Principles And Practice of Psychiatric Nursing,10th Edition by Gail Wiscarz Stuart
Principles And Practice of Psychiatric Nursing,10th Edition by Gail Wiscarz Stuart
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Chapter 16: Psychophysiological Responses and Somatoform and Sleep Disorders
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | A person with chronic pain in the right ankle after a skiing injury |
| b. | A person who experiences occasional chest pain after a myocardial infarction |
| c. | A college graduate who cannot maintain steady employment because of multiple vague complaints |
| d. | A person who dislikes going out to social events with large groups because of embarrassment about facial acne |
ANS: C
Somatization disorder is often characterized by multiple vague complaints that encourage others to take care of the individual and enable the individual to avoid demands of adult responsibility. The patients described in the other options have either a physiological basis for the complaint or a disturbed body image.
DIF: Cognitive Level: Analysis REF: Text Page: 246
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
| a. | A toddler with frequent ear infections |
| b. | An athlete with exercise-induced asthma |
| c. | A night guard who suddenly goes blind |
| d. | An older adult whose fractured foot is not healing well |
ANS: C
Conversion disorder is a type of somatoform disorder in which symptoms of some physical illness appear without any underlying organic cause. The organic symptom reduces the patient’s anxiety and usually gives a clue to the conflict.
DIF: Cognitive Level: Analysis REF: Text Page: 246
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
| a. | Focus discussions on the patient’s inability to fulfill usual roles. |
| b. | Focus discussions on the patient’s unusual and unexplainable physical symptom. |
| c. | Spend time with the patient to give recognition for positive qualities and strengths. |
| d. | Spend time with the patient when the patient is helpless to perform self-care activities because of paralysis. |
ANS: C
Spending time with a patient focusing on strengths and positive attributes builds self-esteem and self-confidence. This intervention also reduces secondary gains. The remaining options are not therapeutic for patients with conversion disorders.
DIF: Cognitive Level: Application REF: Text Page: 247
TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity
| a. | Mild opioids |
| b. | Benzodiazepines |
| c. | Relaxation techniques |
| d. | Response prevention |
ANS: C
The intervention selected will be one that can be used over the long term. Relaxation training, which helps the patient control tension and anxiety and thereby reduce pain, can be an effective long-term strategy. Benzodiazepines and opioids produce dependency and are not useful for long-term management. Response prevention rarely is used to treat chronic pain.
DIF: Cognitive Level: Application REF: Text Page: 255
TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity
| a. | A patient who is scheduled for knee replacement surgery |
| b. | A patient who has high self-efficacy and has recently accepted a job promotion |
| c. | A patient who has had elective rhinoplasty to correct a prominent hump in the bridge of the nose |
| d. | A person who has severe osteoarthritis and was admitted to a nursing home after the death of a caretaker spouse 2 months ago |
ANS: D
The exhaustion phase of the general adaptation syndrome often is associated with loss. The patient with osteoarthritis has lost a spouse and the ability to live at home.
DIF: Cognitive Level: Analysis REF: Text Page: 251
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
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