Severe and unresolved depression can, in some cases, lead to suicidal and/or homicidal ideation. 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. 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. 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. Domestic Violence 6. 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. 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. As with all aspects of nursing care, nurses evaluate whether or not the client has successfully adapted to situational role changes in terms of whether or not the client has achieved the pre-established goals that were established after a complete assessment of the affected client, their family members, and other significant others. According to Nagi, "Disability is a limitation in performing socially defined roles and tasks expected of an individual within a sociocultural and physical environment. 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. Schizoid Personality Disorder 10. 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. A 52-year-old male client has been hospitalized for depression. 1. 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. Is the client now experiencing self-satisfaction with their new or modified roles? 1-35. questions. 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. As with other NCLEX-RN® exam questions, one of the biggest errors that test takers commit when trying to answer this … 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. 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. 4.discuss commonly used coping behaviors and ego-defense mechanims 5. discuss the effects of prolonged stress on physical and spiritual well-being 6. id ex. During a community visit, volunteer nurses teach stress management to the participants. 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. The nurse is conducting an initial assessment of a client in crisis. c. Sudden blindness It does not occur in the early stage. 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. 6. Test your knowledge of defense mechanisms in psychology with this quiz. 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. 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. 5. Start NOW. NCLEX-RN Sample Questions. The nurse is teaching a patient about therapies for Obsessive Compulsive Disorder. Those who have effective methods of coping should be encouraged to use and refine them during times of crisis. Tourette Syndrome 2. Borderline Personality Disorder 3. “You Learn More From Failure Than From Success. Cognitive-behavioral therapy (CBT) and Antidepressants. Alcohol Withdrawal 2. Chapter 37 Stress and Coping Review Questions" and 1 other study guide by kaleymac24 includes 25 questions covering vocabulary, terms and more. 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. Are the family members and other significant others participating in the care and support of the affected client? A nurse at Nurseslabs Medical Center is developing a care plan for a female client with post-traumatic stress disorder. A disturbed or altered body image, simply defined, is some confusion in the client's mental picture of one's physical body and self. 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". A nurse is observing a 32-year-old client who is experiencing alcohol withdrawal. Some of these role changes are maturational or developmental and others are situational. Assessment data and information that should be collected in respect to the client's level of psychosocial functioning and coping mechanisms should entail the client's age at the onset of the coping disorder, the client's specific psychosocial signs and symptoms, the duration of these episodes, the number of episodes that required intense treatment, the client's family history of any psychiatric mental health disorders, the client's use of support systems, the effectiveness of these support systems, the client's utilization of available resources in their community, the effectiveness of these available resources in terms of the client's needs, the client's past coping mechanisms, and the client's current use of adaptive and effective and/or maladaptive and non effective coping strategies. PLEASE NOTE: The contents of this website are for informational purposes only. Coping Strategies and Defense Mechanisms: Questions to Ask Oneself Mark Dombeck, Ph.D. Fear: Fear is a response to a perceived impending or actual danger, including illness. All losses can be accompanied with grief. The General Adaptation Syndrome theory describes the stages of stress and the effects of this stress on the human being. Topics covered in this practice test include Coping Mechanisms, Sensory/Perceptual Alterations, Therapeutic Medications, Cultural Awareness and Mental Health Concepts. EXAM TIP: Along with a good study plan, time management is important in reviewing a variety of topics. Furthermore, identical types of impairments and similar functional limitations may result in different patterns of disability. Has the client coped with the situational role change? 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". Remember that defense mechanisms serve a purpose and cannot be arbitrarily eliminated without being replaced by more adaptive coping mechanisms. Which defense mechanism allows an individual to return to a point in development when nurturing and dependency were needed and accepted with comfort? The outcome for this diagnosis is that the patient needs to adopt coping mechanisms that are effective for dealing with stress, such as relaxation techniques. 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. 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. Several other factors contribute to shaping the dimensions and severity of disability. That was a lot today for our lesson on defense mechanisms. Rationalization: Rationalization occurs when the client explains away the threatening event or situation with faulty thinking rather than dealing and coping with it. A person’s perception of a loss has little to do with the grieving process. 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. 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. 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. Complains to her doctor she has been unable to sleep lately. What are some developmental stressors for older adults? Depression 5. 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. Mood Disorders 7. 6. 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. Learn vocabulary, terms, and more with flashcards, games, and other study tools. 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. Although there are similarities with both anxiety and fear, there are also some distinct differences. And healthy defense mechanisms are positive, healthy ways of coping with anxiety. Search. 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. ... An ineffective defense mechanism. Although grief is a normal, adaptive response to loss, complicated and unresolved grief is maladaptive. 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. 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" (. Read and understand each question before choosing the best answer. 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. Unresolved guilt, however, can lead to despair, distress, spiritual distress, physical signs and symptoms and psychological signs and symptoms. When assessing the client perception of the precipitating event that led to the crisis, which is the most appropriate question? Avoidance of … Substance Abuse 9. Excessive and intense stress can lead to distress and the damaging physiological effects of the General Adaptation Syndrome. Bulimia Nervosa 4. 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. 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. The nurse recognizes the signs and symptoms of which medical problem. After her mothers death, the daughter states "My mother would have never wanted to live with a colostomy." 15. 10. Most Read ... 31 Defense Mechanisms A look at common defense mechanisms we employ to protect the ego. d. Bright flashes of light Bright flashes of light or photopsia is a common symptom of retinal detachment. 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. Your patient is sternly criticized by her doctor for not complying with the medication regimen. ... An expected coping mechanism. Suicidal Behavior 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 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. Life changes can be broadly classified and categorized as permanent or temporary, physical, psychological and social, mild to highly significant, and situational or maturational. All trademarks are the property of their respective trademark holders. Which statement by the student to the nurse counselor should indicate the use of the ego defense mechanism projection? 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. Guilt: The ultimate purpose of guilt is to let a human know and gain insight into something that they have done that is wrong. Start studying NCLEX: Coping and Defense Mechanisms. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Change affects not only individual clients, but it also affects and impacts on family units, groups, populations and communities, including the global community. Severe eye pain Retinal detachment is painless. 11. From handwashing techniques to client isolation, infection control covers topics of disease prevention, transmission, and management. Start studying mental health-coping and defense mechanism. 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) Take the Quiz. Distress can be characterized with signs and symptoms such as irritability, insomnia and social withdrawal. The client struggles to balance caring for her family and her mother. Since this is a review, answers and rationales are shown after you click on the "Check" button. Is the client exhibiting any objective or subjective signs and symptoms such as those associated with anxiety, stress, grief and/or distress? 9. 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. Can expect approximately 9 % to 15 % of the signs and of., hypertension, pallor, dilated pupils, aggression, hostility coping mechanisms nclex questions fatigue will most likely which! 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