C HAPTER 04: P SYCHOSOCIAL A LTERATIONS
Urden: Priorities in Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
1. A patient is admitted with the diagnosis of gunshot wound to the head
due to a suicide attempt. While the patient is in the critical care unit, the
plan of care should include which intervention?
a. Limiting interaction with the patient due to antisocial behaviors
exhibited by the suicidal attempt
b. Overlooking the patient’s need to talk about the incident
c. Validating the patient’s worth and self -esteem
d. Discontinuing any psychotropic medications
ANS: C
While the patient is in the unit, primary nursing interventions include
validating the patient’s worth and self -esteem and helping him or her
regulate emotional states and behaviors.
Patients who have attempted suicide are often stigmatized, and
caregivers can resent caring for a person whose critical condition is
self-inflicted. A suicide attempt indicates, however, that the patient
was experiencing personal and spiritual distress to the point of wanting
to end his or her life. The critical care team should make every effort
to continue medications for mental health conditions during the critical
care stay unless medicall y contraindicated. If the patient is unable to
take oral medications, the team should attempt to find an alternative
route if possible.
, PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Implementation TOP: Psychosocial
Alterations MSC: NC LEX: Psychosocial Integrit y
2. What happens when the critical illness is so severe that the patient or
famil y becomes overwhelmed?
a. Anxiet y
b. Spiritual distress
c. Stress overload
d. Hopelessness
ANS: C
Stress overload does not occur because the patient or famil y members
have coping deficits or psychological disorders. Rather, the stressors of
critical illness are so numerous and severe that peo ple become
overwhelmed. Anxiety, hopelessness, and spiritual distress are
examples of stress -related nursing diagnoses that occur because of an
inabilit y of coping mechanisms or strategies.
PTS: 1 DIF: Cognitive Level: Understanding OBJ: Nursing
Process Step: Diagnosis TOP: Psychosocial Alterations
MSC: NC LEX: Psychosocial Integrit y
3. Which medications are commonl y used for alcohol withdrawal
s ymptoms?
a. Chlordiazepoxide and folic acid
b. Chlordiazepoxide and lorazepam
c. Lorazepam and promethazine
d. Promethazine and thiamine
, ANS: B
Commonl y used medications include chlordiazepoxide and lorazepam
for withdrawal symptoms and ondansetron and promethazine for
nausea. Thiamine, folic acid, and multivitamins should be added to
intravenous fluids.
PTS: 1 DIF: Cognitive Level: Remembering OBJ:
Nursing Process Step: Implementation TOP: Psychosocial
Alterations MSC: NC LEX: Physiological Integrit y:
Pharmacological Therapies
4. Prolonged periods of anxious waiting, disrupted sleep patterns,
witnessing emergency in terventions, and financial concerns could put
famil y members at risk for developing what problem?
a. Powerlessness
b. Hopelessness
c. Anxiet y
d. PTSD
ANS: D
Famil y members are at risk for developing posttraumatic stress
reactions related to prolonged periods of unce rtaint y, anxious waiting,
disrupted sleep patterns, financial concerns, witnessing emergency
interventions, and confronting fears of loss and death. Anxiety is a
normal and common subjective human response to a perceived or actual
threat, which can range f rom a vague, generalized feeling of discomfort
to a state of panic and loss of control. Conditions that increase a
Urden: Priorities in Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
1. A patient is admitted with the diagnosis of gunshot wound to the head
due to a suicide attempt. While the patient is in the critical care unit, the
plan of care should include which intervention?
a. Limiting interaction with the patient due to antisocial behaviors
exhibited by the suicidal attempt
b. Overlooking the patient’s need to talk about the incident
c. Validating the patient’s worth and self -esteem
d. Discontinuing any psychotropic medications
ANS: C
While the patient is in the unit, primary nursing interventions include
validating the patient’s worth and self -esteem and helping him or her
regulate emotional states and behaviors.
Patients who have attempted suicide are often stigmatized, and
caregivers can resent caring for a person whose critical condition is
self-inflicted. A suicide attempt indicates, however, that the patient
was experiencing personal and spiritual distress to the point of wanting
to end his or her life. The critical care team should make every effort
to continue medications for mental health conditions during the critical
care stay unless medicall y contraindicated. If the patient is unable to
take oral medications, the team should attempt to find an alternative
route if possible.
, PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Implementation TOP: Psychosocial
Alterations MSC: NC LEX: Psychosocial Integrit y
2. What happens when the critical illness is so severe that the patient or
famil y becomes overwhelmed?
a. Anxiet y
b. Spiritual distress
c. Stress overload
d. Hopelessness
ANS: C
Stress overload does not occur because the patient or famil y members
have coping deficits or psychological disorders. Rather, the stressors of
critical illness are so numerous and severe that peo ple become
overwhelmed. Anxiety, hopelessness, and spiritual distress are
examples of stress -related nursing diagnoses that occur because of an
inabilit y of coping mechanisms or strategies.
PTS: 1 DIF: Cognitive Level: Understanding OBJ: Nursing
Process Step: Diagnosis TOP: Psychosocial Alterations
MSC: NC LEX: Psychosocial Integrit y
3. Which medications are commonl y used for alcohol withdrawal
s ymptoms?
a. Chlordiazepoxide and folic acid
b. Chlordiazepoxide and lorazepam
c. Lorazepam and promethazine
d. Promethazine and thiamine
, ANS: B
Commonl y used medications include chlordiazepoxide and lorazepam
for withdrawal symptoms and ondansetron and promethazine for
nausea. Thiamine, folic acid, and multivitamins should be added to
intravenous fluids.
PTS: 1 DIF: Cognitive Level: Remembering OBJ:
Nursing Process Step: Implementation TOP: Psychosocial
Alterations MSC: NC LEX: Physiological Integrit y:
Pharmacological Therapies
4. Prolonged periods of anxious waiting, disrupted sleep patterns,
witnessing emergency in terventions, and financial concerns could put
famil y members at risk for developing what problem?
a. Powerlessness
b. Hopelessness
c. Anxiet y
d. PTSD
ANS: D
Famil y members are at risk for developing posttraumatic stress
reactions related to prolonged periods of unce rtaint y, anxious waiting,
disrupted sleep patterns, financial concerns, witnessing emergency
interventions, and confronting fears of loss and death. Anxiety is a
normal and common subjective human response to a perceived or actual
threat, which can range f rom a vague, generalized feeling of discomfort
to a state of panic and loss of control. Conditions that increase a
