CMN 350 FINAL EXAM ACTUAL QUESTIONS AND
SOLUTIONS RATED A+
✔✔Panic-level anxiety - ✔✔-characterized by markedly disturbed behavior
-not able to process what is occurring in the environment and can lose touch with reality
-experiences extreme fright and horror
-experiences severe hyperactivity or flight
-immobility can occur
-other characteristics can include dysfunction in speech, dilated pupils, severe
shakiness, severe withdrawal, inability to sleep, delusions, and hallucinations
✔✔defense mechanisms - ✔✔-patients use them to try and protect themselves from
pain
-they need to overcome that pain
-nurses should set goals for good coping mechanisms and teach good coping
mechanisms
✔✔altruism - ✔✔-adaptive
-dealing with anxiety by reaching out to others
✔✔sublimation - ✔✔-adaptive
-Consciously or unconsciously channeling instinctual drives into acceptable activities
-Guy, a former heroin addict, starts a local Narcotics Anonymous meeting.
✔✔Suppression - ✔✔-maladaptive
-Conscious exclusion from awareness anxiety-producing feelings, ideas, and situations
Aaron states to the nurse that his recent divorce is no big deal.
-Aaron states to the nurse that his recent divorce is no big deal.
✔✔Repression - ✔✔-maladaptive
-Unconscious and involuntary forgetting of painful ideas, events, and conflicts
-Anna, a victim of incest, has limited memory of her childhood.
✔✔Regression - ✔✔-maladaptive
-Unconscious return to an earlier and more comfortable developmental level
-A 5-year-old child has been wetting the bed at night since the birth of his baby sister.
✔✔Displacement - ✔✔-maladaptive
-Unconsciously discharging pent-up feelings to a less threatening object
-A husband comes home after a hard day at work and yells at his wife and kids.
✔✔Reaction formation - ✔✔-maladaptive
-A conscious behavior that is the exact opposite of an unconscious feeling
-Wren, whose parents are divorcing, tells her mother she doesn't want to spend time
with her dad (so her mother doesn't get mad), even though she really misses him.
,✔✔Undoing - ✔✔-maladaptive
-Consciously doing something to counteract or make up for a transgression or
wrongdoing
-After accidentally eating another patient's cookies, Donnelly apologizes to his peer,
cleans the refrigerator, and labels everyone's snack with their names.
✔✔Rationalization - ✔✔-maladaptive
-Conscious or unconscious attempts to make or prove that one's feelings or behaviors
are justifiable
-John tells his mom that he bit his sister because she pushed him first.
✔✔Dissociation - ✔✔-maladaptive
-The unconscious separation of painful feelings and emotions from an unacceptable
idea, situation, or object
-Mrs. Adams recalls that when her husband was yelling at her, she didn't feel anything
inside, she just went numb.
✔✔Denial - ✔✔-maladaptive
-Unconscious refusal to admit an unacceptable idea or behavior
-Mac, who is alcohol dependent, believes that he can control his drinking if he so
desires.
✔✔Compensation - ✔✔-maladaptive
-Consciously covering up for a weakness by overemphasizing or making up a desirable
trait
-Malcolm, who is depressed and unable to share his feelings with others, writes and
becomes known for his expressive poetry.
✔✔Identification - ✔✔-maladaptive
-Conscious or unconscious attempt to model oneself after a respected person
-Kelly states to her nurse, "When I get out of the hospital, I want to be a nurse just like
you."
✔✔intellectualization - ✔✔-maladaptive
-Consciously or unconsciously using only logical explanations without feelings or an
affective component
-Rene talks about her son's death from cancer as being merciful and shows no signs of
her sadness or anger.
✔✔Conversion - ✔✔-maladaptive
-Unconscious expression of intrapsychic conflict symbolically through physical
symptoms
, -A student awakens with a migraine headache the morning of a final examination and
feels too ill to take the test. If she doesn't pass the exam, she will flunk out of nursing
school.
✔✔Splitting - ✔✔-maladaptive
-Demonstrating an inability to reconcile negative and positive attributes of self or others
-A client tells a nurse that she is the only one who cares about her, yet the following
day, the same client refuses to talk to the nurse.
✔✔Projection - ✔✔-maladaptive
-Unconsciously or consciously attributing one's own repressed thoughts to someone
else
-Connie blames her husband for the fight last night, unable to recognize that she was
the one who started it.
✔✔sexual advance - ✔✔-explain this is a nurse-patient relationship
-don't ignore
-address it
-tell them it is inappropriate
-if you continue with this behavior we will need to take a break then come back
-set limits
✔✔Key nursing interventions for depressed patients - ✔✔-Accept patients where they
are and focus on their strengths.
Reinforce decision making by patients.
-Respond to anger therapeutically. Deescalation techniques include being calm, using a
soft voice, reassuring the patient that you understand.
-Spend time with withdrawn patients.
-Involve patients in activities through which they can experience success.
✔✔Interactions with patients who have violent behavior - ✔✔• Stay out of striking
distance (this also reduces the threat to the patient).
• Avoid touching patients without approval.
• Change the topic temporarily if a patient's behavior is escalating.
• Suggest time out for the patient in a quiet area with fewer stimuli.
• Avoid entering a room alone with a patient who is not in control of his or her behavior.
• Leave temporarily if the patient is agitated and asking to be left alone.
• Call for staff assistance if the patient's behavior escalates.
✔✔Interactions with patients who have hallucinations - ✔✔1. The initial approach with
patients who appear to be listening to or talking with voices is to comment on their
behavior: "You look as if you are listening to something. What do you hear?"
2. If the patient acknowledges hearing something that the nurse cannot hear, then the
nurse can say, "Tell me what you hear."
SOLUTIONS RATED A+
✔✔Panic-level anxiety - ✔✔-characterized by markedly disturbed behavior
-not able to process what is occurring in the environment and can lose touch with reality
-experiences extreme fright and horror
-experiences severe hyperactivity or flight
-immobility can occur
-other characteristics can include dysfunction in speech, dilated pupils, severe
shakiness, severe withdrawal, inability to sleep, delusions, and hallucinations
✔✔defense mechanisms - ✔✔-patients use them to try and protect themselves from
pain
-they need to overcome that pain
-nurses should set goals for good coping mechanisms and teach good coping
mechanisms
✔✔altruism - ✔✔-adaptive
-dealing with anxiety by reaching out to others
✔✔sublimation - ✔✔-adaptive
-Consciously or unconsciously channeling instinctual drives into acceptable activities
-Guy, a former heroin addict, starts a local Narcotics Anonymous meeting.
✔✔Suppression - ✔✔-maladaptive
-Conscious exclusion from awareness anxiety-producing feelings, ideas, and situations
Aaron states to the nurse that his recent divorce is no big deal.
-Aaron states to the nurse that his recent divorce is no big deal.
✔✔Repression - ✔✔-maladaptive
-Unconscious and involuntary forgetting of painful ideas, events, and conflicts
-Anna, a victim of incest, has limited memory of her childhood.
✔✔Regression - ✔✔-maladaptive
-Unconscious return to an earlier and more comfortable developmental level
-A 5-year-old child has been wetting the bed at night since the birth of his baby sister.
✔✔Displacement - ✔✔-maladaptive
-Unconsciously discharging pent-up feelings to a less threatening object
-A husband comes home after a hard day at work and yells at his wife and kids.
✔✔Reaction formation - ✔✔-maladaptive
-A conscious behavior that is the exact opposite of an unconscious feeling
-Wren, whose parents are divorcing, tells her mother she doesn't want to spend time
with her dad (so her mother doesn't get mad), even though she really misses him.
,✔✔Undoing - ✔✔-maladaptive
-Consciously doing something to counteract or make up for a transgression or
wrongdoing
-After accidentally eating another patient's cookies, Donnelly apologizes to his peer,
cleans the refrigerator, and labels everyone's snack with their names.
✔✔Rationalization - ✔✔-maladaptive
-Conscious or unconscious attempts to make or prove that one's feelings or behaviors
are justifiable
-John tells his mom that he bit his sister because she pushed him first.
✔✔Dissociation - ✔✔-maladaptive
-The unconscious separation of painful feelings and emotions from an unacceptable
idea, situation, or object
-Mrs. Adams recalls that when her husband was yelling at her, she didn't feel anything
inside, she just went numb.
✔✔Denial - ✔✔-maladaptive
-Unconscious refusal to admit an unacceptable idea or behavior
-Mac, who is alcohol dependent, believes that he can control his drinking if he so
desires.
✔✔Compensation - ✔✔-maladaptive
-Consciously covering up for a weakness by overemphasizing or making up a desirable
trait
-Malcolm, who is depressed and unable to share his feelings with others, writes and
becomes known for his expressive poetry.
✔✔Identification - ✔✔-maladaptive
-Conscious or unconscious attempt to model oneself after a respected person
-Kelly states to her nurse, "When I get out of the hospital, I want to be a nurse just like
you."
✔✔intellectualization - ✔✔-maladaptive
-Consciously or unconsciously using only logical explanations without feelings or an
affective component
-Rene talks about her son's death from cancer as being merciful and shows no signs of
her sadness or anger.
✔✔Conversion - ✔✔-maladaptive
-Unconscious expression of intrapsychic conflict symbolically through physical
symptoms
, -A student awakens with a migraine headache the morning of a final examination and
feels too ill to take the test. If she doesn't pass the exam, she will flunk out of nursing
school.
✔✔Splitting - ✔✔-maladaptive
-Demonstrating an inability to reconcile negative and positive attributes of self or others
-A client tells a nurse that she is the only one who cares about her, yet the following
day, the same client refuses to talk to the nurse.
✔✔Projection - ✔✔-maladaptive
-Unconsciously or consciously attributing one's own repressed thoughts to someone
else
-Connie blames her husband for the fight last night, unable to recognize that she was
the one who started it.
✔✔sexual advance - ✔✔-explain this is a nurse-patient relationship
-don't ignore
-address it
-tell them it is inappropriate
-if you continue with this behavior we will need to take a break then come back
-set limits
✔✔Key nursing interventions for depressed patients - ✔✔-Accept patients where they
are and focus on their strengths.
Reinforce decision making by patients.
-Respond to anger therapeutically. Deescalation techniques include being calm, using a
soft voice, reassuring the patient that you understand.
-Spend time with withdrawn patients.
-Involve patients in activities through which they can experience success.
✔✔Interactions with patients who have violent behavior - ✔✔• Stay out of striking
distance (this also reduces the threat to the patient).
• Avoid touching patients without approval.
• Change the topic temporarily if a patient's behavior is escalating.
• Suggest time out for the patient in a quiet area with fewer stimuli.
• Avoid entering a room alone with a patient who is not in control of his or her behavior.
• Leave temporarily if the patient is agitated and asking to be left alone.
• Call for staff assistance if the patient's behavior escalates.
✔✔Interactions with patients who have hallucinations - ✔✔1. The initial approach with
patients who appear to be listening to or talking with voices is to comment on their
behavior: "You look as if you are listening to something. What do you hear?"
2. If the patient acknowledges hearing something that the nurse cannot hear, then the
nurse can say, "Tell me what you hear."
