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The nurse is obtaining a health history from a client with stress-related illnesses. When the nurse asks the client how the client copes with stress, which coping mechanism causes the nurse the most concern?
- A. I play video games for an hour.
- B. I run eight hours per day.
- C. I lift weights after work.
- D. I go out with friends.
Correct Answer: B
Rationale: The nurse is most concerned about the maladaptive coping mechanism of running eight hours per day. Playing video games, exercising or lifting weights, and going out with friends are more positive, beneficial coping mechanisms which, if done appropriately and in moderation, can reduce stress.
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The nurse is caring for a client who consistently presents to the emergency department with symptoms of varied illnesses. Family members correlate the symptoms to illnesses seen on television or in other family members. When viewing past documentation of client history, which would the nurse anticipate?
- A. An autoimmune disorder
- B. Hypochondriasis
- C. Paranoid schizophrenia
- D. Physical abuse
Correct Answer: B
Rationale: Hypochondriasis is an abnormal fixation about the status of one's health. Some would propose that the disorder occurs when a person receives excessive attention and concern from others during childhood illnesses, which were unconsciously perceived as rewarding. The other disorders are not related.
The nurse is caring for a client on a behavioral health unit. What would support the theory that mental illness is a psychobiologic disorder?
- A. The client needs supervision in performing self-care.
- B. The client behavior improves with group therapy.
- C. The client has an alteration in neurotransmitter levels.
- D. The client has developed inappropriate interpersonal skills.
Correct Answer: C
Rationale: The nurse is correct to confirm the biologic disorder of an alteration in neurotransmitter levels. The neurotransmitters dopamine, norepinephrine, epinephrine, serotonin, and acetylcholine often are implicated in the psychobiology of mental illness. Evaluating the client's need for personal assistance, behavior improvement with group therapy, and inappropriate interpersonal skills addresses behavior aspects alone.
Impaired balance and uncontrolled tremors of Parkinson disease is correlated with which neurotransmitter?
- A. Glutamate
- B. Acetylcholine
- C. Dopamine
- D. Serotonin
Correct Answer: C
Rationale: The impaired balance and uncontrolled tremors of Parkinson disease have been linked with low levels of dopamine. The other neurotransmitters have not been implicated in Parkinson's disease in this manner.
The nurse is reviewing ways to foster effective coping skills with a client who has an anxiety disorder. What should the nurse include in the teaching? Select all that apply.
- A. Re-establish priorities and strike a healthy balance between work and play.
- B. Engage in a daily exercise program.
- C. Learn about stress management education and join a support group.
- D. Avoid verbalizing or writing about feelings of anxiety.
- E. Delay stressful tasks as desired.
Correct Answer: A,B,C
Rationale: The nurse should suggest re-establishing priorities and striking a healthy balance between work and play, engaging in a daily exercise program, pursuing stress management education, and joining a support group as ways to foster effective coping skills. The client should be encouraged to clearly state feelings or write about them in a diary if verbalizing dramatic or angry thoughts is difficult. The nurse should also discuss time management techniques such as avoiding procrastination; therefore, delaying stressful tasks as desired would not be included in the teaching.
What is the result of the appropriate use of coping mechanisms?
- A. Maintenance of psychobologic equilibrium
- B. Psychological growth
- C. Altered body functions or symptoms
- D. Restored biologic functions
Correct Answer: B
Rationale: When used appropriately and in moderation, coping mechanisms allow maintenance of psychological equilibrium and lead to psychological growth. Appropriate use of coping mechanisms does not alter body functions or symptoms or restore biologic functions.