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S3 psych trauma; eating disorders

Terms in this set (69)

A client with posttraumatic stress disorder (PTSD) is treated with exposure therapy. What change is most likely expected in the client after receiving this therapy?

a) The client may become more socially active.
b) The client may be able to control his thoughts and feelings about the event.
c) The client may be able to sleep better.
d) The client may stop having dreams associated with the traumatic event.
d) The client may stop having dreams associated with the traumatic event
While doing the routine basic physical assessment of a client with posttraumatic stress disorder (PTSD), the nurse finds that the client appears totally numb with a blank stare. What does this sign most likely indicate?

a) The client may have lost consciousness.
b) The client may have dissociative symptoms.
c) The client may be under the influence of illicit drugs.
d) The client may have improved with psychotherapy
b
A suicidal client with a history of manic behavior is admitted to the ED. The client's diagnosis is documented as Bipolar I Disorder: Current Episode Depressed. What is the rationale for this diagnosis instead of a diagnosis of Major Depressive Disorder?
a. The physician does not believe the client is suffering from major depression.
b. The client has experienced a manic episode in the past.
c.The client does not exhibit psychotic symptoms.
d.There is no history of major depression in the client's family
B
The client's past history of mania and current suicide attempt support the diagnosis of Bipolar I Disorder: Current Episode Depressed. According to the DSM-5 criteria, a manic episode rules out the diagnosis of Major Depressive Disorder.
A mute client diagnosed with schizophrenia displays catatonia and waxy flexibility. Which nursing intervention would assist the client in communicating with others?

1) Providing assistance with self-care needs


2) Using clear, concrete statements


3) Conveying acceptance of client's need for false beliefs


4) Attempting to decode incomprehensible communication patterns
Feedback 2: The use of clear, concrete statements shows the client what is expected. Because clients diagnosed with schizophrenia experience concrete thinking, explanations must be provided at the client's concrete level of comprehension.
A client is admitted with a diagnosis of schizoaffective disorder. Which symptoms are characteristic of this diagnosis?


1) Strong ego boundaries and abstract thinking

2) Ataxia and akinesia

3) Altered mood and thought disturbances

4) Substance use disorder and cachexi
3) Altered mood and thought disturbances
Two months ago, Ms. T was sexually assaulted while jogging in an isolated park. She is hospitalized for suicidal ideation at this time. She awakens in the middle of the night screaming about having nightmares of the incident. Which of the following is the most appropriate initial nursing intervention?

A. Call the doctor to report the incident.
B. Stay with Ms. T until the anxiety has subsided.
C. Administer prn alprazolam.
D. Allow her some privacy to work through the emotions.
Correct answer: B

It is important to not leave a client who is experiencing flashbacks or nightmares alone. Clients often feel they are "going crazy" when this happens, and the presence of a trusted individual calms fears and reassures the client of her safety
Which of the following medications is considered to be a first-line medication of choice in the treatment of PTSD?

A. Alprazolam
B. Propranolol
C. Carbamazepine
D. Paroxetine
Correct answer: D

The SSRIs are now considered first-line treatment of choice for PTSD because of their efficacy, tolerability, and safety ratings. Paroxetine and sertraline have been approved by the FDA for this purpose.
A 13-year-old client's father has recently been deployed to Afghanistan. Since deployment, the client has begun to participate in isolative behaviors, truancy, vandalism, and fighting. The pediatric nurse practitioner should identify this behavior with which adjustment disorder?

A. An adjustment disorder with anxiety
B. An adjustment disorder with disturbance of conduct
C. An adjustment disorder with mixed disturbance of emotions and conduct
D. An adjustment disorder unspecified
C. An adjustment disorder with mixed disturbance of emotions and conduct

The predominant features of an adjustment disorder with mixed disturbance of emotions and conduct include symptoms of anxiety or depression as well as behaviors to include violations of rights of others, truancy, vandalism, and fighting.
A client has been extremely nervous ever since a person died as a result of the client's drunk driving. When assessing for the diagnosis of adjustment disorder, within what timeframe should the nurse expect the client to exhibit these symptoms?

A. To meet the DSM-IV criteria for adjustment disorder, the client should exhibit symptoms within 1 year of the accident.
B. To meet the DSM-IV criteria for adjustment disorder, the client should exhibit symptoms within 3 months of the accident.
C. To meet the DSM-IV criteria for adjustment disorder, the client should exhibit symptoms within 6 months of the accident.
D. To meet the DSM-IV criteria for adjustment disorder, the client should exhibit symptoms within 9 months of the accident.
ANS: B
According to the DSM-IV diagnostic criteria for adjustment disorders, the development of emotional or behavioral symptoms in response to an identifiable stressor occurs within 3 months of the onset of the stressor.
A client with acute stress disorder has avoided feelings of anger toward her rapist and cannot verbally express them. The nurse suggests which of the following activities to assist the client with expressing her feelings?
1. Working on a puzzle.
2. Writing in a journal.
3. Meditating.
4. Listening to music.
2.
Writing in a journal can help the client safely express feelings, particularly anger, when the client cannot verbalize them. Safely externalizing anger by writing in a journal helps the client to maintain control over her feelings
A physically healthy, 35-year-old single client lives with parents who provide total financial support. According to Erikson's theory, which developmental task should a nurse assist the client to accomplish?

A. Establishing the ability to control emotional reactions
B. Establishing a strong sense of ethics and character structure
C. Establishing and maintaining self-esteem
D. Establishing a career, personal relationships, and societal connections
ANS: D
The nurse should assist the client in establishing a career, personal relationships, and societal connections. According to Erikson, non-achievement in the generativity versus stagnation stage results in self-absorption, including withdrawal from others and having no capacity for giving of the self to others.
Ms. T has been diagnosed with agoraphobia. Which behavior would be most characteristic of this disorder?

a. Ms. T experiences panic anxiety when she encounters snakes.
b. Ms. T refused to fly in an airplane.
c. Ms. T. will not eat in a public place.
d. Ms. T stays in her home for fear of being in a place from which she cannot escape.
d. Ms. T stays in her home for fear of being in a place from which she cannot escape.
Which of the following is the most appropriate therapy for a client with agoraphobia?

a. 10 mg Valium qid.
b. Group therapy with other agoraphobics.
c. Facing her fear in gradual step progression.
d. Hypnosis.
c. Facing her fear in gradual step progression.
With implosion therapy, a client with phobic anxiety would be:

a. Taught relaxation exercises.
b. Subjected to graded intensities of the fear.
c. Instructed to stop the therapeutic session as soon as anxiety is experienced.
d. Presented with massive exposure to a variety of stimuli associated with phobic object/stimulation.
d. Presented with massive exposure to a variety of stimuli associated with phobic object/stimulation.
A client with OCD spends many hours each day washing her hands. The most likely reason she washers her hands so much is that it:

a. Relieves her anxiety
b. Reduces the probability of infection
c. Gives her a feeling of control over her life
d. Increases her self confidence
a. Relieves her anxiety
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