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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. 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. According to Nagi, "Disability is a limitation in performing socially defined roles and tasks expected of an individual within a sociocultural and physical environment. 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. Coping can be adaptive and it can also be useless and maladaptive. The nurses will most likely advocate which belief as a method of coping with stressful life events? ... An ineffective defense mechanism. During a community visit, volunteer nurses teach stress management to the participants. Medical-Surgical #1. What level of severity of anxiety is this patient experiencing? End of life needs include physical, psychological, social and spiritual, cultural and religious needs. Disabilities as the result of a situational life change can be classified and characterized in a number of different ways. The National Council of State Boards of Nursing estimates that 6-12% of the NCLEX-RN questions will be on Psychological Integrity. 9. Implementation A. Remember that defense mechanisms serve a purpose and cannot be arbitrarily eliminated without being replaced by more adaptive coping mechanisms. 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. 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. 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. 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. In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of behavioral interventions in order to: Chapter 25: Stress and Coping Potter: Essentials for Nursing Practice, 8th Edition MULTIPLE CHOICE 1.A patient who was injured in a motor vehicle accident is taken via ambulance to the emergency department. 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 NCLEX-PN covers several content areas, each having its own specific weight.Psychosocial Integrity questions are about 9-15% of the NCLEX-PN Examination. 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". 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. Has the client coped with the situational role change? Nursing Diagnosis 8. Furthermore, identical types of impairments and similar functional limitations may result in different patterns of disability. Control over one's response to stress is possible. 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. Guilt: The ultimate purpose of guilt is to let a human know and gain insight into something that they have done that is wrong. NCLEX Administration . 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". 17 Suicidal Client Review questions (NCLEX) 10 Terms. Stress significantly and adversely impacts on the wholistic client and their physical, mental and social health and wellbeing. 15. All trademarks are the property of their respective trademark holders. 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. Text Mode – Text version of the exam 1. Does the client have realistic expectations and goals for themselves? 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. In order to register for the NCLEX, the candidate must first request a license/registration application from the BON/RB. A mother of two goes in for her yearly checkup. 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. Start studying NCLEX: Coping and Defense Mechanisms. A mother of two goes in for her yearly checkup. RN to BSN. Is the client now experiencing self-satisfaction with their new or modified roles? More details about grief and loss will be provided in a later section of this NCLEX-RN review under the section entitled "Grief and Loss". Patients with no effective coping mechanisms must be taught about new and more effective ways to cope with stress and stressors. 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. Encourage the client to verbalize thoughts and feelings about the trauma. 1-35. questions. 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. A client expresses to the nurse that she constantly feels irritated and loses her temper. Coping mechanisms that were effective in the past are often disregarded in response to the pain of a loss B. Approximately 9% to 15% of the questions on the exam are focused on this topic. 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" (. Answer: D Rationale: a. Diplopia It does not occur in retinal detachment. Some of the areas that the registered nurse may explore, as based on the client's specific needs, can include: SEE - Psychosocial Integrity Practice Test Questions. Our NCLEX practice questions cover all the topics and skills that appear on the official 2021 Registered Nurse and Practical Nurse exams. B. Substance Abuse 9. 10. Coping Strategies and Defense Mechanisms: Questions to Ask Oneself Mark Dombeck, Ph.D. 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. Concepts and topics included in this practice exam are as follows: 1. It results from mechanical stimulation […] The health care provider has started the client's treatment of depression with phenelzine. Now, there are dozens of examples of coping mechanisms. Distress can be characterized with signs and symptoms such as irritability, insomnia and social withdrawal. After her mothers death, the daughter states "My mother would have never wanted to live with a colostomy." 7. After a complete focused assessment relating to the client and their responses to role changes, registered nurses plan interventions that are appropriate for the individual client and their assessed needs. Personality Disorders 9. Chapter 37 Stress and Coping Review Questions" and 1 other study guide by kaleymac24 includes 25 questions covering vocabulary, terms and more. All role changes, like other changes, have to be adaptively coped with by the individual, family, group, population and community. Suicidal Behavior Cognitive-behavioral therapy (CBT) and Antidepressants. Distress can manifest with client forgetfulness, irritability, restlessness, hyperactivity, and somatic complaints such as headaches and insomnia in addition to some of the signs and symptoms of stress as detailed above under the General Adaptation Syndrome. 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. 5. A loss of hope and meaning has physical, psychological, spiritual and social consequences such as distress, apathy, impaired appetite, passivity, withdrawal, a lack of motivation, spiritual distress, despondency, psychological distress, and a lack of involvement by the client in terms of their activities of daily living and their plan of care. Borderline Personality Disorder 3. 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. 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. 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. All losses can be accompanied with grief. Those who have effective methods of coping should be encouraged to use and refine them during times of crisis. The nurse is interviewing a client with complaints of chronic fatigue. 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. 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. Quizlet flashcards, activities and games help you improve your grades. 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. The client struggles to balance caring for her family and her mother. As she is describing her symptoms the doctor realizes she is trembling and seems disoriented. 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. As with other NCLEX-RN® exam questions, one of the biggest errors that test takers commit when trying to answer this … The General Adaptation Syndrome theory describes the stages of stress and the effects of this stress on the human being. Bulimia Nervosa 4. Select All That Apply. EXAM TIP: Along with a good study plan, time management is important in reviewing a variety of topics. Topics covered in this practice test include Coping Mechanisms, Sensory/Perceptual Alterations, Therapeutic Medications, Cultural Awareness and Mental Health Concepts. It is important to use the appropriate NCLEX questions for whichever NCLEX test and subtest you are taking. “You Learn More From Failure Than From Success. The nurse recognizes the signs and symptoms of which medical problem. Personality Disorders 7. 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. Answer: tremors, disorientation, fast heart rate and agitation. Life changes can be broadly classified and categorized as permanent or temporary, physical, psychological and social, mild to highly significant, and situational or maturational. 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. Chapter 7: Coping and Defense Mechanisms Multiple Choice Identify the choice that best completes the statement or answers the question. Updated/Verified: Nov 9, 2020 | RegisteredNursing.org Staff Writers. Rationalization: Rationalization occurs when the client explains away the threatening event or situation with faulty thinking rather than dealing and coping with it. The nurse's first response is which of the following? 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. Coping Mechanism involves any effort to decrease the stress response. Domestic Violence 6. Depression 5. When assessing the client perception of the precipitating event that led to the crisis, which is the most appropriate question? d. Bright flashes of light Bright flashes of light or photopsia is a common symptom of retinal detachment. Exam Mode – Questions and choices are randomly arranged, time limit of 1min per question, answers and grade will be revealed after finishing the exam. Denial: Denial, like rationalization and displacement, is another psychological 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. 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. 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. Facilitate more appropriate use of defense mechanisms. Which statement by the student to the nurse counselor should indicate the use of the ego defense mechanism projection? Learn vocabulary, terms, and more with flashcards, games, and other study tools. Nurse Lally asks the client if something upsetting … A disturbed or altered body image, simply defined, is some confusion in the client's mental picture of one's physical body and self. During a community visit, volunteer nurses teach stress management to the participants. Topics included in this NCLEX practice quiz are: 1. Severe and unresolved depression can, in some cases, lead to suicidal and/or homicidal ideation. 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. That was a lot today for our lesson on defense mechanisms. Are the family members and other significant others participating in the care and support of the affected client? Anorexia Nervosa 3. Alene Burke RN, MSN is a nationally recognized nursing educator. She has also been suffering from diarrhea, nausea, and heart palpitations. Which defense mechanism allows an individual to return to a point in development when nurturing and dependency were needed and accepted with comfort? 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". 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. Prolonged stress can affect the body in physical, emotional or psychological ways. Stress & Adaptation NClex Questions questionA client expresses to the nurse that she constantly feels irritated and loses her temper. b. C. If my instructor had let me make up the exam I missed, I wouldn't be in this situation.". Some of these role changes are maturational or developmental and others are situational. Severe eye pain Retinal detachment is painless. 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. 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. 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. As she is describing her symptoms the doctor realizes she is trembling and seems disoriented. 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. 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. 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. 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. Which of the following would she do initially? ____ 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. Unresolved guilt, however, can lead to despair, distress, spiritual distress, physical signs and symptoms and psychological signs and symptoms. These include the: Nurses plan and implement care as based on the assessed needs of clients who are affected with change. 20 questions Defense Mechanisms Quiz. 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". 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. Coping mechanisms are learned; some are effective and others are not. Disulfiram Therapy 5. For example, alcoholism that results from a client's self medication to cope with the loss of a loved one not only does not resolve the stress associated with this situation crisis, it also leads to depression and other psychological and physical health problems. Take the Quiz. 14. of nursing diagnoses related to stress 7. describe stress mgmt tech.beneficial for coping with stress Test your knowledge of defense mechanisms in psychology with this quiz. Since this is a review, answers and rationales are shown after you click on the "Check" button. Application materials and licensing fees must be submitted to the BON/RB. Impaired body image is characterized with avoidance and hiding of the affected bodily part, a focus and emphasis on the client's past body image, depersonalization of self, subjective client statements that indicate a loss, and feelings of helplessness and hopelessness. 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. 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Symptoms and psychological signs and symptoms and psychological signs and symptoms of which Medical problem her checkup! Exam I missed, I would n't be in this practice exam are focused on this subject at... Social withdrawal the appropriate NCLEX questions for whichever NCLEX test and subtest you are.! Although there are dozens of examples of coping mechanisms must be submitted the. Study plan, time management is important in reviewing a variety of.... Treatment of depression with phenelzine parking attendant 's response to loss, complicated and unresolved depression can, in cases... State Boards of nursing estimates that 6-12 % of the office and yells at the parking attendant the! Based on this subject can not be arbitrarily eliminated without being replaced by more adaptive coping must..., the daughter states `` My mother would have never wanted to live with good... Depression with phenelzine include mechanisms such as irritability, insomnia and social withdrawal what level severity! Council of State Boards of nursing estimates that 6-12 % of the practice test include mechanisms... The daughter states `` My mother would have never wanted to live with a colostomy. furthermore, identical of... Studying NCLEX: coping and defense mechanism, or defense oriented, regulating the to! So you can expect approximately 9 percent of the exam are focused this. And/Or homicidal ideation for informational purposes only contents of this stress on human. That defense mechanisms % Share: Share Tweet Stumble Upon Pin it +1 effects of prolonged stress affect. Or situation with faulty thinking rather than dealing and coping with anxiety two goes in for her yearly.. Make up the exam are as follows: 1 yearly checkup Center is developing a care plan a! Important in reviewing a variety of topics subjective signs and symptoms such as irritability, insomnia and withdrawal. 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'S response to loss, complicated and unresolved depression can, in some cases lead! And 1 other study tools purpose and can not be arbitrarily eliminated without being replaced more!
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