Psychiatric Mental Health Nursing 5th Edition By Fortinash- Test Bank

Psychiatric Mental Health Nursing 5th Edition By Fortinash- Test Bank

Fortinash: Psychiatric Mental Health Nursing, 5th Edition

Chapter 10: Anxiety and Anxiety Disorders

Test Bank

MULTIPLE CHOICE

1. A patient who was savagely attacked by a bear has no memory of the event. Which statement best explains the patient’s inability to remember the attack?
a. The woman lost consciousness and was not cognitively aware of what happened during the attack
b. The brain has produced a chemical anemia that will repress the memories of the attack indefinitely.
c. The patient is unconsciously using a defense mechanism to protect against the repeated memory of the attack.
d. It is a temporary suppression of the attack; her memory will return when she is physically and emotionally ready to handle the memories.

ANS: C
Defense mechanisms are used unconsciously to protect us from threats to the physical, mental, and social aspects of ourselves. The memory of the event may or may not come back but this is not generally related to the patient’s ability to handle the memories. Memory may be lost or impaired as a result of brain trauma but not as likely from a chemical alteration.

DIF: Cognitive Level: Application REF: Page 187
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

2. Which assessment finding exhibited by a patient being assessed for posttraumatic stress disorder (PTSD) would be considered a defining behavior and support such a diagnosis?
a. Can describe the attack in great detail
b. Experiences dramatic swings in affect
c. Describes vivid “flashbacks” of being attacked
d. Is preoccupied with the need to “tell someone about the attack”

ANS: C
One defining behavior that is seen when an individual has PTSD is that the person re-experiences the traumatic event. This takes place by having recurrent and intrusive disturbing recollections of the trauma, including thoughts, images, or perceptions about the incident. The person sometimes experiences recurrent dreams of the incident and acts or feels as though the event was recurring in the present (flashback). Generally the PTSD patient cannot remember all the details of the trauma nor are they particularly interested in re-telling the events of the trauma. The patient generally has a very limited range of affect.

DIF: Cognitive Level: Application REF: Page 196
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

3. What is the basis for assessing a male patient who is agoraphobic for panic attacks?
a. Men are more likely to experience panic attacks.
b. An overwhelming number of agoraphobic patients also have panic attacks.
c. Patients are often unaware that the symptoms they are experiencing are those of panic.
d. Panic attacks are generally the cause of a patient developing phobias like agoraphobia.

ANS: B
Almost all patients who present with agoraphobia in clinical samples have a current diagnosis or history of panic disorder. Males are not more likely than females to experience panic attacks. Patients are not usually unaware of panic attack symptoms. Panic attacks don’t cause, but are often triggered by, phobias.

DIF: Cognitive Level: Application REF: Page 193
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

4. Discharge preparation for a patient includes the administration of the Hamilton Anxiety Scale (HAS). When asked by the patient to explain the purpose of the assessment the nurse responds:
a. “It is an assessment tool used to evaluate the symptoms of anxiety.”
b. “The tool is used to help confirm the diagnosis of anxiety disorder.”
c. “This tool helps determine if your symptoms have improved with treatment.”
d. “It helps identify the presence of any other disorder associated with anxiety.”

ANS: C
The HAS is a valid and time-tested tool that gives the most objective measure of the degree to which anxiety has been effectively treated. The HAS does not evaluate for symptoms of anxiety or act as a diagnosis tool for anxiety or another other associated disorder.

DIF: Cognitive Level: Application REF: Page 202
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

5. A patient is admitted for treatment for persistent, severe anxiety. Which nursing diagnosis would help effectively direct patient care?
a. Disturbed sensory perception related to narrowed perceptual field
b. Risk for injury related to closed perception
c. Hopelessness related to total loss of control
d. Risk for other-directed violence related to combative behavior

ANS: A
A narrowed perceptual field occurs with severe anxiety; therefore this diagnosis should be considered. Data are not present to support the other diagnoses.

DIF: Cognitive Level: Analysis REF: Page 189 TOP: Nursing Process: Diagnosis
MSC: NCLEX: Psychosocial Integrity