H360 Exam 2 Questions With
Accurate Answers
A patient checks and rechecks electrical cords related to an obsessive thought
that the house may burn down. The nurse and patient explore the likelihood of
an actual fire. The patient states this event is not likely. This counseling
demonstrates principles of:
a.
flooding.
c.
relaxation technique.
b.
desensitization.
d.
cognitive restructuring. - ANSWER ANS: D
Cognitive restructuring involves the patient in testing automatic thoughts and
drawing new conclusions. Desensitization involves graduated exposure to a
feared object. Relaxation training teaches the patient to produce the opposite of
the stress response. Flooding exposes the patient to a large amount of an
undesirable stimulus in an effort to extinguish the anxiety response.
A patient undergoing diagnostic tests says, "Nothing is wrong with me except a
stubborn chest cold." The spouse reports the patient smokes, coughs daily, lost
15 pounds, and is easily fatigued. Which defense mechanism is the patient
using?
a.
Displacement
c.
Projection
b.
Regression
d.
Denial - ANSWER ANS: D
Denial is an unconscious blocking of threatening or painful information or
feelings. Regression involves using behaviors appropriate at an earlier stage of
psychosexual development. Displacement shifts feelings to a more neutral
,person or object. Projection attributes one's own unacceptable thoughts or
feelings to another.
A patient preparing for surgery has moderate anxiety and is unable to
understand preoperative information. Which nursing intervention is most
appropriate?
a.
Reassure the patient that all nurses are skilled in providing postoperative care.
b.
Present the information again in a calm manner using simple language.
c.
Tell the patient that staff is prepared to promote recovery.
d.
Encourage the patient to express feelings to family. - ANSWER ANS: B
Giving information in a calm, simple manner will help the patient grasp the
important facts. Introducing extraneous topics as described in the distracters
will further scatter the patient's attention.
A patient is experiencing moderate anxiety. The nurse encourages the patient to
talk about feelings and concerns. What is the rationale for this intervention?
a.
Offering hope allays and defuses the patient's anxiety.
b.
Concerns stated aloud become less overwhelming and help problem solving
begin.
c.
Anxiety is reduced by focusing on and validating what is occurring in the
environment.
d.
Encouraging patients to explore alternatives increases the sense of control and
lessens anxiety. - ANSWER ANS: B
All principles listed are valid, but the only rationale directly related to the
intervention of assisting the patient to talk about feelings and concerns is the
one that states that concerns spoken aloud become less overwhelming and help
problem solving begin.
A nurse assesses a patient with a tentative diagnosis of generalized anxiety
disorder. Which question would be most appropriate for the nurse to ask?
a.
"Have you been a victim of a crime or seen someone badly injured or killed?"
b.
"Do you feel especially uncomfortable in social situations involving people?"
c.
,"Do you repeatedly do certain things over and over again?"
d.
"Do you find it difficult to control your worrying?" - ANSWER ANS: D
Patients with generalized anxiety disorder frequently engage in excessive
worrying. They are less likely to engage in ritualistic behavior, fear social
situations, or have been involved in a highly traumatic event.
A person has minor physical injuries after an auto accident. The person is
unable to focus and says, "I feel like something awful is going to happen." This
person has nausea, dizziness, tachycardia, and hyperventilation. What is the
person's level of anxiety?
a.
Mild
c.
Severe
b.
Moderate
d.
Panic - ANSWER ANS: C
The person whose anxiety is severe is unable to solve problems and may have a
poor grasp of what is happening in the environment. Somatic symptoms such as
those described are usually present. The individual with mild anxiety is only
mildly uncomfortable and may even find his or her performance enhanced. The
individual with moderate anxiety grasps less information about a situation and
has some difficulty with problem solving. The individual in panic will
demonstrate markedly disturbed behavior and may lose touch with reality.
Two staff nurses applied for promotion to nurse manager. The nurse not
promoted initially had feelings of loss but then became supportive of the new
manager by helping make the transition smooth and encouraging others. Which
term best describes the nurse's response?
a.
Altruism
c.
Intellectualization
b.
Suppression
d.
Reaction formation - ANSWER ANS: A
Altruism is the mechanism by which an individual deals with emotional conflict
by meeting the needs of others and receiving gratification vicariously or from
the responses of others. The nurse's reaction is conscious rather than
unconscious. There is no evidence of suppression. Intellectualization is a
process in which events are analyzed based on remote, cold facts and without
, passion, rather than incorporating feeling and emotion into the processing.
Reaction formation is when unacceptable feelings or behaviors are controlled
and kept out of awareness by developing the opposite behavior or emotion.
A patient experiencing panic suddenly began running and shouting, "I'm going
to explode!" Select the nurse's best action.
a.
Ask, "I'm not sure what you mean. Give me an example."
b.
Capture the patient in a basket-hold to increase feelings of control.
c.
Tell the patient, "Stop running and take a deep breath. I will help you."
d.
Assemble several staff members and say, "We will take you to seclusion to help
you regain control." - ANSWER ANS: C
Safety needs of the patient and other patients are a priority. Comments to the
patient should be simple, neutral, and give direction to help the patient regain
control. Running after the patient will increase the patient's anxiety. More than
one staff member may be needed to provide physical limits, but using seclusion
or physically restraining the patient prematurely is unjustified. Asking the
patient to give an example would be futile; a patient in panic processes
information poorly
A nurse plans health teaching for a patient with generalized anxiety disorder
who begins a new prescription for lorazepam (Ativan). What information should
be included? Select all that apply.
a.
Caution in use of machinery
b.
Foods allowed on a tyramine-free diet
c.
The importance of caffeine restriction
d.
Avoidance of alcohol and other sedatives
e.
Take the medication on an empty stomach - ANSWER ANS: A, C, D
Caffeine is a central nervous system stimulant that acts as an antagonist to the
benzodiazepine lorazepam. Daily caffeine intake should be reduced to the
amount contained in one cup of coffee. Benzodiazepines are sedatives, thus the
importance of exercising caution when driving or using machinery and the
importance of not using other central nervous system depressants such as
alcohol or sedatives to avoid potentiation. Benzodiazepines do not require a
special diet. Food will reduce gastric irritation from the medication.
Accurate Answers
A patient checks and rechecks electrical cords related to an obsessive thought
that the house may burn down. The nurse and patient explore the likelihood of
an actual fire. The patient states this event is not likely. This counseling
demonstrates principles of:
a.
flooding.
c.
relaxation technique.
b.
desensitization.
d.
cognitive restructuring. - ANSWER ANS: D
Cognitive restructuring involves the patient in testing automatic thoughts and
drawing new conclusions. Desensitization involves graduated exposure to a
feared object. Relaxation training teaches the patient to produce the opposite of
the stress response. Flooding exposes the patient to a large amount of an
undesirable stimulus in an effort to extinguish the anxiety response.
A patient undergoing diagnostic tests says, "Nothing is wrong with me except a
stubborn chest cold." The spouse reports the patient smokes, coughs daily, lost
15 pounds, and is easily fatigued. Which defense mechanism is the patient
using?
a.
Displacement
c.
Projection
b.
Regression
d.
Denial - ANSWER ANS: D
Denial is an unconscious blocking of threatening or painful information or
feelings. Regression involves using behaviors appropriate at an earlier stage of
psychosexual development. Displacement shifts feelings to a more neutral
,person or object. Projection attributes one's own unacceptable thoughts or
feelings to another.
A patient preparing for surgery has moderate anxiety and is unable to
understand preoperative information. Which nursing intervention is most
appropriate?
a.
Reassure the patient that all nurses are skilled in providing postoperative care.
b.
Present the information again in a calm manner using simple language.
c.
Tell the patient that staff is prepared to promote recovery.
d.
Encourage the patient to express feelings to family. - ANSWER ANS: B
Giving information in a calm, simple manner will help the patient grasp the
important facts. Introducing extraneous topics as described in the distracters
will further scatter the patient's attention.
A patient is experiencing moderate anxiety. The nurse encourages the patient to
talk about feelings and concerns. What is the rationale for this intervention?
a.
Offering hope allays and defuses the patient's anxiety.
b.
Concerns stated aloud become less overwhelming and help problem solving
begin.
c.
Anxiety is reduced by focusing on and validating what is occurring in the
environment.
d.
Encouraging patients to explore alternatives increases the sense of control and
lessens anxiety. - ANSWER ANS: B
All principles listed are valid, but the only rationale directly related to the
intervention of assisting the patient to talk about feelings and concerns is the
one that states that concerns spoken aloud become less overwhelming and help
problem solving begin.
A nurse assesses a patient with a tentative diagnosis of generalized anxiety
disorder. Which question would be most appropriate for the nurse to ask?
a.
"Have you been a victim of a crime or seen someone badly injured or killed?"
b.
"Do you feel especially uncomfortable in social situations involving people?"
c.
,"Do you repeatedly do certain things over and over again?"
d.
"Do you find it difficult to control your worrying?" - ANSWER ANS: D
Patients with generalized anxiety disorder frequently engage in excessive
worrying. They are less likely to engage in ritualistic behavior, fear social
situations, or have been involved in a highly traumatic event.
A person has minor physical injuries after an auto accident. The person is
unable to focus and says, "I feel like something awful is going to happen." This
person has nausea, dizziness, tachycardia, and hyperventilation. What is the
person's level of anxiety?
a.
Mild
c.
Severe
b.
Moderate
d.
Panic - ANSWER ANS: C
The person whose anxiety is severe is unable to solve problems and may have a
poor grasp of what is happening in the environment. Somatic symptoms such as
those described are usually present. The individual with mild anxiety is only
mildly uncomfortable and may even find his or her performance enhanced. The
individual with moderate anxiety grasps less information about a situation and
has some difficulty with problem solving. The individual in panic will
demonstrate markedly disturbed behavior and may lose touch with reality.
Two staff nurses applied for promotion to nurse manager. The nurse not
promoted initially had feelings of loss but then became supportive of the new
manager by helping make the transition smooth and encouraging others. Which
term best describes the nurse's response?
a.
Altruism
c.
Intellectualization
b.
Suppression
d.
Reaction formation - ANSWER ANS: A
Altruism is the mechanism by which an individual deals with emotional conflict
by meeting the needs of others and receiving gratification vicariously or from
the responses of others. The nurse's reaction is conscious rather than
unconscious. There is no evidence of suppression. Intellectualization is a
process in which events are analyzed based on remote, cold facts and without
, passion, rather than incorporating feeling and emotion into the processing.
Reaction formation is when unacceptable feelings or behaviors are controlled
and kept out of awareness by developing the opposite behavior or emotion.
A patient experiencing panic suddenly began running and shouting, "I'm going
to explode!" Select the nurse's best action.
a.
Ask, "I'm not sure what you mean. Give me an example."
b.
Capture the patient in a basket-hold to increase feelings of control.
c.
Tell the patient, "Stop running and take a deep breath. I will help you."
d.
Assemble several staff members and say, "We will take you to seclusion to help
you regain control." - ANSWER ANS: C
Safety needs of the patient and other patients are a priority. Comments to the
patient should be simple, neutral, and give direction to help the patient regain
control. Running after the patient will increase the patient's anxiety. More than
one staff member may be needed to provide physical limits, but using seclusion
or physically restraining the patient prematurely is unjustified. Asking the
patient to give an example would be futile; a patient in panic processes
information poorly
A nurse plans health teaching for a patient with generalized anxiety disorder
who begins a new prescription for lorazepam (Ativan). What information should
be included? Select all that apply.
a.
Caution in use of machinery
b.
Foods allowed on a tyramine-free diet
c.
The importance of caffeine restriction
d.
Avoidance of alcohol and other sedatives
e.
Take the medication on an empty stomach - ANSWER ANS: A, C, D
Caffeine is a central nervous system stimulant that acts as an antagonist to the
benzodiazepine lorazepam. Daily caffeine intake should be reduced to the
amount contained in one cup of coffee. Benzodiazepines are sedatives, thus the
importance of exercising caution when driving or using machinery and the
importance of not using other central nervous system depressants such as
alcohol or sedatives to avoid potentiation. Benzodiazepines do not require a
special diet. Food will reduce gastric irritation from the medication.
