Chapter 45: Care of Patients with Anxiety, Mood, and Eating Disorders |DeWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition

MULTIPLE CHOICE 1. The nurse observes a coworker who is always behind because he checks and rechecks the accuracy of his medication dosages. Even after being reassured his dosages are correct, he checks them again. The nurse suspects her coworker suffers from which disorder? a. Perfectionism b. Phobic disorder c. Obsessive-compulsive disorder (OCD) d. General anxiety disorder ANS: C When a person has an OCD, he experiences an obsession, recurrent, or intrusive thoughts that he cannot stop thinking about, and these thoughts create anxiety. A compulsive act is an act that the person feels compelled to perform. For example, a person may experience anxiety and so performs repetitive handwashing in an attempt to reduce that anxiety. Time spent in these thoughts and rituals can become overwhelming to the point of interfering with normal life. PTS:1 DIF: Cognitive Level: Application REF: 1055 OBJ:3 (theory) TOP: OCD: Signs KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity 2. The nurse is helping a patient get dressed to go to her dialysis treatment. The patient bursts into tears and says, “I can’t go! I can’t stand another day in that awful place. I will die if I have to go!” Which intervention is best? a. Stop the dressing process and calmly ask the patient talk about her feelings. b. Continue to dress the patient and reassure her that she will feel better after her treatment. c. Stop the dressing process and remind the patient that missing a treatment can make her very sick. d. Continue dressing the patient and remind her that she must stay on task in order to be on time. ANS: A A calm and supportive attitude will help the patient identify feelings. The nurse should put the dressing process on hold so that the nurse can focus attention on a therapeutic response to the patient’s concerns. The nurse should then ask an open ended question to give the patient freedom to express her concerns. Making a threatening statement about consequences of missed treatments only exacerbates the patient’s concern. Continuing to dress the patient while offering empty reassurance or changing the subject ignores the problem at hand. PTS:1 DIF: Cognitive Level: Analysis REF:1056, 1070 OBJ:1 (theory) TOP: Moderate Anxiety: Intervention KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity 3. The nurse is caring for a patient who was admitted with fractures sustained during an MVC (motor vehicle collision). The patient tearfully confesses that she relives the accident in her dreams and is afraid to sleep. The nurse recognizes that this scenario is consistent with which disorder? a. Post-traumatic stress disorder (PTSD) b. Phobic disorder c. obsessive-compulsive disorder (OCD) d. Panic level of anxiety disorder