CHAPTER 21 The Physically Ill CLient Experiencing Emotional Distress

CHAPTER 21 The Physically Ill CLient Experiencing Emotional Distress

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The nurse working with a client in recovery from a serious illness or physical crisis would MOST need to teach:

ANS:  A

The nurse would most need to teach clients recovering from serious illnesses to pace themselves. The nurse must acknowledge the frustration the client is having and the risk of the client giving up. The emphasis should be on remaining active without increasing the risk of additional health problems. The nurse should also explain to the client the recovery process will take longer than either of them would like.

PTS:   1                    DIF:    Application

REF:   Psychological Responses to Physical Illness| Cancer| Exploring Your Reaction to Very Ill Clients

2. When a client has an illness where brain dysfunction directly influences his or her feelings, the DSM-IV diagnosis would be which of the following?

ANS:  B

Mood Disorder due to a General Medical Condition is the DSM-IV diagnosis given when an organic dysfunction acts as a direct influence on a client’s emotions. Depression following a stroke is an example of this phenomenon. Such depression can have roots in the neurological effect the stroke has had on the client.

PTS:   1                    DIF:    Comprehension

REF:   DSM-IV-TR and Physical Illness

3. Three weeks after recovering from a myocardial infarction, a client reports that she is sad every day and unable to sleep. She states she believes she did something wrong because she should be better by now. The physical assessment by the nurse shows that this client has lost weight. These symptoms indicate this client has:

ANS:  C

The indicators for a diagnosis of Major Depressive Disorder in a client include feelings of sadness, guilt, insomnia, weight loss, or any combination of these following a myocardial infarction. Such symptoms cannot solely be explained by the physiologic after-effects of the myocardial infarction.

PTS:   1                    DIF:    Application    REF:   DSM-IV-TR and Physical Illness

4. Strong psychological responses to physical illness are more common when individuals are threatened with loss of:

ANS:  C

Having been threatened with the loss of life is much more likely to elicit strong psychological responses. While the threat of loss of autonomy, livelihood, and social relationships can result in some psychological response, strong psychological responses are much more common among those threatened with a loss of life.

PTS:   1                    DIF:    Comprehension

REF:   Psychological Responses to Physical Illness

5. When a client with advanced cancer is in pain and complains to the nurse that the nurse does not respond to the call light fast enough, the client is probably expressing which of the following emotions?

ANS:  A

While the client’s response may seem to be an expression of dislike or anger, it is most likely an expression of fear. The client may find him- or herself feeling overwhelmed by fear, depression, and powerlessness over the situation. Previous coping methods may no longer be adequate in helping the client manage these emotions, due to the severity of the situation.

PTS:   1                    DIF:    Analysis

REF:   Psychological Responses to Physical Illness| Cancer| We Will Fight Amongst the Platelets