Chapter 18: Emotional Responses and Mood Disorders

Principles And Practice of Psychiatric Nursing,10th Edition by Gail Wiscarz Stuart

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Chapter 18: Emotional Responses and Mood Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

  1. According to the Stuart Stress Adaptation Model, which person can be assessed as being the closest to the maladaptive responses end of the continuum of emotional responses?
a. A patient whose child died of sudden infant death syndrome (SIDS) 2 weeks ago, who states, “I can’t believe I’ll never hold my baby in my arms again.”
b. A patient whose spouse died 2 years ago, who states, “Strong people don’t mourn. I’ve kept busy and focused on supporting the kids.”
c. A patient whose spouse died 6 months ago, who states, “I hate the fact that my spouse died and left me alone after all the years we shared.”
d. A patient whose fiancée died 6 weeks ago, who tells the nurse, “My life will never be the same. I find myself crying every day when I think of my fiancée.”

 

 

ANS:  B

Suppression of emotions for a prolonged period is less adaptive than showing emotional responsiveness to loss.

 

DIF:    Cognitive Level: Analysis                REF:   Text Page: 290

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

 

  1. The initial response of a steelworker who was fired from a job was disbelief. At home the steelworker told family members about the firing but retreated to the bedroom, saying, “I’m too choked up to talk about it right now.” These behaviors are characteristic of:
a. disbelief.
b. depression.
c. normal grief reaction.
d. delayed grief reaction.

 

 

ANS:  C

Loss of one’s job can precipitate a grief reaction. The steelworker is showing emotional responsiveness to the loss as evidenced by initial disbelief, anger, and pain.

 

DIF:    Cognitive Level: Application           REF:   Text Pages: 290-291

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

 

  1. Which coping mechanism should a nurse expect to see a patient initially use to mourn the death of a spouse?
a. Denial
b. Introjection
c. Suppression
d. Dissociation

 

 

ANS:  B

Mourning begins with introjection of the lost object. Denial, suppression, and dissociation are seen in delayed grief reactions.

 

DIF:    Cognitive Level: Comprehension     REF:   Text Pages: 304-305

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

 

  1. A patient was widowed 8 months ago. The patient has never cried and speaks of the spouse as if they were still together. The prominent defense mechanism exhibited by the patient is:
a. denial.
b. projection.
c. introjection.
d. sublimation.

 

 

ANS:  A

Inability to cry or express emotions and speaking of the deceased in the present tense suggest the use of denial.

 

DIF:    Cognitive Level: Comprehension     REF:   Text Page: 302

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

 

  1. A patient’s husband is distraught over his wife’s behavior since their child died in a car accident 1 month ago. He says, “She still cries herself to sleep each night. Help my wife control herself.” The nurse’s most therapeutic response would be:
a. “I wonder why it is that you are so bothered by her crying.”
b. “I’m more concerned that you don’t seem to be grieving.”
c. “I’ll spend some time with her to help her see that crying is counterproductive.”
d. “It’s hard to see her so upset, but crying is one way of expressing her feelings.”

 

 

ANS:  D

This reply is empathetic and allows the nurse to begin teaching the spouse the value of expressing feelings related to loss.

 

DIF:    Cognitive Level: Application           REF:   Text Page: 308

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

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