Cognitive-behavioral therapy (CBT) and Antidepressants. Start Quiz % Share: Share Tweet Stumble Upon Pin It +1. Start NOW. 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. It is important to use the appropriate NCLEX questions for whichever NCLEX test and subtest you are taking. Topics included in this NCLEX practice quiz are: 1. The nurse performing the physical assessment knows that, according to the general adaptation syndrome, the patient should be expected to exhibit: a. increased blood flow to the intestines. 10. 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. A nurse is observing a 32-year-old client who is experiencing alcohol withdrawal. Assessment data and information that should be collected in respect to the client's level of psychosocial functioning and coping mechanisms should entail the client's age at the onset of the coping disorder, the client's specific psychosocial signs and symptoms, the duration of these episodes, the number of episodes that required intense treatment, the client's family history of any psychiatric mental health disorders, the client's use of support systems, the effectiveness of these support systems, the client's utilization of available resources in their community, the effectiveness of these available resources in terms of the client's needs, the client's past coping mechanisms, and the client's current use of adaptive and effective and/or maladaptive and non effective coping strategies. 6. 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. Facilitate more appropriate use of defense mechanisms. Avoidance of … She worked as a registered nurse in the critical care area of a local community hospital and, at this time, she was committed to become a nursing educator. Personality Disorders 7. She graduated Summa Cum Laude from Adelphi with a double masters degree in both Nursing Education and Nursing Administration and immediately began the PhD in nursing coursework at the same university. A mother of two goes in for her yearly checkup. Schizoid Personality Disorder 10. Stress significantly and adversely impacts on the wholistic client and their physical, mental and social health and wellbeing. 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. 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. During the course of the interview, the nurse finds that the client takes care of her mother who was confined to bed following a stroke. All trademarks are the property of their respective trademark holders. 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. Some of the signs and symptoms of fear include tachycardia, hypertension, pallor, dilated pupils, aggression, hostility and fatigue. Domestic Violence 6. More details about grief and loss will be provided in a later section of this NCLEX-RN review under the section entitled "Grief and Loss". 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. Coping mechanisms are learned; some are effective and others are not. A woman who was sexually assaulted a month ago presents to the emergency department with complaints of recurrent nightmares, fear of going to sleep, repeated vivid memories of the sexual assault, and inability to feel much emotion. 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. b. Complains to her doctor she has been unable to sleep lately. A nurse at Nurseslabs Medical Center is developing a care plan for a female client with post-traumatic stress disorder. A 52-year-old male client has been hospitalized for depression. Marty is pacing and complains of racing thoughts. 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. The daughter is exhibiting which defense mechanism? Over 200 free NCLEX-RN exam practice test questions with thorough rationales for explanation of answers to help give you a leg up for the special day. According to Nagi, "Disability is a limitation in performing socially defined roles and tasks expected of an individual within a sociocultural and physical environment. Coping strategies are thoughts, behaviors, perceptions, and emotions that a client can and does use to cope with stress and any of their disruptions of psychosocial homeostasis. The General Adaptation Syndrome theory describes the stages of stress and the effects of this stress on the human being. Stress & Adaptation NClex Questions questionA client expresses to the nurse that she constantly feels irritated and loses her temper. 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. 6. ... An ineffective defense mechanism. 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. 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. In addition to the assessment of individual client's signs and symptoms, nurses also assess their support systems, available resources, coping strategies of families, other groups, communities and populations. Coping can be adaptive and it can also be useless and maladaptive. 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. This may be an example of which defense mechanism? PLEASE NOTE: The contents of this website are for informational purposes only. ____ 1. Nurses must be able to assess and plan care for clients to enhance and facilitate their ability to adapt to temporary and permanent life changes. Substance Abuse 9. Models of Chronic Illness: Two examples of chronic illness models and theories are the Self in Chronic Illness and Time and the Chronic Illness Trajectory theories or models. Assessing the Client's Support Systems And Available Resources, Assessing the Abilities of the Client to Adapt to Temporary and Permanent Role Changes, Assessing the Client's Reactions and Responses to Acute and Chronic Illnesses Including Mental Illness, Assessing the Client in Coping with Life Changes and Providing Support, Identifying Situations Which May Necessitate Role Changes for a Client, Providing Support to the Client with An Unexpected Altered Body Image, Evaluating the Constructive Use of Defense Mechanisms by a Client, Evaluating Whether the Client has Successfully Adapted to Situational Role Changes, Post-Master’s Certificate Nurse Practitioner, Advanced Practice Registered Nurse (APRN), http://ptjournal.apta.org/content/86/5/726.full, Chemical and Other Dependencies/Substance Abuse Disorders, Cultural Awareness and Influences on Health, Religious and Spiritual Influences on Health, Psychosocial Integrity Practice Test Questions, Assess the client's support systems and available resources, Assess the client's ability to adapt to temporary/permanent role changes, Assess the client's reaction to a diagnosis of acute or chronic mental illness (e.g., rationalization, hopefulness, anger), Assess client in coping with life changes and provide support, Identify situations which may necessitate role changes for a client (e.g., spouse with chronic illness, death of parent), Provide support to the client with unexpected altered body image (e.g., alopecia), Evaluate the constructive use of defense mechanisms by a client, Evaluate whether the client has successfully adapted to situational role changes (e.g., accept dependency on others). What symptoms might the nurse see? Which statement by the student to the nurse counselor should indicate the use of the ego defense mechanism projection? 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. The patient walks out of the office and yells at the parking attendant. of nursing diagnoses related to stress 7. describe stress mgmt tech.beneficial for coping with stress Tourette Syndrome Depression 5. Is the client exhibiting any objective or subjective signs and symptoms such as those associated with anxiety, stress, grief and/or distress? Text Mode – Text version of the exam 1. A mother of two goes in for her yearly checkup. Severe and unresolved depression can, in some cases, lead to suicidal and/or homicidal ideation. Mania 6. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Home / NCLEX-RN Exam / Coping Mechanisms: NCLEX-RN. A loss of hope and meaning has physical, psychological, spiritual and social consequences such as distress, apathy, impaired appetite, passivity, withdrawal, a lack of motivation, spiritual distress, despondency, psychological distress, and a lack of involvement by the client in terms of their activities of daily living and their plan of care. Although there are similarities with both anxiety and fear, there are also some distinct differences. The nurses will most likely advocate which belief as a method of coping with stressful life events? Take this part three of the practice test about safety and infection control. RN to BSN. Encourage the client to verbalize thoughts and feelings about the trauma. 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. Some of these role changes are maturational or developmental and others are situational. In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of behavioral interventions in order to: 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. The nurses will most likely advocate which belief as a method of coping with stressful life events? 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. It can be constructive or destructive, task oriented, or defense oriented, regulating the response to protect oneself. 9. If destructive coping mechanism is happened, it often cause a mental health disorder because the person avoids the problem or stress that causes the disorder. Furthermore, identical types of impairments and similar functional limitations may result in different patterns of disability. Mood Disorders 7. Select All That Apply. “You Learn More From Failure Than From Success. Search. 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. The health care provider has started the client's treatment of depression with phenelzine. Unhealthy adjustment patterns may include mechanisms such as regression, repression, denial, projection, and dissociation. This category focuses on promoting and supporting the emotional, mental, and social well-being of clients experiencing stressful events, as well as clients with acute or chronic mental illness. Are the family members and/or other significant others exhibiting any objective or subjective signs and symptoms such as those associated with anxiety, stress, grief and/or distress. 5. Answer: D Rationale: a. Diplopia It does not occur in retinal detachment. ... An expected coping mechanism. 8. 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. Suicidal Tendencies 10. In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of coping mechanisms in order to: 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. Disabilities as the result of a situational life change can be classified and characterized in a number of different ways. Topics covered in this practice test include Coping Mechanisms, Sensory/Perceptual Alterations, Therapeutic Medications, Cultural Awareness and Mental Health Concepts. Application materials and licensing fees must be submitted to the BON/RB. Take the Quiz. For example, stress can lead anxiety, chronic pain, a weight gain or loss, distress, tension, distress, dangerous and harmful behaviors towards self and/or others, irritability, depression, a lack of focus, forgetfulness, hypertension, fatigue, poor concentration levels, headaches, sleeping impairments, trembling, stomach aches, muscular tension and other somatic complaints, increased vulnerability to disorders and diseases such as a cerebrovascular accident, infections, a myocardial infarction, and poor control of preexisting diabetes. 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. Stress occurs as the result of significant life events such as illness, divorce, moving, parenthood, financial problems, and the death of a loved one and it also can occur secondary to the daily stressors that occur in normal life. The mother of a 38yr/old female recently died due to complications from a surgery which required an unexpected colostomy. Has the client coped with the situational role change? Therefore, there are anyplace somewhere in the range of 85 and 205 inquiries on the NCLEX-PN. The signs, symptoms and interventions for these changes were discussed above under the sections entitled "Assessing the Client's Reactions and Responses to Acute and Chronic Illnesses Including Mental Illness" and "Assessing the Client in Coping with Life Changes and Providing Support". Is the client able to accept their need to be dependent on others when necessary? d. Bright flashes of light Bright flashes of light or photopsia is a common symptom of retinal detachment. The stage of resistance is characterized with the return of many physiological changes to their normal level in addition to maintained increased blood glucose, cortisol and adrenalin levels, increased blood pressure, cardiac rate and respiratory rate. Your patient is sternly criticized by her doctor for not complying with the medication regimen. Severe eye pain Retinal detachment is painless. Is the client able to identify and maximize their strengths rather than focusing on their weaknesses and limitations? C. "Would you like for me to sit down with you for a few minutes so you can talk about this?". Distress can be characterized with signs and symptoms such as irritability, insomnia and social withdrawal. 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. 7. Temporary role changes are typically less stressful to the client when compared to permanent role changes that can lead to stressful major life changes and an increasing dependency on others which are also often coupled with a decrease in the client's levels of self-worth and self-esteem. 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