Chapter 10: Obsessive-Compulsive and Related
Disorders
MULTIPLE CHOICE
1. A patient who was savagely attacked by a bear has no memory of the event. Which statement
best explains the patients 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 patients 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.
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
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,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.
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 dont cause, but are
often triggered by, phobias.
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.
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, 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.
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.
MSC: NCLEX: Psychosocial Integrity
6. The patient was an awkward child who was ridiculed by his father for his inability to catch a
ball. As an adult, the patient developed panic attacks at the time his company established after-
work team sporting activities. Which data discussed during the nursing interview provides
insight to the possible cause of this anxiety disorder when applying the behavioral model?
a. He always avoids sports because Im short and not the least bit athletic.
b. When in fifth grade, the patient caused his team to lose the big softball game.
c. The company he works for places tremendous emphasis of successful team
work.
d. As a child he wore a leg brace that prevented him from participating in school
sports.
ANS: A
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Disorders
MULTIPLE CHOICE
1. A patient who was savagely attacked by a bear has no memory of the event. Which statement
best explains the patients 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 patients 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.
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
HTTPS://PASINGGRADES.COM/
,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.
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 dont cause, but are
often triggered by, phobias.
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.
HTTPS://PASINGGRADES.COM/
, 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.
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.
MSC: NCLEX: Psychosocial Integrity
6. The patient was an awkward child who was ridiculed by his father for his inability to catch a
ball. As an adult, the patient developed panic attacks at the time his company established after-
work team sporting activities. Which data discussed during the nursing interview provides
insight to the possible cause of this anxiety disorder when applying the behavioral model?
a. He always avoids sports because Im short and not the least bit athletic.
b. When in fifth grade, the patient caused his team to lose the big softball game.
c. The company he works for places tremendous emphasis of successful team
work.
d. As a child he wore a leg brace that prevented him from participating in school
sports.
ANS: A
HTTPS://PASINGGRADES.COM/
