Chapter 29: Mental and Emotional Responses to Medical Illness

Chapter 29: Mental and Emotional Responses to Medical Illness

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A teenaged patient hospitalized with the diagnosis of HIV places a “No Visitors” sign on the door, refuses phone calls, and states to the nurse, “I know you don’t want to be around me.” Which of these nursing diagnoses is applicable to this situation?

a.	Fear of dying related to medical diagnosis
b.	Social isolation related to fear of rejection
c.	Deficient knowledge related to cognitive limitations
d.	Anger related to having to face death at such a young age

 

ANS: B

The patient has placed barriers between self and others. His statement referring to the nurse not wanting to be around him suggests use of projection as a means of defending against anxiety. Data given in the scenario do not support the diagnosis of fear. Neither lack of knowledge nor cognitive limitation is suggested in the scenario. Anger is not a NANDA-accepted diagnosis.

 

DIF:   Cognitive Level: Application        REF:  Page 670        TOP:  Nursing Process: Diagnosis

MSC: NCLEX: Psychosocial Integrity

 

2. Which factor should be the primary consideration when assessing the advisability of prescribing psychotropic medications for a patient with AIDS?

a.	Nutritional status of the patient
b.	Tolerance for oral medications
c.	Characteristics of emotional distress
d.	Length of time since the diagnosis was made

 

ANS: C

The severity of symptoms present will determine the type and dosage of medication that should be prescribed (e.g., antidepressants would be used for symptoms of depression, anxiolytics for acute anxiety, and psychotropics for symptoms of acute psychosis such as delusions or hallucinations). The other factors are not as relevant to the prescription of medications.

 

DIF:   Cognitive Level: Application        REF:  Page 673

TOP:  Nursing Process: Assessment        MSC: NCLEX: Psychosocial Integrity

 

 

3. A patient diagnosed with AIDS is observed attempting to hide an article on the subject of lethal injections. Which response by the nurse would be most appropriate?

a.	“Please let me have the journal. An article like that will only upset you.”
b.	“I noticed what you are reading. Why are you trying to hide it?”
c.	“Tell me what you think of the article you were reading.”
d.	“Isn’t that a pretty grim article?”

 

ANS: C

Suicide thoughts are common in the patient with AIDS. The correct option accepts this fact and indicates the nurse’s willingness to listen to the patient’s thoughts about the article and his situation. This intervention can address feelings of hopelessness and powerlessness. The remaining options imply the patient was doing something wrong or is passing judgment on the article.

 

DIF:   Cognitive Level: Application        REF:  Page 672

TOP:  Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

 

4. Which statement made by a patient with AIDS indicates that the patient is exhibiting symptoms associated with acute psychotic-type dementia?

a.	“I move more slowly than I used to.”
b.	“I don’t enjoy being with other people anymore.”
c.	“I’d like to stop the voices I hear in my head.”
d.	“I can’t always remember where I put things.”

 

ANS: C

Hallucinations, dementia, psychomotor agitation, and other psychotic behaviors are part of acute psychotic presentation of dementia associated with AIDS. The other options are more consistent with dementia chiefly characterized by mild depression.

 

DIF:   Cognitive Level: Analysis             REF:  Page 667

TOP:  Nursing Process: Assessment        MSC: NCLEX: Psychosocial Integrity

 

5. A patient with HIV infection asks the nurse, “What do they mean by opportunistic infections?” The nurse’s best response would be, “They are:

a.	Infections transmitted by sexual contact.”
b.	Rare illnesses that occur only in homosexual men.”
c.	Infectious diseases from tropical or subtropical countries.”
d.	Infections that develop when the immune system is suppressed.”

 

ANS: D

Opportunistic infections occur when the immune system is suppressed. Under ordinary circumstances with an active immune system, these infectious organisms would not cause illness. Opportunistic infections are not sexually transmitted diseases. Both homosexual and heterosexual men, as well as women who are HIV-positive, may develop opportunistic infections. Opportunistic infections are not limited to tropical diseases.

 

DIF:   Cognitive Level: Application        REF:  Page 665

TOP:  Nursing Process: Implementation

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation