Borderline Personality Disorder 3. Distress can be characterized with signs and symptoms such as irritability, insomnia and social withdrawal. Take this part three of the practice test about safety and infection control. A mother of two goes in for her yearly checkup. 10. These theories focus on how well the client with a chronic illness can cope with and manage their chronic illness, and how well the client is able to learn about and successfully cope with and manage their disabilities and limitation, respectively. CNA to RN; ... of coping in order to deal with the crisis that is not being effectively coped with using one’s currently used coping mechanisms. Rationalization will also be more fully discussed later in this review with the section entitled "Evaluating the Constructive Use of Defense Mechanisms by a Client". All trademarks are the property of their respective trademark holders. Concepts and topics included in this practice exam are as follows: 1. ____ 1. “You Learn More From Failure Than From Success. 4. Take the Quiz. Alene Burke RN, MSN is a nationally recognized nursing educator. Hans Selye developed the General Adaptation Syndrome theory, in addition to the Local Adaptation theory which details the inflammatory process, as previously discussed with the "Infection Control" section at the beginning of this NCLEX-RN review. 9. Alcohol Withdrawal 2. Severe eye pain Retinal detachment is painless. Encourage the client to verbalize thoughts and feelings about the trauma. Two standardized assessment measurement tools that can be used to collect psychosocial data and information are the "Interval Follow Up Evaluation" and the "Range of Impaired Functioning" tool which assess and measure the client's level of functioning in terms of their interpersonal relationships, their work, their leisure and recreational activities, and their overall level of satisfaction with life over time as well as the measurement and assessment of these same variables at the current time, respectively. Implementation A. The adverse effects of stress are intensified as based on the intensity of the stress, the duration of the stress, the effectiveness of the client's protective mechanisms against stress, and the effectiveness of the coping mechanisms that the client is using to cope with the stress. Complains to her doctor she has been unable to sleep lately. The nurse recognizes the signs and symptoms of which medical problem. The topics covered under the category also include substance abuse, coping mechanisms and related stuff which leads to problems like different types of mental disorders and depression. This set of Diabetes NCLEX questions is intended to help nurses brush up on the concepts of managing patients with this chronic disease. The process of looking at how you may or may not use defense mechanisms can be helped along by asking yourself questions to get yourself thinking about whether you use any of the defense mechanisms. Exam Mode – Questions and choices are randomly arranged, time limit of 1min per question, answers and grade will be revealed after finishing the exam. Your patient is sternly criticized by her doctor for not complying with the medication regimen. In order to register for the NCLEX, the candidate must first request a license/registration application from the BON/RB. What level of severity of anxiety is this patient experiencing? Based on this fact, nurses and other health care professionals should never debate or argue with the client about their use of these subconscious ego defense mechanisms; they should not be stripped away until the client has garnered the psychological health and fortitude to deal with the threatening stress that they are confronted and affected with. The health care provider has started the client's treatment of depression with phenelzine. Commonly used coping mechanisms include changing one's perception of the issue at hand, using humor, using problem solving skills, employing stress management and relaxation techniques, seeking out and using the support of others, ventilating feelings, embarking on a physical exercise and activity routine, decreasing personal expectations, and avoiding self-blame. The patient walks out of the office and yells at the parking attendant. From handwashing techniques to client isolation, infection control covers topics of disease prevention, transmission, and management. End of life needs include physical, psychological, social and spiritual, cultural and religious needs. The nurse is teaching a patient about therapies for Obsessive Compulsive Disorder. As with all aspects of nursing care, nurses evaluate whether or not the client has successfully adapted to situational role changes in terms of whether or not the client has achieved the pre-established goals that were established after a complete assessment of the affected client, their family members, and other significant others. Answer: tremors, disorientation, fast heart rate and agitation. As she is describing her symptoms the doctor realizes she is trembling and seems disoriented. Anorexia Nervosa 3. Severe and unresolved depression can, in some cases, lead to suicidal and/or homicidal ideation. Mood Disorders 7. 4.discuss commonly used coping behaviors and ego-defense mechanims 5. discuss the effects of prolonged stress on physical and spiritual well-being 6. id ex. Chapter 25: Stress and Coping Potter: Essentials for Nursing Practice, 8th Edition MULTIPLE CHOICE 1.A patient who was injured in a motor vehicle accident is taken via ambulance to the emergency department. When assessing the client perception of the precipitating event that led to the crisis, which is the most appropriate question? Topics included in this NCLEX practice quiz are: 1. Ineffective coping-techniques people try are not successful or are hazardous; Excessive use of the defense mechanisms ... Ch. Topics covered include abuse and neglect, religious and spiritual health, coping mechanisms, cultural concepts, end-of-life issues, grief, stress management, support systems, therapeutic communication, and crisis intervention. On the NCLEX-RN® exam, you can expect approximately 9 percent of the questions to relate to Psychosocial Integrity. Unhealthy adjustment patterns may include mechanisms such as regression, repression, denial, projection, and dissociation. 1-35. questions. The General Adaptation Syndrome theory describes the stages of stress and the effects of this stress on the human being. Practice Mode – Questions and choices are randomly arranged, the answer is revealed instantly after each question, and there is no time limit for the exam. Application materials and licensing fees must be submitted to the BON/RB. The psychological ego defense mechanisms, their purposes and some examples will be discussed now. It can be constructive or destructive, task oriented, or defense oriented, regulating the response to protect oneself. The daughter is exhibiting which defense mechanism? The identification and the recognition of guilt give the person the opportunity to change their unacceptable behaviors and to make amends for their transgressions and wrong doings. Does the client have realistic expectations and goals for themselves? Search. Quizlet flashcards, activities and games help you improve your grades. Examples of temporary role changes include things like an extensive loss of work as the result of an injury such as a back injury that prohibits one's working and the temporary inability of the client to adequately care for their children because of a physical or psychological problem such as a broken leg or a substance related addiction; and examples of permanent role changes include the loss of children as the result of child abuse or neglect and a client's permanent lack of ability to perform their basic activities as the result of paralysis. Depression: Depression commonly occurs as the result of an acute or chronic illness, including mental health disorders; depression can affect both the client and the family unit. 8. Nurses can help the patient to overcome and resolve their guilt by emotionally and spiritually supporting the client, by facilitating the client's ventilation of feelings, by encouraging the patient to change behaviors, and by encouraging the client to make necessary amends to others for their wrong doings. Has the client coped with the situational role change? Now, there are dozens of examples of coping mechanisms. During a community visit, volunteer nurses teach stress management to the participants. Permanent as well as temporary role changes can often lead to anxiety and stress. In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of coping mechanisms in order to: Coping Strategies and Defense Mechanisms: Questions to Ask Oneself Mark Dombeck, Ph.D. As she is describing her symptoms the doctor realizes she is trembling and seems disoriented. Although grief is a normal, adaptive response to loss, complicated and unresolved grief is maladaptive. All changes threaten the homeostasis of the human being. Some of the signs and symptoms associated with depression include feelings of helplessness, hopelessness, low self-esteem, decreased sense of self-worth, sadness, insomnia, poor problem solving and decision making processes, and decreased libido among other signs and symptoms. Examples of permanent and temporary changes are a physical disfigurement that occurs as the result of a bomb blast and a transient episode of depression or grief, respectively; examples of physical, psychological and social changes can include the loss of a breast secondary to breast cancer or alopecia secondary to therapeutic cancer chemotherapy, grief that occurs as the result of a loved one, and the loss of financial income, respectively; examples of moderate or mild and significantly powerful changes include the birth of a newborn into a previously childless family unit and the loss of a home as the result of a disaster like a cyclone or tornado; and examples of change that can be classified and categorized as situational and developmental or maturational are the loss of work and a salary as the result of an acute illness or accident and the empty nest syndrome that is often seen among middle aged clients as the children leave the home and the normal changes associated with the aging process and disabilities, respectively. The World Health Organization (WHO) Model: This integrated model defines disability as the inability to meet the criteria of this model's two parts which are bodily structures and functions (physiological criteria) and the environment and personal contextual problems. Which defense mechanism allows an individual to return to a point in development when nurturing and dependency were needed and accepted with comfort? The nurse is interviewing a client with complaints of chronic fatigue. Control over one's response to stress is possible. 1. Is the client exhibiting any objective or subjective signs and symptoms such as those associated with anxiety, stress, grief and/or distress? This may be an example of which defense mechanism? Some of the nursing diagnoses associated with role performance and ineffective role performance include: Some of the interventions that are used to promote the client's ability to cope with role changes, both maturational and situational, include: Clients can be expectedly and predictably affected with an alteration of their bodily image along the life span and they can also be unpredictably affected with body image changes along the lifespan and they can be also be unpredictably and unexpectedly as the result of an illness, disease, disorder and some therapeutic treatments. A nurse at Nurseslabs Medical Center is developing a care plan for a female client with post-traumatic stress disorder. What therapies would the nurse discuss with the patient? 11. Some of the models and frameworks that can be used to gain a fuller understanding of these situational changes and their nursing considerations are discussed below. The stages of stress, according to the General Adaptation Syndrome theory, in correct sequential order, include: Some patients use a wide variety of coping mechanisms and other patients may have only a few or no coping mechanisms. Substance Abuse 9. Although there are similarities with both anxiety and fear, there are also some distinct differences. The stage of exhaustion, which can lead to death, is characterized with the complete loss of and exhaustion of all the body's resources and mechanisms. For example, the loss of the use of a limb as the result of paralysis is a physical loss, the loss of a loved one and the loss of self-esteem are losses which can be accompanied with grief. Denial: Denial, like rationalization and displacement, is another psychological defense mechanism. ... An ineffective defense mechanism. Topics covered in this NCLEX-RN practice test for Psychological Integrity include Coping Mechanisms, Sensory/Perceptual Alterations, Therapeutic Medications, Cultural Awareness, and Mental Health Concepts. After a complete focused assessment relating to the client and their responses to role changes, registered nurses plan interventions that are appropriate for the individual client and their assessed needs. PLEASE NOTE: The contents of this website are for informational purposes only. Some of the most commonly occurring psychological and emotional alterations associated acute and chronic illness, including a mental illness can include: Distress: Distress can range from mild to severe and even disabling with signs and symptoms which can be behavioral as well as physical in nature. 20 questions Defense Mechanisms Quiz. Coping mechanisms are learned; some are effective and others are not. All losses can be accompanied with grief. In your outline, we’ve given you 12 more common ones, and here I just want to touch on some of the most common ones you’ll see. The NCLEX-PN is a PC versatile test (CAT), which means each question you answer accurately decides the trouble of the following inquiry, just as the general number of questions you will reply. Individual's definition of the situation and reactions, which at times compound the limitations; Definition of the situation by others, and their reactions and expectations—especially those who are significant in the lives of the person with the disabling condition (e.g., family members, friends and associates, employers and co-workers, and organizations and professions that provide services and benefits); and, Characteristics of the environment and the degree to which it is free from, or encumbered with, physical and sociocultural barriers" (. Some of the areas that the registered nurse may explore, as based on the client's specific needs, can include: SEE - Psychosocial Integrity Practice Test Questions. After a complete assessment of the client's perception of their body image which can include the use of standardized assessment measurement scales such as the Body Image Quality of Life Inventory, the nurse will plan care for the client. The National Council of State Boards of Nursing estimates that 6-12% of the NCLEX-RN questions will be on Psychological Integrity. Fear: Fear is a response to a perceived impending or actual danger, including illness. Start studying mental health-coping and defense mechanism. Denial occurs when the client pushes the threatening situation into the subconscious so that the client is not forced to deal and cope with it until the client's psyche is better able to deal with it. The nurse's first response is which of the following? 17 Suicidal Client Review questions (NCLEX) 10 Terms. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Read and understand each question before choosing the best answer. Bulimia Nervosa 4. The nurse is conducting an initial assessment of a client in crisis. Loss of hope and meaning: A loss of hope or hopelessness, as defined by the North American Nursing Diagnosis Association (NANDA), is "the subjective state in which an individual sees limited or no alternatives for personal choices available and is unable to mobilize energy on one's own behalf". A college student presents to the counseling center because they are having difficulty dealing with having been informed that, due to continued poor grades, they are being dismissed from the college. Major traumatic accidents that lead to disfigurement and/or physical disability, alopecia secondary to cancer chemotherapy treatments, a loss of cognitive functioning, disfiguring surgeries such as a radical mastectomy and an orchiectomy, and therapeutic interventions such as a structural fecal diversion colostomy are examples of unexpected and unpredicted altered bodily image changes. In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of coping mechanisms in order to: Simply defined, coping, is the patient's ability to institute, maintain and regain psychological homeostasis when this homeostasis is disrupted for one reason or another. Nursing Diagnosis 8. NCLEX Administration . Coping mechanisms that were effective in the past are often disregarded in response to the pain of a loss B. Anger is often displaced onto another as will be discussed below under the section entitled "Evaluating the Constructive Use of Defense Mechanisms by a Client". And really focus on using that therapeutic communication to foster your relationship and don’t focus on the anxiety; focus on digging deeper and being there for them. For example, alcoholism that results from a client's self medication to cope with the loss of a loved one not only does not resolve the stress associated with this situation crisis, it also leads to depression and other psychological and physical health problems. Life changes can be broadly classified and categorized as permanent or temporary, physical, psychological and social, mild to highly significant, and situational or maturational. The NCLEX-PN covers several content areas, each having its own specific weight.Psychosocial Integrity questions are about 9-15% of the NCLEX-PN Examination. Search. Start studying NCLEX: Coping and Defense Mechanisms. Some of the maturational and developmental role changes and challenges along the life span include: Some of the situational role changes and challenges include those physical, psychological and social changes that occur as the result of some acute or chronic disorder or disease. The outcome for this diagnosis is that the patient needs to adopt coping mechanisms that are effective for dealing with stress, such as relaxation techniques. Topics covered in this practice test include Coping Mechanisms, Sensory/Perceptual Alterations, Therapeutic Medications, Cultural Awareness and Mental Health Concepts. Is the client now experiencing self-satisfaction with their new or modified roles? These roles and tasks are organized in spheres of life activities such as those of the family or other interpersonal relations; work, employment, and other economic pursuits; and education, recreation, and self-care. 6. Distress can manifest with client forgetfulness, irritability, restlessness, hyperactivity, and somatic complaints such as headaches and insomnia in addition to some of the signs and symptoms of stress as detailed above under the General Adaptation Syndrome. Patents with actual and perceived body image changes and alterations need the support of nurses and other members of the health care team in order to successfully cope with these losses. She has also been suffering from diarrhea, nausea, and heart palpitations. Depression 5. After her mothers death, the daughter states "My mother would have never wanted to live with a colostomy." Coping is adaptive when it resolves the stress, and it is maladaptive when it does not resolve the stress and/or it creates further problems for the client. Which of the following exercises would be appropriate for the nurse to suggest the client engage in initially? A mother of two goes in for her yearly checkup. Approximately 9% to 15% of the questions on the exam are focused on this topic. In addition to establishing a supportive and open client-nurse relationship, the nurse also establishes trust with the client and allows and encourages the client to openly ventilate their feelings in an environment that is nonjudgmental and supportive, and they also facilitate the client's learning and utilization of coping mechanisms such as: Role changes occur along the life span. Unresolved guilt, however, can lead to despair, distress, spiritual distress, physical signs and symptoms and psychological signs and symptoms. Some of these interventions can include facilitating and encouraging the client to ventilate their true feelings about this loss in an accepting, open and trusting nurse-client relationship, engaging the client with the identification of realistic expectations of self and then nurses can assist patients with their responses and reactions to permanent and temporary role changes by allowing and encouraging the patient to ventilate their feelings and also by helping the patient explore and identify realistic goals and to establish realistic expectations of what they are able to do despite some role changes and losses. 15. of nursing diagnoses related to stress 7. describe stress mgmt tech.beneficial for coping with stress Some of the normally occurring and predictable body image changes that occur along the life span include changes and events such as adolescent puberty, middle years female menopause, middle years male climacteric, and in the elder years when the normal changes of the aging process occur. 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