Varcarolis Chapter 11 Guaranteed Success
1. A nurse wishes to teach alternative coping strategies to a patient who is experiencing severe anxiety.
The nurse will first need to:
a. Lower the patient's current anxiety level.
b. Verify the patient's learning style.
c. Create outcomes and a t...
Varcarolis Chapter 11 Guaranteed Success
1. A nurse wishes to teach alternative coping strategies to a patient who is experiencing severe anxiety.
The nurse will first need to:
a. Lower the patient's current anxiety level.
b. Verify the patient's learning style.
c. Create outcomes and a teaching plan.
d. Assess how the patient uses defense mechanisms. ✔️ANS: A
A patient experiencing severe anxiety has a significantly narrowed perceptual field and difficulty
attending to events in the environment. A patient experiencing severe anxiety will not learn readily.
Determining preferred modes of learning, devising outcomes, and constructing teaching plans are
relevant to the task but are not the priority measure. The nurse has already assessed the patient's
anxiety level. Using defense mechanisms does not apply.
2. A patient approaches the nurse and impatiently blurts out, "You've got to help me! Something terrible
is happening. My heart is pounding." The nurse responds, "It's almost time for visiting hours. Let's get
your hair combed." Which approach has the nurse used?
a. Distracting technique to lower anxiety
b. Bringing up an irrelevant topic
c. Responding to physical needs
d. Addressing false cognitions ✔️ANS: B
The nurse has closed off patient-centered communication. The introduction of an irrelevant topic makes
the nurse feel better. The nurse is uncomfortable dealing with the patient's severe anxiety.
3. A patient who is experiencing moderate anxiety says, "I feel undone." An appropriate response for the
nurse would be:
a. "Why do you suppose you are feeling anxious?"
b. "What would you like me to do to help you?"
c. "I'm not sure I understand. Give me an example."
d. "You must get your feelings under control before we can continue." ✔️ANS: C
Increased anxiety results in scattered thoughts and an inability to articulate clearly. Clarification helps
the patient identify his or her thoughts and feelings. Asking the patient why he or she feels anxious is
nontherapeutic, and the patient will not likely have an answer. The patient may be unable to determine
, what he or she would like the nurse to do to help. Telling the patient to get his or her feelings under
control is a directive the patient is probably unable to accomplish.
4. A patient with a high level of motor activity runs from chair to chair and cries, "They're coming!
They're coming!" The patient does not follow the staff's directions or respond to verbal interventions.
The initial nursing intervention of highest priority is to:
a. provide for patient safety.
b. increase environmental stimuli.
c. respect the patient's personal space.
d. encourage the clarification of feelings. ✔️ANS: A
Safety is of highest priority; the patient who is experiencing panic is at high risk for self-injury related to
an increase in non-goal-directed motor activity, distorted perceptions, and disordered thoughts. The
goal should be to decrease the environmental stimuli. Respecting the patient's personal space is a lower
priority than safety. The clarification of feelings cannot take place until the level of anxiety is lowered.
5. A patient with a high level of motor activity runs from chair to chair and cries, "They're coming!
They're coming!" The patient is unable to follow staff direction or respond to verbal interventions.
Which nursing diagnosis has the highest priority?
a. Risk for injury
b. Self-care deficit
c. Disturbed energy field
d. Disturbed thought processes ✔️ANS: A
A patient who is experiencing panic-level anxiety is at high risk for injury, related to an increase in non-
goal-directed motor activity, distorted perceptions, and disordered thoughts. Existing data do not
support the nursing diagnoses of Self-care deficit or Disturbed energy field. This patient has disturbed
thought processes, but the risk for injury has a higher priority.
6. A supervisor assigns a worker a new project. The worker initially agrees but feels resentful. The next
day when asked about the project, the worker says, "I've been working on other things." When asked 4
hours later, the worker says, "Someone else was using the copier, so I couldn't finish it." The worker's
behavior demonstrates:
a. acting out.
b. projection.
c. rationalization.
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