Foundations of Psychiatric Mental Health Nursing A Clinical Approach, 5th Edition by Elizabeth M. Varcarolis
Foundations of Psychiatric Mental Health Nursing A Clinical Approach, 5th Edition by Elizabeth M. Varcarolis
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Chapter 29: Psychological Needs of the Medically Ill
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
1) A diabetic client is to have a mid-thigh amputation of his left leg. He tells the nurse “I guess I will be called ‘Gimpy’ after the surgery. My life is really going to change when I cannot carry out my exercise program any more.” The nurse assesses that the client is at risk for the nursing diagnosis of
| A. | spiritual distress. |
| B. | ineffective denial. |
| C. | disturbed body image. |
| D. | impaired social interaction. |
ANS: C
The nature of the surgery, which involves an actual change in body structure, places the client at greater risk for developing disturbed body image than any of the other diagnoses listed. The client’s statements about what he is expecting also suggest risk for this diagnosis.
DIF: Cognitive Level: Analysis REF: Text Page: 596
TOP: Nursing Process: Nursing Diagnosis
MSC: NCLEX: Psychosocial Integrity
2) A client’s breast cancer was diagnosed after a mammogram. Her doctor advised a lumpectomy, followed by radiation and chemotherapy. The client schedules consultations with the surgeon, the radiation oncologist, and the medical oncologist so that she may ask questions regarding her treatment. The coping strategy being used can be identified as
| A. | keeping busy and distracting oneself. |
| B. | conforming and complying. |
| C. | sharing concern and finding consolation. |
| D. | seeking information and obtaining guidance. |
ANS: D
The client is coping by gathering information that will help her understand her treatment goals and the effects of treatment. Most clients who use this strategy believe knowledge reduces anxiety. Option A: Keeping busy and distracting oneself has as its goal postponing dealing with the problem. Option B: Conforming and complying would involve simply accepting the physician’s treatment plan. Option C: Sharing concern and finding consolation are usually carried out with family and friends and would not necessitate medical appointments.
DIF: Cognitive Level: Analysis REF: Text Page: 596
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
3) Of the common client problems listed below, the one taking priority for nursing assessment and intervention is the client’s
| A. | fear of the unknown. |
| B. | future plans. |
| C. | present level of pain. |
| D. | reaction to the illness. |
ANS: C
Pain is considered a physiological warning of tissue damage, and as such would take priority over the other client problems listed. Pain management begins with assessment. Once the level of pain has been assessed, appropriate intervention can occur. Intervention may be necessary before further psychosocial assessment can take place.
DIF: Cognitive Level: Analysis REF: Text Page: 594, Text Page: 595
TOP: Nursing Process: Assessment MSC: NCLEX: Physiologic Integrity
4) Which situation indicates use of a negative coping strategy by a client?
| A. | A client states “That heart attack was no fun, but at least it woke me up to my need for a better diet and more exercise.” |
| B. | A client tells the nurse “I am going to do whatever my doctor advises; after all, he knows more about things than I do.” |
| C. | The client muses “I definitely have cancer. Now I need to look at the effects of treatment and decide whether I will be able to work daily.” |
| D. | A client states “I would not be in this position if the company had a better safety program. I blame them for not explaining the hazards of that machine.” |
ANS: D
Blaming someone else is not usually considered a highly adaptive coping strategy. Options A (redefinition), B (conforming), and C (confronting) are seen as more effective.
DIF: Cognitive Level: Analysis REF: Text Page: 596
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
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