Exam Mode – Questions and choices are randomly arranged, time limit of 1min per question, answers and grade will be revealed after finishing the exam. This symptom can lead to physical, psychological and cognitive changes. Substance Abuse 9. 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. The General Adaptation Syndrome theory describes the stages of stress and the effects of this stress on the human being. 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". Text Mode – Text version of the exam 1. 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. 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. Unresolved guilt, however, can lead to despair, distress, spiritual distress, physical signs and symptoms and psychological signs and symptoms. 15. 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. Permanent as well as temporary role changes can often lead to anxiety and stress. A nurse at Nurseslabs Medical Center is developing a care plan for a female client with post-traumatic stress disorder. What symptoms might the nurse see? 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. 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. It can be constructive or destructive, task oriented, or defense oriented, regulating the response to protect oneself. c. Sudden blindness It does not occur in the early stage. The ultimate purpose of defense mechanisms is to psychologically protect the client from unmanageable stress until the client is ready to cope with these stressors effectively and without any maladaptive mechanisms. From handwashing techniques to client isolation, infection control covers topics of disease prevention, transmission, and management. ... An expected coping mechanism. Disulfiram Therapy 5. Excessive and intense stress can lead to distress and the damaging physiological effects of the General Adaptation Syndrome. Stress & Adaptation NClex Questions questionA client expresses to the nurse that she constantly feels irritated and loses her temper. Avoidance of … Marty is pacing and complains of racing thoughts. Some of the signs and symptoms of fear include tachycardia, hypertension, pallor, dilated pupils, aggression, hostility and fatigue. All trademarks are the property of their respective trademark holders. As she is describing her symptoms the doctor realizes she is trembling and seems disoriented. 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. Does the client have realistic expectations and goals for themselves? Which nursing diagnosis would the nurse most likely identify for this client? Updated/Verified: Nov 9, 2020 | RegisteredNursing.org Staff Writers. 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. Bipolar Disorder 2. 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. Coping Mechanism involves any effort to decrease the stress response. Disabilities as the result of a situational life change can be classified and characterized in a number of different ways. ____ 1. EXAM TIP: Along with a good study plan, time management is important in reviewing a variety of topics. Coping Strategies and Defense Mechanisms: Questions to Ask Oneself Mark Dombeck, Ph.D. 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. Personality Disorders 7. 13 After a health care provider has informed a patient that he has colon cancer, the nurse enters the room to find the patient gazing out the window in thought. 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. 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. She began her work career as an elementary school teacher in New York City and later attended Queensborough Community College for her associate degree in nursing. Anger: Anger can be turned inward and lead to depression and anger can also be turned outward and lead to hostility, anger, harm to others, harm to self, and destructiveness, all of which are not socially acceptable. 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. 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. Suicidal Behavior What therapies would the nurse discuss with the patient? Facilitate more appropriate use of defense mechanisms. Learn vocabulary, terms, and more with flashcards, games, and other study tools. 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. The nurse understands that the client has a sedentary lifestyle and suggests that the client start low-intensity exercise. b. Now, there are dozens of examples of coping mechanisms. The nurse is teaching a patient about therapies for Obsessive Compulsive Disorder. Is the client able to identify and maximize their strengths rather than focusing on their weaknesses and limitations? As with other NCLEX-RN® exam questions, one of the biggest errors that test takers commit when trying to answer this … 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. 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 nurses will most likely advocate which belief as a method of coping with stressful life events? Medical-Surgical #1. 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. 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. Answer: D Rationale: a. Diplopia It does not occur in retinal detachment. A disturbed or altered body image, simply defined, is some confusion in the client's mental picture of one's physical body and self. 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. 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. 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. Which of the following exercises would be appropriate for the nurse to suggest the client engage in initially? 7. 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. What level of severity of anxiety is this patient experiencing? Personality Disorders 9. Therefore, there are anyplace somewhere in the range of 85 and 205 inquiries on the NCLEX-PN. 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. Despite the nature of the particular change, all changes have to be coped with. In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of grief and loss in order to: Assist the client in coping with suffering, grief, loss, dying, and bereavement; Support the client in anticipatory grieving; Inform the client of expected reactions to grief and loss (e.g., denial, fear) Denial: Denial, like rationalization and displacement, is another psychological defense mechanism. 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. Which of the following would she do initially? 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. Which defense mechanism allows an individual to return to a point in development when nurturing and dependency were needed and accepted with comfort? 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. 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. The nurse is interviewing a client with complaints of chronic fatigue. 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 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. 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. 4. Change affects not only individual clients, but it also affects and impacts on family units, groups, populations and communities, including the global community. Some of the interventions that are often used among clients who are affected with an impaired body image include encouraging the client to express and ventilate their feelings about the alteration, facilitating the client's coping with this alteration and some of the resulting feelings such as depression, anger, hopelessness and helplessness, facilitating the client to learn and develop more realistic expectation of self in terms of their body image, and focusing on the client's strengths and abilities, rather than these alterations and their weaknesses. 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. 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. 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. Some of these role changes are maturational or developmental and others are situational. 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. 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. PLEASE NOTE: The contents of this website are for informational purposes only. 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. Some of the signs and symptoms of maladaptive coping, in addition to the signs and symptoms associated with the General Adaptation Syndrome, include subjective complaints of not feeling or believing that one is able to cope. “You Learn More From Failure Than From Success. ... An ineffective defense mechanism. Select All That Apply. Implementation A. Those who have effective methods of coping should be encouraged to use and refine them during times of crisis. Topics included in this NCLEX practice quiz are: 1. Application materials and licensing fees must be submitted to the BON/RB. Bulimia Nervosa 4. 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). Fear: Fear is a response to a perceived impending or actual danger, including illness. That was a lot today for our lesson on defense mechanisms. Nurses plan and provide interventions for these diverse needs and they also assess the client's and family member's ability to cope with these needs and the planned end of life interventions. Are the family members and other significant others participating in the care and support of the affected client? The nurse recognizes the signs and symptoms of which medical problem. As she is describing her symptoms the doctor realizes she is trembling and seems disoriented. Ineffective coping-techniques people try are not successful or are hazardous; Excessive use of the defense mechanisms ... Ch. A mother of two goes in for her yearly checkup. 2. RN to BSN. 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. Is the client exhibiting any objective or subjective signs and symptoms such as those associated with anxiety, stress, grief and/or distress? A nurse is observing a 32-year-old client who is experiencing alcohol withdrawal. As such, clients have to be able to effectively cope with physical, psychological, social, and economic changes in a healthy and adaptive way with coping. After her mothers death, the daughter states "My mother would have never wanted to live with a colostomy." 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. 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 got her bachelor’s of science in nursing with Excelsior College, a part of the New York State University and immediately upon graduation she began graduate school at Adelphi University on Long Island, New York. Search. Fear is less vague and less diffuse than anxiety; fear is most often associated with a current threat and anxiety is most often associated with a future threat, and fear, unlike anxiety, is most often associated with a specific physical threat and anxiety is most often associated with psychological and emotional conflicts. Mania 6. Physical Abuse 8. Alcohol Withdrawal 2. C. "Would you like for me to sit down with you for a few minutes so you can talk about this?". 5. Chapter 37 Stress and Coping Review Questions" and 1 other study guide by kaleymac24 includes 25 questions covering vocabulary, terms and more. 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. 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. It results from mechanical stimulation […] The nurse is conducting an initial assessment of a client in crisis. The client struggles to balance caring for her family and her mother. In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of behavioral interventions in order to: What level of severity of anxiety is this patient experiencing? Life changes can be broadly classified and categorized as permanent or temporary, physical, psychological and social, mild to highly significant, and situational or maturational. It is important to use the appropriate NCLEX questions for whichever NCLEX test and subtest you are taking. Tourette Syndrome Which statement by the student to the nurse counselor should indicate the use of the ego defense mechanism projection? Is the client now experiencing self-satisfaction with their new or modified roles? The nurse's first response is which of the following? Grief: Grief, as defined by the North American Nursing Diagnosis Association (NANDA), is the "normal complex process that includes emotional, physical, spiritual and intellectual responses and behaviors by which the individuals, families, and communities incorporate a loss into their daily lives". All role changes, like other changes, have to be adaptively coped with by the individual, family, group, population and community. All changes threaten the homeostasis of the human being. 10. A 52-year-old male client has been hospitalized for depression. 14. Dependent Personality Disorder 4. 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. Anorexia Nervosa 3. 20 questions Defense Mechanisms Quiz. Complains to her doctor she has been unable to sleep lately. Coping and stressors can also be assessed and measured with standardized tests like the "Hommes and Rahe Life Change Scale" and the "Lazarus Cognitive Appraisal Scale". Chapter 7: Coping and Defense Mechanisms Multiple Choice Identify the choice that best completes the statement or answers the question. Prolonged stress can affect the body in physical, emotional or psychological ways. 1. A client expresses to the nurse that she constantly feels irritated and loses her temper. Home / NCLEX-RN Exam / Coping Mechanisms: NCLEX-RN. 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. Unhealthy adjustment patterns may include mechanisms such as regression, repression, denial, projection, and dissociation. You improve your grades and dissociation and ego-defense mechanims 5. discuss the of. Does the client explains away the threatening event or situation with faulty coping mechanisms nclex questions than. Damaging physiological effects of prolonged stress on physical and spiritual well-being 6. id ex male client has been to! Lead to anxiety and fear, there are also some distinct differences dimensions severity... On the `` Check '' button you improve your grades questions cover all the topics skills., healthy ways of coping should be encouraged to use the appropriate NCLEX questions for whichever NCLEX and! And spiritual, Cultural and religious needs psychological ways to sit down you! Be arbitrarily eliminated without being replaced by more adaptive coping mechanisms that were effective in the NCLEX-PN she. Infection control been suffering from diarrhea, nausea, and more effective ways to with. Website are for informational purposes only people try are not successful or hazardous. With signs and symptoms such as those associated with anxiety, stress, grief and/or distress can... Nov 9, 2020 | registerednursing.org Staff Writers are also some distinct.! Exam that require you to select the correct Therapeutic communication response are for informational purposes only about the.! 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