomfort the day after the tornado.
b. ) Carter comes to the crisis clinic complaining of depression and expresses that he does not want to go on living.
c. ) Carter experiences a panic attack at his mother’s home in a nearby town where he is staying after the tornado.
d. ) Carter experiences anxiety symptoms the day after he was fired.
b.) Carter comes to the crisis clinic complaining of depression and expresses that he does not want to go on living.
This describes phase IV, which, if coping is ineffective, may lead to depression, confusion, violence, or suicidality.
The other options describe phase II, phase III, and phase I in Caplan’s phases of crisis.
Which statement reflects a fact about family violence?
a. ) Ninety-five percent of abuse victims are women.
b. ) The victim’s behavior is often the cause of the violence.
c. ) Violence occurs in families of all backgrounds.
d. ) Alcohol and stress are the major causes of abuse.
c.) Violence occurs in families of all backgrounds.
Option C is a true statement. The others are false.
The victim of abuse can expect the abuse to worsen when
a. ) the perpetrator feels he is in complete control.
b. ) the perpetrator is feeling remorseful for being abusive.
c. ) the victim moves toward independence from the abuser.
d. ) the victim submits to the domination of the perpetrator.
c.) the victim moves toward independence from the abuser.
When the abuser thinks he is losing control over the victim, the violence escalates.
An elderly woman who has been abused by her caregiver daughter tells the nurse, “You don’t have to worry about me. My daughter cried and apologized. She promised me she will never hit me again.” The nurse can assess that this is the stage in the cycle of violence known as
a. ) tension building.
b. ) acute battering.
c. ) honeymoon.
d. ) escalation.
c.) honeymoon.
During the honeymoon stage, the perpetrator apologizes, promises never to abuse again, and tries to make up for the violence.
This stage is usually brief.
Which statement made by a parent of a child diagnosed with Tourette’s syndrome would be assessed as a risk factor for family violence?
a. ) “My husband lost his job, and it seems all our savings are going to pay for our son’s expensive medication and all the other things he needs.”
b. ) “Our son is really a good little boy, but he needs to be disciplined both at home and in school.”
c. ) “We shouldn’t be, but we are ashamed of our son’s disorder and his inability to control the tics in public.”
d. ) “We have become active in the support group but still find the suggestions extremely difficult to put into practice.”
a.) “My husband lost his job, and it seems all our savings are going to pay for our son’s expensive medication and all the other things he needs.”
Job loss, financial problems, and a child who is “different” and has special needs should alert the nurse to the risk for family violence, because all these factors contribute to a crisis situation.
An elderly client pays the bills because she fears that her family will make her live elsewhere if she doesn’t “help out.” The nurse assesses it as
a. ) neglect.
b. ) physical violence.
c. ) psychological abuse.
d. ) financial maltreatment.
d.) financial maltreatment.
Financial maltreatment occurs when the perpetrator takes financial advantage of the elderly person, often through the use of subtle threats of what unpleasant or frightening outcome will occur if the elder does not supply funds.
The nurse performing the assessment of a wheelchair-bound client suspects that his wife’s explanation of how he sustained facial contusions and a broken nose may not be entirely truthful. The nurse should
a. ) confront the wife with the suspicion that her husband’s injuries are the result of abuse.
b. ) have the wife wait in the waiting room so her husband can be interviewed in private.
c. ) report the husband’s injuries to the police and ask for a confidential investigation.
d. ) document the suspicion and follow a policy of “wait and see” whether he returns again.
b.) have the wife wait in the waiting room so her husband can be interviewed in private.
Suspected victims of abuse should always be interviewed in private.
If the perpetrator is in the room, the victim cannot speak freely.
When interviewing an adult victim of abuse, the nurse’s best approach is to be
a. ) confrontational and assertive.
b. ) gentle and direct.
c. ) direct and professional.
d. ) sympathetic and outraged.
c.) direct and professional.
Expressing strong emotion does not help the victim.
A direct, honest, and professional manner of asking questions produces the best results.
When treatment for injuries sustained during an incident of abuse is sought from the primary physician, the client is receiving
a. ) primary prevention.
b. ) secondary prevention.
c. ) tertiary prevention.
d. ) stop-gap therapy.
b.) secondary prevention.
Secondary prevention is synonymous with treatment.
Which child is at lowest risk for abuse?
a. ) A 3-month-old who has colic and teenaged parents.
b. ) A 4-year-old who has cerebral palsy and retarded parents.
c. ) A 2-year-old who has leukemia and two working parents.
d. ) A 5-year-old who has ADHD and a father who was abused as a child.
c.) A 2-year-old who has leukemia and two working parents.
Although the child in option C has a serious physical disorder, she is at lower risk than the child in option A, whose inconsolable crying can be frustrating; the child in option B, who will not be as independent as other children his age and who has parents who may not understand his needs; or the child in option D, whose hyperactivity can be annoying, especially to a parent who himself has been abused.
What distinction can be made between abuse and neglect?
a. ) Neglect occurs in the psychological domain; abuse occurs in the physical domain.
b. ) Neglect is always physical; abuse can be verbal, physical, sexual, or emotional.
c. ) Neglect is perpetrated against children; abuse victims can be children or adults.
d. ) Neglect is a failure to provide; abuse is a failure to control aggression.
d.) Neglect is a failure to provide; abuse is a failure to control aggression.
Neglect is failure to provide necessary care, and abuse is physical maltreatment.
The risk of elder abuse in a home is best determined by assessing
a. ) the vulnerability of the elder and the stress of the caregiver.
b. ) the amount of disruption the elder causes in the home.
c. ) how much actual physical assistance the elder needs on a daily basis.
d. ) the financial contribution of the elder and the caregiver’s early life experience with abuse.
a.) the vulnerability of the elder and the stress of the caregiver.
Abuse occurs across all segments of society and is reinforced by the society and the culture.
The actual occurrence of violence requires:
- a perpetrator,
- someone who by age or situation is vulnerable (e.g., children, women, men, the elderly, mentally ill persons, and physically challenged persons), and
- a crisis situation.
An abuse victim tearfully tells the nurse in the emergency department, “Don’t tell my husband that you know he beats me because if he thinks anyone knows, he will beat me again.” Based on this information, the most appropriate nursing diagnosis is
a. ) chronic pain.
b. ) fear.
c. ) post-trauma syndrome.
d. ) risk for self-directed violence.
b.) fear.
The client is expressing fear based on a known threat.
To best assure the safety of a 3-year-old child whose parent admits to finding it difficult to control their anger, the most appropriate short-term goal would be for the parent to
a. ) understand the impact of violence on the child within 2 days.
b. ) begin attending anger management training sessions within 2 weeks.
c. ) state a willingness to attend a support group for physical abusers within 1 week.
d. ) show remorse for their anger management issues within 2 days.
b.) begin attending anger management training sessions within 2 weeks.
Perpetrators of violence need help learning how to manage anger.
A structured group is an excellent way to provide this teaching.
A nursing intervention directed at the psychological needs of an abused woman is to
a. ) encourage the client to immediately leave the abuser.
b. ) affirm that the client did not deserve or cause the abuse.
c. ) provide a referral to social services for economic problems.
d. ) facilitate contact with law enforcement to take legal action.
b.) affirm that the client did not deserve or cause the abuse.
Abused clients often believe that they are deserving of the abuse and, in some way, prompt the abuser to attack.
They need specific reassurance that they did not deserve to be abused and they did not cause the attack.
Which factor is of least importance as a victim of spousal abuse constructs an escape plan?
a. ) How the victim will explain her decision to leave
b. ) Where the victim will go to be safe
c. ) How the victim will arrange for transportation
d. ) What the victim will need to take with her when she leaves
a.) How the victim will explain her decision to leave
Any abused person has been threatened.
This is a given and does not enter into the details of the escape planning.
A battered woman has been referred to a women’s shelter. When the woman’s abuser demands to be told where she is, the nurse
a. ) refuses to provide any information.
b. ) gives him the telephone number, but not the address, of the shelter.
c. ) informs him that no information can be given for a minimum of 24 hours.
d. ) calls law enforcement to arrest the husband for the assault and battery of his wife.
a.) refuses to provide any information.
The nurse must respect the client’s right to confidentiality.
Whether the questioner asks pleadingly or in a demanding way, the answer must be the same.
Which of the following is a likely behavior for a woman attempting to escape a chronically abusive relationship?
a. ) Relying on alcohol to escape the emotional pain of abuse
b. ) Adapting an aggressive attitude toward her abuser to scare him
c. ) Considering ways to commit suicide
d. ) Threatening to call the police if she is abused again
c.) Considering ways to commit suicide
A person experiencing violence may feel so trapped in a detrimental relationship, yet so desperate to get out, that suicide may seem the only answer.
A suicide attempt may be the presenting symptom in the emergency department.
At least 10% of abused women attempt suicide.
The other reports are not realistic for a woman who is being abused.
When the nurse believes the cycle of abuse is escalating and that a woman may be in severe physical danger, the priority nursing intervention is to
a. ) advise her to enter counseling at the mental health center.
b. ) assist her to develop a plan to go to a shelter in case of a crisis.
c. ) suggest she leave the abuser and go to a trusted friend’s home.
d. ) teach her to counter verbal abuse with assertive replies.
b.) assist her to develop a plan to go to a shelter in case of a crisis.
Every victim of abuse should have an escape plan, but one is particularly important when the nurse believes the client is in severe danger.
A 4-year-old child tells the nurse, “I’m a bad boy. Daddy always says I’m not worth a second look.” This situation can be an example of
a. ) neglect.
b. ) physical maltreatment.
c. ) emotional violence.
d. )harsh parenting.
c.) emotional violence.
Emotional violence occurs when the child’s self-esteem is attacked.
It is as devastating to the child as physical abuse.
When there is reason to suspect that a child is being abused, the nurse must initially
a. ) call the local police to report it.
b. ) follow agency policy for reporting.
c. ) confront the parent or parents.
d. ) interrogate the child to obtain proof.
b.) follow agency policy for reporting.
Nurses are mandated reporters of child abuse.
They must follow the rules set forth by the state regarding the steps to take to report child abuse.
Which of the following persons has the highest risk factors for physical abuse?
a. ) Emma, a 7-month-old baby who has colic and doesn’t sleep through the night
b. ) Roland, a 53-year-old man with cardiovascular disease living with his son
c. ) Penny, a 28-year-old wife whose husband has a diagnosis of an anxiety disorder
d. ) Rose, a 77-year-old woman living with her daughter and son-in-law
d.) Rose, a 77-year-old woman living with her daughter and son-in-law
Older women dependent on family members for care are at higher risk for abuse.
The other options do not describe specific characteristics that put them at higher risk for abuse.
Nurses working in emergency departments and walk-in clinics should be aware that some victims of violence may present:
a. ) with vague physical complaints such as insomnia or pain.
b. ) with extreme anger and unpredictable behavior.
c. ) with many family members there to support them.
d. ) with psychosis and/or mania as a result of long-term abuse.
a.) with vague physical complaints such as insomnia or pain.
Patients may present with symptoms that may be vague and can include chronic pain, insomnia, hyperventilation, or gynecological problems.
Attention to the interview process and setting is important to facilitate accurate assessment of physical and behavioral indicators of family violence.
Presenting with extreme anger is possible but not as common as presenting with vague physical complaints.
Having many family members there is unlikely as many victims keep their history of being battered a secret.
It is not known that psychosis or mania is a result of physical violence, and this would not be a usual presenting complaint.
Lauren brings her 4-year-old daughter, Mikayla, to the emergency department and states that Mikayla has been “acting funny.” Lauren states, “She touches her vagina and rubs herself down there all the time and she never did that before. She drew me a picture showing two people with one on top of the other and said they were ‘doing sex’ and I saw her acting that out with her dolls too. I didn’t know where else to go.” Based on Lauren’s description, you suspect that:
a. ) this is normal developmental behavior in a 4-year-old child.
b. ) Mikayla has been sexually abused.
c. ) Lauren needs education in parenting skills.
d. ) Mikayla has been exposed to graphic sexual images on television.
b.) Mikayla has been sexually abused.
Sexualized behavior is one of the most common symptoms of sexual abuse in children. Younger children may draw sexually explicit images, demonstrate sexual aggression, or act out sexual interactions in play, for example, with dolls.
Masturbation may be excessive in sexually abused children.
It is not normal developmental behavior for a 4-year-old child. The other options may be true, but sexual abuse is more likely and must be investigated.
After arranging for a sexual assault nurse examiner (SANE) to see Lauren and Mikayla for further assessment for abuse and proper reporting and follow-up, Lauren tells you she lives with her boyfriend, Darrin, who is not Mikayla’s father. What statement by Lauren would make you suspect she is being emotionally abused?
a. ) “Darrin has a good job and keeps control of all the finances but our electricity still got turned off last week.”
b. ) “I didn’t tell Darrin I was coming because he is under so much stress at work I didn’t want to add to it.”
c. ) “Darrin yells a lot and calls me names, but that’s because I am so stupid and make so many mistakes.”
d. ) “Darrin is Latin American and has a fiery temper.”
c.) “Darrin yells a lot and calls me names, but that’s because I am so stupid and make so many mistakes.”
Emotional abuse may be less obvious and more difficult to assess than physical violence, but it can be identified through indicators such as low self-esteem, reported feelings of inadequacy, and anxiety.
Controlling the finances and having the electricity turned off describes the possibility of economic abuse. Not wanting to add to the boyfriend’s stress does not describe an abusive situation.
The spouse being Latin American with a temper would more likely hint at physical abuse rather than emotional.
If it is determined that Mikayla has been sexually abused, what is the priority outcome for Mikayla?
a. ) Mikayla’s mother will learn coping techniques to support Mikayla.
b. ) Mikayla will be able to verbalize exactly what happened to her.
c. ) Mikayla will no longer act out sexually.
d. ) The sexual abuse will cease.
d.) The sexual abuse will cease.
The highest priority in this case is that the abuse stops so that the patient can be safe and undergo recovery. The question is asked about the priority outcome for the victim, not the mother.
Verbalizing exactly what happened is not a priority.
The victim will most likely stop the sexualized behavior when the abuse has stopped and recovery is supported by age appropriate interventions.
Which nursing diagnosis should be investigated for clients with somatoform disorders?
a. ) Deficient fluid volume
b. ) Self-care deficit
c. ) Ineffective coping
d. ) Delayed growth and development
c.) Ineffective coping
Soma is the Greek word for “body,” and somatization is the expression of psychological stress through physical symptoms.
A physician describes a client as “malingering.” The nurse knows this means that the client
a. ) is falsely claiming to have symptoms.
b. ) experiences symptoms that cannot be explained medically.
c. ) experiences symptoms that have a physiological basis.
d. ) is seeking medication to ease pain of psychological origin.
a.) is falsely claiming to have symptoms.
Malingering is a consciously motivated act to deceive based on the desire for material gain.
An example of a somatoform disorder is
a. ) depersonalization.
b. ) dissociative fugue.
c. ) conversion disorder.
d. ) dissociative identity disorder.
c.) conversion disorder.
Somatic disorders include conversion disorders that are functional neurological disorders.
Therapeutic intervention for a client with a somatoform disorder would include
a. ) steering conversation away from the client’s feelings.
b. ) conveying an interest in the client rather than in the symptoms.
c. ) encouraging the client to use benzodiazepines liberally.
d. ) encouraging the client to rely on the nurse to meet the client’s needs.
b.) conveying an interest in the client rather than in the symptoms.
When the nurse focuses on the client rather than on the symptoms, the client’s self-worth and coping skills are enhanced.
The most likely client to initially demonstrate behaviors suggesting a somatic disorder is a
a. ) 13-year-old male
b. ) 23-year-old female
c. ) 33-year-old male
d. ) 43-year-old female
b.) 23-year-old female
Which disorder is characterized by the client’s misinterpretation of physical sensations or feelings?
a. ) Somatic disorder
b. ) Factitious disorder
c. ) Illness anxiety disorder
d. ) Conversion disorder
c.) Illness anxiety disorder
Previously known as hypochondriasis, illness anxiety disorder results in the misinterpretation of physical sensations as evidence of a serious illness.
Illness anxiety can be quite obsessive, because thoughts about illness may be intrusive and difficult to dismiss, even when the patient recognizes that his or her fears are unrealistic.
