Psychology and Psychiatric Nursing MCQ Quiz - Objective Question with Answer for Psychology and Psychiatric Nursing - Download Free PDF

• Building trust with a grieving client and their family requires empathy, honesty, and emotional support. Grief is a deeply personal and often overwhelming experience, and clients value sincerity and reassurance over superficial promises or avoidance of difficult topics.
• By being honest and assuring them that you will not abandon them, you create a foundation of trust. This approach demonstrates that you acknowledge their pain and are committed to supporting them through their journey, no matter how long it takes.
• Maintaining open communication and showing consistent care reinforces the idea that you are a reliable source of support during their time of need. This honesty allows the grieving individuals to process their emotions more effectively, knowing they have a dependable ally.

• Rationale: This approach is not ideal because grief does not have a set timeline, and recovery varies significantly from person to person. Making statements that minimize the complexity of grief can come across as dismissive and may diminish trust.
• Grieving individuals need validation of their emotions rather than a focus on rapid recovery, which may feel unrealistic and unhelpful.

• Rationale: Promising that nothing will go wrong is unrealistic and sets expectations that cannot always be fulfilled. Grief is inherently unpredictable, and challenges may arise during the process.
• Clients and families value transparency over false assurances. Broken promises can erode trust and damage relationships.

• Rationale: Avoiding emotional topics neglects the primary needs of grieving individuals. They often require a safe space to express their emotions and process their loss.
• By evading conversations about their grief, you risk appearing indifferent or detached, which can prevent meaningful connection and trust-building.

• The best way to build trust with a grieving client and their family is to be honest and assure them of your support and presence. This approach fosters open communication, emotional connection, and a safe environment for healing.
• While other options may seem helpful on the surface, they fail to address the core needs of grieving individuals and can unintentionally harm the relationship.
• Empathy, honesty, and commitment are essential qualities in providing effective support to those experiencing grief.

• When a family is struggling with grief and decision-making, the most appropriate nursing action is to assist with problem-solving when asked. This approach respects the autonomy of the family and allows them to process their emotions while seeking support when they feel ready.
• Nurses play a key role in providing emotional support, offering education about care options, and guiding families through the decision-making process without imposing their own views.
• Offering assistance only when asked ensures that the family does not feel overwhelmed or pressured, allowing them to make decisions at their own pace and based on their unique values and circumstances.
• Grief can cloud judgment and decision-making, so a nurse's role is to facilitate clarity and provide resources rather than dictate choices. This fosters trust and a supportive environment for the family.

• Rationale: Offering personal opinions is not appropriate in this context. Nurses must remain neutral and avoid imposing their own beliefs, which could create bias or pressure on the family. Families need to make decisions based on their own values, goals, and understanding of the situation.

• Rationale: Avoiding discussions about treatment options can leave the family feeling unsupported and uninformed. While respecting their space and grief is important, families often need guidance and information to make decisions. Completely avoiding these conversations can result in confusion and hinder decision-making.

• Rationale: While spiritual care from a chaplain can be beneficial, immediately directing the family to a chaplain may not address the practical and medical concerns they are facing. Nurses should first assess the family's needs, provide initial support, and then refer them to appropriate resources, including chaplains, if necessary.

• The best nursing action is to assist with problem-solving when asked, as it allows the family to retain control over their decisions while receiving support tailored to their needs. This approach respects their emotional state and encourages informed and thoughtful decision-making during a challenging time.

• When caring for a sexual assault victim, the primary role of the nurse is to provide emotional support and ensure the victim's safety. Victims of sexual assault are often in a vulnerable and traumatized state, and the presence of a compassionate and trained nurse can help establish a sense of security and comfort.
• Emotional support involves actively listening to the victim, validating their feelings, and offering reassurance. This helps to reduce their distress and anxiety, which are often heightened after such a traumatic event.
• Ensuring safety includes both physical safety (such as protecting the victim from further harm) and psychological safety (creating an environment where the victim feels secure and respected). This is essential for the victim to begin the healing process and cooperate with any necessary medical or legal procedures.
• The nurse also plays a critical role in maintaining a nonjudgmental and empathetic approach, which is crucial for fostering trust and helping the victim feel supported during this difficult time.

• Rationale: While preventing legal issues is important, it is not the primary reason for the nurse to remain with the victim. Legal matters are typically addressed by law enforcement and legal professionals. The nurse's focus should remain on the victim's emotional and physical well-being.

• Rationale: Nurses may collaborate with law enforcement by collecting evidence or documenting findings, but their primary role is not to assist law enforcement. Their main responsibility is to provide care and support to the victim, ensuring their needs are met during this challenging time.

• Rationale: Although medical treatment, including medications, may be necessary, it is not the first or primary action. Emotional support and safety take precedence to ensure the victim feels secure and is willing to proceed with medical care and legal protocols as needed.

• The nurse's primary role when caring for a sexual assault victim is to provide emotional support and ensure their safety. This creates a foundation for the victim's recovery and helps them feel secure enough to engage in further medical and legal processes. While other aspects, such as assisting law enforcement and administering medications, are important, they are secondary to the immediate need for support and safety.

• When a substance abuse client expresses frustration, identifying anger triggers is the best response. This approach focuses on understanding the underlying causes of the client's emotional state, which can help in managing their reactions and developing effective coping mechanisms.
• By identifying anger triggers, the therapist or counselor can guide the client to recognize patterns in their emotions, behaviors, and circumstances that lead to frustration or anger. This awareness is crucial for self-regulation and reducing the risk of relapse.
• Acknowledging and addressing anger triggers allows for a proactive approach in therapy. It can help the client develop healthier strategies for dealing with similar situations in the future, improving emotional resilience and overall recovery outcomes.

• Rationale: While avoiding confrontation might seem like a way to prevent escalation, it does not address the root cause of the client’s frustration. Simply avoiding the issue might leave the client feeling unheard or invalidated, which could exacerbate their emotional state.

• Rationale: Ignoring the client's emotions is not a therapeutic approach. It can lead to feelings of neglect and may harm the therapeutic relationship. Emotional validation is essential in helping clients process and work through their feelings.

• Rationale: Restricting interaction with the client is counterproductive in a therapeutic setting. It can damage trust and hinder progress. Instead, open communication and active listening are necessary for effective therapy.

• The best response to a substance abuse client expressing frustration is to identify anger triggers. This approach promotes emotional awareness, self-regulation, and the development of effective coping mechanisms. Other options, such as avoiding confrontation, ignoring emotions, or restricting interaction, fail to address the root cause of the frustration and may hinder the therapeutic process.

• Severe withdrawal symptoms, especially in cases such as alcohol withdrawal, can lead to serious complications, including seizures. These seizures pose a significant risk for injury due to loss of physical control and consciousness.
• Implementing seizure precautions is a critical nursing intervention to prevent injury during withdrawal. Seizure precautions include measures like padding side rails, ensuring bed safety, removing harmful objects from the environment, and monitoring the client closely for signs of seizure activity.
• Withdrawal seizures are most common within the first 6 to 48 hours of cessation of substance use, making it imperative for nurses to be proactive and vigilant during this period.
• Seizure precautions also involve educating the healthcare team about recognizing signs of impending seizures, administering prescribed medications such as benzodiazepines, and ensuring quick access to emergency equipment like oxygen and suction devices.
• By implementing seizure precautions, nurses help reduce the risk of injury and provide a safer environment for patients undergoing withdrawal.

• Rationale: While group therapy is an effective intervention for long-term recovery and emotional support, it is not appropriate during severe withdrawal symptoms. Withdrawal is a critical physical phase requiring immediate medical attention rather than psychological interventions.
• Clients experiencing severe withdrawal symptoms may not be able to actively participate in group therapy due to physical discomfort, confusion, or agitation.

• Rationale: Starting an IV line is a helpful intervention for administering medications and fluids, especially in cases of dehydration or electrolyte imbalance during withdrawal. However, it does not directly address the risk of injury caused by seizures, which is the primary concern in severe withdrawal.
• While IV access is important, seizure precautions are more specific to injury prevention during withdrawal seizures.

• Rationale: Caffeinated drinks are not a recommended intervention during severe withdrawal symptoms. In fact, caffeine can exacerbate agitation, restlessness, or anxiety, which are common during withdrawal.
• Providing caffeine does not address the risk of seizures or other physical complications and may worsen the client's condition.

• Severe withdrawal symptoms, such as those from alcohol or benzodiazepines, can lead to seizures, which pose a high risk for injury. Among the given options, implementing seizure precautions is the most appropriate nursing intervention to prevent injury during this critical phase.
• Other options, while they may have merit in specific situations, do not directly address the risk of injury caused by seizures and are therefore not suitable as the primary intervention for this scenario.

Explanation:

• A phobia is an exaggerated usually inexplicable and illogical fear of a particular object, class of objects, or situation
• The term ‘phobia’ is often used to refer to a fear of one particular trigger.
• There are three types of phobia recognized by the American Psychiatric Association (APA).

1. Specific phobia:
   • This is an intense, irrational fear of a specific trigger.
2. Social phobia, or social anxiety:
   • This is a profound fear of public humiliation and being singled out or judged by others in a social situation.
   • These kinds of people avoid large gatherings because of social anxiety.
   • It is different than shyness.
3. Agoraphobia:
   • This is a fear of situations from which it would be difficult to escape if a person were to experience extreme panic, such as being in a lift or being outside of the home.

The correct answer is mood.

Key Points

• Depression is a mood disorder.
• Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act.
• It is treatable.
• It causes feelings of sadness and a loss of interest in activities you once enjoyed.
•  It can lead to a variety of emotional and physical problems and can decrease your ability to function at work and at home.​

Additional Information

Concept:-

• The concepts of id, ego and superego are proposed by 'Sigmund Freud' in his 'Psychoanalytic Theory of Personality. Freud used these three concepts to describe the three parts of the human personality and to explain the way a human mind works.  

According to Freud, the human personality is made up of three major systems: the id, ego, and superego. 

Important Points

Another concept introduced by Freud was the “unconscious”. He conceived of the mind like an Iceberg, the tip of which is called the conscious, a small portion as subconscious and the remaining large portion as the Unconscious.

Let's Understand in Brief:

• The ID:
  • It is the unconscious part of the human personality that works to fulfil basic desires.
  • It is based on the pleasure principle which aspires for the satisfaction of antisocial desires.
• The Ego:
  • It looks for rules and morals and resides in the unconscious mind. 
  • The Ego always postpones the desire and discharge the tension until it gets the desired object. 
• The Super-Ego:
  • It is the moral part of the personality, which is known as conscience too. It stands for perfection, rather than pleasure.
  • It acts as a balance between id and super-ego, it tries to figure the solution which does not hurt either id or super-ego.
• Unconscious:
  • A reservoir of feelings, thoughts, urges, and memories that are outside of our conscious awareness.
  • Most of the contents of the unconscious are unacceptable or unpleasant, such as feelings of pain, anxiety, or conflict.
  • According to Freud, the unconscious continues to influence the conscious behaviours of the individual.

Key Points

• The deep-seated unconscious mind is the storehouse of all our memories and experiences. It is the centre for emotions and feelings and for all our behaviour and habits.
• Freud proved that through various psychoanalytical techniques which are also partly therapeutic like the free association technique or the dream analysis technique, changes can be brought in the unconscious mind.

The Psychosocial crisis ‘Trust vs Mistrust’ is linked with the stage infancy (0 – 18 months) of Erikson’s theory. There are 8 stages in Erikson’s theory.

Erikson covered human personality development in a series of eight stages that take place from the time of birth and continue throughout an individual’s complete life. Erik Erikson’s Psycho-social Theory focused on the adaptive function of the ego and the development of ego strength. There are some reasons due to which his theory is considered as stage theory:

• Personality develops in stages in a pre-determined order, from infancy to adulthood.
• Each stage has a psychological crisis, which could be positive or negative.
• Each crisis comes with its psychological needs which conflicts with the need of society.
• On completing the stage, a healthy personality comes out along with basic virtues.

Hence, there are four reasons behind Erikson’s theory being a stage theory.

Concept:

Mania

• Mania is a psychological condition that causes a person to experience unreasonable euphoria, very intense moods, hyperactivity, and delusions.
• Mania (or manic episodes) is a common symptom of bipolar disorder.
• A doctor will also likely prescribe a mood stabilizer, also called an “antimanic” medication.
• These help control mood swings and prevent them, and may help to make someone less likely to attempt suicide.
• Patients may need to take medicine for a long time, sometimes indefinitely.
• The doctor may prescribe lithium (Eskalith, Lithobid) and certain anti-seizure drugs like carbamazepine (Tegretol) or valproate (Depakote).
• Patients may need very close medical supervision and blood tests while you take these.

Additional Information

• Glutamate is an excitatory neurotransmitter that is elevated during mania. Lithium acutely stimulates the NMDA receptor, increasing glutamate availability in the postsynaptic neuron.
• It takes about 1 to 3 weeks for lithium to show the effects of symptoms.
• Therapeutic lithium level is somewhere between 0.6 to 1.2 mEq/L

Concept:-

In psychoanalytic theory, given by Sigmund Freud says that the defense mechanism is an unconscious psychological action that functions to protect a person from anxiety-producing thoughts and feelings related to internal conflicts and outer stressors. There are many defense mechanisms enlist which a person uses in his day to day life:

• Sublimation: It is similar to displacement, but takes place when a person manages to displace his unacceptable emotions into behaviors that are constructive and socially acceptable, rather than destructive activities.
• Sublimation is one of Freud's original defense mechanisms in which his deep sexual desires were turned into socially acceptable behavior by his writings and paintings.

Additional Information   1. Regression

• Regression is a defense mechanism proposed by Anna Freud whereby the ego reverts to an earlier stage of development usually in response to stressful situations. Regressions enable a person to psychologically go back in time to a period when the person felt safer.
• Example: When a person is troubled, he behaves most often childish or primitively to cope with the undesirable situation.

    2. Identification: 

• also known as Introjection. Is a defense mechanism when a person not only takes on a belief or voice of another person but also begins to identify with that individual. For example, a father tells his son that women do the household work and the son keeps this thought in his mind and acts in the same manner as his father does.

Concept:

• Anorexia nervosa: it is an eating disorder occurs most often in adolescent girls.
• The problem is found as refusal of food to maintain normal body weight by reducing food intake, especially fats and carbohydrates.
• Sign and symptoms:
  • Extreme weight loss or not making expected developmental weight gains.
  • Thin appearance.
  • Abnormal blood counts.
  • Fatigue.
  • Insomnia.
  • Dizziness or fainting.
  • Bluish discoloration of the fingers.

Explanation:

• Complication in anorexia nervosa:

Osteoporosis: A condition in which bones become weak and brittle.

• The body constantly absorbs and replaces bone tissue. With osteoporosis, new bone creation doesn't keep up with old bone removal.
• Many people have no symptoms until they have a bone fracture.

Myocardial hypertrophy:

• Myocardial hypertrophy is defined as an increase in ventricular myocardial mass.
• In clinical practice and in animal studies, left ventricular (LV) hypertrophy (LVH) is often assessed by measurement of end-diastolic thickness of septal and LV posterior wall and may be associated with normal or dilated LV cavity.

Electrolyte imbalance:

• It occurs when you have too much or not enough of certain minerals in your body.
• This imbalance may be a sign of a problem like kidney disease.

Additional Information 

• Bulimia nervosa: Eating disorder where the person will have binge eating
• Pica: Eating disorder where the child eats non nutritive substances
• Geophagia : Eating mud
• Trichophagia : Eating hair

Obsessive-compulsive disorder (OCD) is characterized by the occurrence of unwanted, intrusive obsessive thoughts and distressing images which are usually accompanied by compulsive behaviors. Compulsive behaviors are carried out either to undo or neutralize the obsessions or to prevent the occurrence of some dreadful event.

Key Points

• Anxiety disorders are disorders that decrease the performance or social functioning of an individual due to hyper-anxiety. Anxiety disorder can be of many types such as generalized anxiety disorder, obsessive-compulsive disorder, somatoform disorder, etc.
• Obsessive behavior is the inability to stop thinking about a particular idea or topic. The person involved, often finds these thoughts to be unpleasant and shameful.
• Compulsive behavior is the need to perform certain behaviors over and over again. Many compulsions deal with counting, ordering, checking, touching, and washing.  
• People affected by the obsessive-compulsive disorder are unable to control their preoccupation with specific ideas or are unable to prevent themselves from repeatedly carrying out a particular act or series of acts that affect their ability to carry out normal activities.

Thus, it is concluded that Obsessive-compulsive disorder is an anxiety disorder.

Hint

• Somatoform disorders refer to physical problems which have no organic basis, for example, fatigue, headaches, vague body pains, etc. The persons suffering from this disease remain preoccupied with symptoms.
• Dissociative disorders describe a persistent mental state that is marked by feelings of being detached from reality, being outside of one’s own body, or experiencing memory loss.
• Adjustment disorders are a group of conditions that can occur when you have difficulty in coping with a stressful life event. Example"the death of a loved one, relationship issues, or being fired from work. 

Concept:-

Erickson's Theory

• Erickson's theory for adolescent- Identity vs confusion.
• Erikson described eight stages of development. Each stage is characterized by a psychosocial crisis, representing a conflict between the individual and society.
• The progression to the next stage depends on the resolution of these conflicts.
• Out of eight stages,​ only five are relating to childhood.

Additional Information