Psychiatric Nursing Degree Questions - Foundations of Psychiatric Nursing (11-20)

Psychiatric Nursing Degree Questions

11. Which of the following is a generally accepted criterion of mental health?

a) self-acceptance
b) absence of anxiety
c) ability to control others
d) happiness

12. The basis for a therapeutic nurse-patient relationship begins with the nurse's:

a) sincere desire to help others
b) acceptance of others
c) self-awareness and understanding
d) sound knowledge of psychiatric nursing

13. Which of the following should occur during the working phase of the nurse-patient relationship?

a) the nurse assesses the patient's needs and develops a plan of care for the patient
b) the nurse and the patient together evaluate and modify the goals of the relationship
c) the nurse and the patient discuss their feelings regarding the termination of the relationship
d) the nurse and the patient explore each others expectations of the relationship

14. The nurse should introduce information about the end of the nurse-patient relationship:

a) during the orientation phase
b) as the goals of the relationship are reached
c) at least one or two sessions before the last meeting
d) when the patient is able to tolerate it

15. One example of the psychiatric nurse's role in primary prevention is:

a) handling crisis intervention in an outpatient setting
b) visiting the patient's home to discuss medication management
c) conducting a post-discharge support group
d) providing sex education classes for adolescents

16. the most effective way for the nurse to set limits for newly admitted patient who puts out his cigarettes on the dayroom floor is to:

a) restrict the patient's smoking to times when he can be closely supervised by a staff member
b) encourage other patients to speak with the patient about dirtying the dayroom floor
c) ask the patient if he puts out his cigarettes on the floor at home
d) hand the patient and astray and tell him he must use it or he will not be allowed to smoke

17. A busy woman attorney with a successful law practice is admitted to the acute care hospital with epigastric pain. Since admission, she has called the nurse every 15 minutes with one request or another. The patient exhibiting:

a) repression
b) somatization
c) regression
d) converson

18. G. Lost an important advertising account and had a flat tire on the way home. That evening, he began to find fault with everyone. Which defense mechanism is he using?

a) displacement
b) projection
c) regression
d) sublimation

19. Which primary unconscious defense mechanism keeps highly anxiety-producing situations out of conscious awareness?

a) introjection
b) regression
c) repression
d) denial

20. J. age 17; rarely expresses his feelings and usually remains passive; however, when he is angry, his face typically becomes flushed and his blood pressure rises to 170/100 mm Hg. His parents are described as passive and easygoing. J may be using which defense mechanism to handle anger?

a) displacement
b) introjection
c) projection
d) sublimation




Psychiatric Nursing Degree Questions:
ANSWERS AND RATIONALE 

11) A
- Rationale: self-acceptance is a generally accepted criterion of mental health and serves as the basis for healthy relationships with others. Some degree of anxiety is necessary to stimulate growth and adaptation. Self-control and self-direction rather than the ability to control others are indicative of mental health. Happiness, though desirable, is not an effective indicator of mental health because even mentally healthy people are unhappy when faced events and illness, loss, and death.

12) C
- Rationale: Although all the choices are certainly desirable, knowledge of self serves as the basis for building a strong therapeutic nurse-patient relationship. Then nurse must be aware and understand her feelings and behavior before she can understand and help others.

13) B
- Rationale: the therapeutic nurse-patient relationship consists of four phases; Preinteraction, introduction or orientation, working, and termination. In the working phase, the nurse and the patient together evaluate and refine the goals established in the orientation phase. In addition, major therapeutic work takes place, and insight is integrated into a plan of action. The orientation phase involves assessing the client, formulating a contract, exploring feelings, and establishing expectations about the relationship. In the termination phase, the nurse prepares the patient for separation and explores feelings about the end of the relationship.

14) A
- Rationale: preparation for ending the nurse-patient relationship begins during the orientation phase, when the limits of the relationship are established. Termination also should be discussed as goals are achieved and the relationship nears an end. Although the nurse should remind the patient that only one or two sessions are left, she must not wait until then to prepare the patient for the relationship's termination. Waiting until the patient can tolerate ending the relationship also is too late. Because many patients have had negative experience when ending relationships, the nurse can use termination of the nurse-patient relationship to prepare the patient for -- and work him through -- positive termination experiences with others.

15) D
- Rationale: the psychiatric nurse participates in primary, secondary, and tertiary prevention activities. Primary prevention includes providing sex education classes for adolescents and education programs that promote mental health and prevent future psychiatric episodes. Secondary prevention involves treatment to reduce psychiatric problems. Crisis intervention in an outpatient setting is one example of secondary prevention. Administering and supervising medication regimens and participating in the therapeutic milieu are other means of secondary prevention. Tertiary prevention involves helping patients who are recovering from psychiatric illness; activities that are directed toward providing aftercare and rehabilitation are part of this role. Conducting a post discharge support group is a tertiary prevention activity.

16) D
- Rationale: setting limits is necessary to help patients behave in socially acceptable ways. By handling the patient an ashtray and clearly stating that he must use it or he will not be allowed to smoke, the nurse is setting limits on his behavior. Because he is a newly admitted patient, the nurse need to restate these limits in a manner that shows disapproval of the behavior but does not reject him as a person. A manner-of-fact, nonpunitive tone of voice is important. If the patient does not comply, he must face the consequences, in this case, not to be allowed to smoke. If the patient's mental status is such that he cannot understand or follow these limits, his smoking may need to supervised. Encouraging other patients to deal with new patient is not advisable. asking the patient if he puts out cigarettes on the floor at home has no bearing on whether this behavior is acceptable in the hospital.

17. C
- Rationale: the patient is exhibiting the defense mechanism of regression - - a return to behaviors characteristic of an earlier developmental level. Her dependent, attention-getting behavior is an attempt to relieve anxiety. Repression would be evidenced by ignoring the symptoms. Somatization is the channeling of anxiety into a preoccupation with physical complaints. Conversion involves the transfer of a mental conflict into a physical symptom to relieve anxiety.

18) A
- Rationale: G is using displacement, a mechanism in which the patient discharges his feelings of anger and rejection in an indirect way that he perceives as safe - - in this situation, by displacing his anger from work and car problems onto family members. Projection is attributing one's emotion to -- or blaming them on -- others. Regression is a retreat to earlier levels of developmental behavior to relieve anxiety. Sublimation is a socially acceptable discharge of psychic energy or anger, such as through exercise or some other productive activity.

19) C
- Rationale: Repression, the unconscious exclusion of painful or conflicting thoughts, impulses, or memories from awareness, is the primary ego defense. Other defense mechanisms tend to reinforce the anxiety. Introjection is an intense identification in which an individual incorporates another person's or group's values or qualities into his own ego structure. Regression is a retreat into an earlier developmental level in a time of stress. Denial is avoidance of unpleasant realities by ignoring them.

20) B
- Rationale: J may be introjecting his parent's belief that anger should not be outwardly expressed. He also may be holding in his angry feelings, as evidenced by his increased high blood pressure. (Increased blood pressure is a common physiologic reaction to the fight-or-flight response brought on by strong emotions. Habitual failure to express anger may contribute to hypertension.) Displacement is the discharge of negative feelings onto another person or an object. Projection is the attribution of one's own thoughts or impulses to another person. Sublimation is the channeling of unbearable or socially unacceptable behaviors to more socially acceptable outlets.


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