REF: Pages 15-45, 46, 91 (Box 15-2) TOP: Nursing Process: Planning MSC: Client Needs: Physiological Integrity 28. The nurse assesses a patient who complains of loneliness and episodes of anxiety. Which
statement by the patient is mostly likely if this patient also has agoraphobia? a. “I’m sure I will get over not wanting to leave home soon. It takes time.” b. “Being afraid to go out seems ridiculous, but I can’t go out the door.” c. “My family says they like it now that I stay home most of the time.” d. “When I have a good incentive to go out, I can do it.” ANS: B
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Individuals who are agoraphobic generally acknowledge that the behavior is not constructive and that they do not really like it. The symptom is ego dystonic. However, patients will state they are unable to change the behavior. Agoraphobics are not optimistic about change. Most families are dissatisfied when family members refuse to leave the house.
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PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Pages 15-20, 71 (Table 15-3) | Pages 15-38, 81 (Table 15-8) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
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29. A patient diagnosed with obsessive-compulsive disorder has this nursing diagnosis: Anxiety
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related to __________ as evidenced by inability to control compulsive cleaning. Which phrase correctly completes the etiological portion of the diagnosis? a. feelings of responsibility for the health of family members b. approval-seeking behavior from friends and family c. persistent thoughts about bacteria, germs, and dirt d. needs to avoid interactions with others
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ANS: C
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Many compulsive rituals accompany obsessive thoughts. The patient uses these rituals for anxiety relief. Unfortunately, the anxiety relief is short lived, and the patient must frequently repeat the ritual. The other options are unrelated to the dynamics of compulsive behavior.
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PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 15-25 to 27, 79 (Table 15-7), 81 (Table 15-8) TOP: Nursing Process: Diagnosis/Analysis MSC: Client Needs: Psychosocial Integrity 30. A patient performs ritualistic hand washing. Which action should the nurse implement to help
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the patient develop more effective coping? a. Allow the patient to set a hand-washing schedule. b. Encourage the patient to participate in social activities. c. Encourage the patient to discuss hand-washing routines. d. Focus on the patient’s symptoms rather than on the patient. ANS: B
Because obsessive-compulsive patients become overly involved in the rituals, promotion of involvement with other people and activities is necessary to improve coping. Daily activities prevent constant focus on anxiety and symptoms. The other interventions focus on the compulsive symptom. PTS: 1
DIF: Cognitive Level: Apply (Application)
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