11. Furthermore, identical types of impairments and similar functional limitations may result in different patterns of disability. Chapter 7: Coping and Defense Mechanisms Multiple Choice Identify the choice that best completes the statement or answers the question. 5. What level of severity of anxiety is this patient experiencing? Application materials and licensing fees must be submitted to the BON/RB. It results from mechanical stimulation […] Remember that defense mechanisms serve a purpose and cannot be arbitrarily eliminated without being replaced by more adaptive coping mechanisms. Substance Abuse 9. Start NOW. A nurse at Nurseslabs Medical Center is developing a care plan for a female client with post-traumatic stress disorder. Positive reframing with techniques such as the appropriate use of humor, Eliciting and utilizing community resources that are appropriate to the client's needs, Learning and using new and more effective coping skills, problem solving skills and decision making skills, The use of relaxation and stress management techniques, Readjusting and setting expectations of self that are achievable and realistic as based on the client's current state or status, Ineffective role performance related to an inadequate or lacking role model, Ineffective role performance related to a new role and its expectations, Ineffective role performance related to unrealistic role expectations, Ineffective role performance related to depression, poor self-esteem, pain, physical limitations and/or the lack of adequate social support systems, Ineffective role performance related to domestic violence and poor parenting skills, Ineffective role performance related to substance related disorders, Ineffective role performance related to diminished cognitive functioning, poor decision making and poor problem solving skills, Facilitating the client's ventilation of feelings, Emphasizing the client's strengths and minimizing their weaknesses, Physiological assistive devices to overcome any lacks of the ability of the client to perform independent self care and activities of daily living such as bathing, ambulation, dressing and grooming. Fear: Fear is a response to a perceived impending or actual danger, including illness. Disabilities as the result of a situational life change can be classified and characterized in a number of different ways. EXAM TIP: Along with a good study plan, time management is important in reviewing a variety of topics. Coping mechanisms are learned; some are effective and others are not. The nurse is teaching a patient about therapies for Obsessive Compulsive Disorder. 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. Which of the following would she do initially? 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. ... An ineffective defense mechanism. Approximately 9% to 15% of the questions on the exam are focused on this topic. Complains to her doctor she has been unable to sleep lately. Exam Mode – Questions and choices are randomly arranged, time limit of 1min per question, answers and grade will be revealed after finishing the exam. She has also been suffering from diarrhea, nausea, and heart palpitations. 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. 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. As she is describing her symptoms the doctor realizes she is trembling and seems disoriented. Rationalization will also be more fully discussed later in this review with the section entitled "Evaluating the Constructive Use of Defense Mechanisms by a Client". Topics covered in this practice test include Coping Mechanisms, Sensory/Perceptual Alterations, Therapeutic Medications, Cultural Awareness and Mental Health Concepts. 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. 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. Some of the maturational and developmental role changes and challenges along the life span include: Some of the situational role changes and challenges include those physical, psychological and social changes that occur as the result of some acute or chronic disorder or disease. A nurse is observing a 32-year-old client who is experiencing alcohol withdrawal. Control over one's response to stress is possible. Loss of hope and meaning: A loss of hope or hopelessness, as defined by the North American Nursing Diagnosis Association (NANDA), is "the subjective state in which an individual sees limited or no alternatives for personal choices available and is unable to mobilize energy on one's own behalf". In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of coping mechanisms in order to: Rationalization: Rationalization occurs when the client explains away the threatening event or situation with faulty thinking rather than dealing and coping with it. Avoidance of … 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 National Council of State Boards of Nursing estimates that 6-12% of the NCLEX-RN questions will be on Psychological Integrity. Some of these role changes are maturational or developmental and others are situational. 17 Suicidal Client Review questions (NCLEX) 10 Terms. 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. Which statement by the student to the nurse counselor should indicate the use of the ego defense mechanism projection? 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. As she is describing her symptoms the doctor realizes she is trembling and seems disoriented. Topics included in this NCLEX practice quiz are: 1. Domestic Violence 6. 1-35. questions. b. Which nursing diagnosis would the nurse most likely identify for this client? 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". Denial: Denial, like rationalization and displacement, is another psychological defense mechanism. Topics covered in this NCLEX-RN practice test for Psychological Integrity include Coping Mechanisms, Sensory/Perceptual Alterations, Therapeutic Medications, Cultural Awareness, and Mental Health Concepts. End of life needs include physical, psychological, social and spiritual, cultural and religious needs. Now, there are dozens of examples of coping mechanisms. What are some developmental stressors for older adults? The nurses will most likely advocate which belief as a method of coping with stressful life events? Select All That Apply. 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. 10. The daughter is exhibiting which defense mechanism? Is the client now experiencing self-satisfaction with their new or modified roles? All trademarks are the property of their respective trademark holders. 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. Answer: D Rationale: a. Diplopia It does not occur in retinal detachment. The psychological ego defense mechanisms, their purposes and some examples will be discussed now. Chapter 37 Stress and Coping Review Questions" and 1 other study guide by kaleymac24 includes 25 questions covering vocabulary, terms and more. Life changes can be broadly classified and categorized as permanent or temporary, physical, psychological and social, mild to highly significant, and situational or maturational. A client expresses to the nurse that she constantly feels irritated and loses her temper. Some of the models and frameworks that can be used to gain a fuller understanding of these situational changes and their nursing considerations are discussed below. Updated/Verified: Nov 9, 2020 | RegisteredNursing.org Staff Writers. In order to register for the NCLEX, the candidate must first request a license/registration application from the BON/RB. All losses can be accompanied with grief. Individual's definition of the situation and reactions, which at times compound the limitations; Definition of the situation by others, and their reactions and expectations—especially those who are significant in the lives of the person with the disabling condition (e.g., family members, friends and associates, employers and co-workers, and organizations and professions that provide services and benefits); and, Characteristics of the environment and the degree to which it is free from, or encumbered with, physical and sociocultural barriers" (. What symptoms might the nurse see? 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. What level of severity of anxiety is this patient experiencing? 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. Although grief is a normal, adaptive response to loss, complicated and unresolved grief is maladaptive. The nurse recognizes the signs and symptoms of which medical problem. 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. 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. Nursing Diagnosis 8. 1. Coping Mechanism involves any effort to decrease the stress response. d. Bright flashes of light Bright flashes of light or photopsia is a common symptom of retinal detachment. 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. Your patient is sternly criticized by her doctor for not complying with the medication regimen. The mother of a 38yr/old female recently died due to complications from a surgery which required an unexpected colostomy. B. 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. Tourette Syndrome Unhealthy adjustment patterns may include mechanisms such as regression, repression, denial, projection, and dissociation. 6. 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. A 52-year-old male client has been hospitalized for depression. 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. 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". ... An expected coping mechanism. Take this part three of the practice test about safety and infection control. Dependent Personality Disorder 4. 7. The health care provider has started the client's treatment of depression with phenelzine. 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) Test your knowledge of defense mechanisms in psychology with this quiz. Guilt: The ultimate purpose of guilt is to let a human know and gain insight into something that they have done that is wrong. It is important to use the appropriate NCLEX questions for whichever NCLEX test and subtest you are taking. This may be an example of which defense mechanism? 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. Coping can be adaptive and it can also be useless and maladaptive. Bulimia Nervosa 4. Mania 6. These roles and tasks are organized in spheres of life activities such as those of the family or other interpersonal relations; work, employment, and other economic pursuits; and education, recreation, and self-care. Are the family members and other significant others participating in the care and support of the affected client? “You Learn More From Failure Than From Success. Part 1: Therapeutic Communication in Nursing NCLEX Practice Quiz (25 Questions) Part 2: Therapeutic Communication in Nursing NCLEX Practice Quiz (25 Questions) Guidelines. 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. Medical-Surgical #1. 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. The patient walks out of the office and yells at the parking attendant. 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. The stage of alarm also referred to as "Fight or Flight": The signs and symptoms of this first stage of the stress response include increases in terms of the person's cardiac, respiratory, and blood pressure measurements, increased blood cortisol and adrenalin levels, increased cardiac output, the increased and enhanced use of glucose by the body, an increased metabolic rate, apprehension, fear, dilated pupils, decreased gastrointestinal functioning, sympathetic nervous system activation, and impaired immune system functioning, all of which prepare the client to fight or flee. Borderline Personality Disorder 3. The stage of exhaustion, which can lead to death, is characterized with the complete loss of and exhaustion of all the body's resources and mechanisms. Is the client able to identify and maximize their strengths rather than focusing on their weaknesses and limitations? Schizoid Personality Disorder 10. Personality Disorders 7. Is the client exhibiting any objective or subjective signs and symptoms such as those associated with anxiety, stress, grief and/or distress? Which of the following exercises would be appropriate for the nurse to suggest the client engage in initially? This symptom can lead to physical, psychological and cognitive changes. 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. Read and understand each question before choosing the best answer. As with other NCLEX-RN® exam questions, one of the biggest errors that test takers commit when trying to answer this … Stress & Adaptation NClex Questions questionA client expresses to the nurse that she constantly feels irritated and loses her temper. 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. On the NCLEX-RN® exam, you can expect approximately 9 percent of the questions to relate to Psychosocial Integrity. Concepts and topics included in this practice exam are as follows: 1. Search. The nurse is interviewing a client with complaints of chronic fatigue. Personality Disorders 9. Excessive and intense stress can lead to distress and the damaging physiological effects of the General Adaptation Syndrome. 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. Start Quiz % Share: Share Tweet Stumble Upon Pin It +1. Bipolar Disorder 2. Coping Strategies and Defense Mechanisms: Questions to Ask Oneself Mark Dombeck, Ph.D. 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. 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. 4. 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