Tess Nicholson
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Dulcinea Anxiety disorder lecture

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Tess Nicholson
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Anxiety Test

Question 1 of 25

1

A nursing instructor is teaching about specific phobias. Which student statement should indicate that learning has occurred?

Select one of the following:

  • A. "These clients do not recognize that their fear is excessive and rarely seek treatment."

  • B. "These clients have a panic level of fear that is overwhelming and unreasonable."

  • C. "These clients experience symptoms that mirror a cerebrovascular accident (CVA)."

  • D. "These clients experience the symptoms of tachycardia, dysphagia, and diaphoresis."

Explanation

Question 2 of 25

1

How would a nurse differentiate a client diagnosed with panic disorder from a client diagnosed with generalized anxiety disorder (GAD)?

Select one of the following:

  • A. GAD is acute in nature, and panic disorder is chronic.

  • B. Chest pain is a common GAD symptom, whereas this symptom is absent in panic disorders.

  • C. Hyperventilation is a common symptom in GAD and rare in panic disorder.

  • D. Depersonalization is commonly seen in panic disorder and absent in GAD.

Explanation

Question 3 of 25

1

Which 2 treatments should a nurse identify as most appropriate for clients diagnosed with generalized anxiety disorder (GAD)?

Select one or more of the following:

  • A. Long-term treatment with diazepam (Valium)

  • B. Acute symptom control with citalopram (Celexa)

  • C. Long-term treatment with buspirone (BuSpar)

  • D. Acute symptom control with ziprasidone (Geodon)

  • E. Ongoing Cognitive Behavioral Therapy

Explanation

Question 4 of 25

1

A client refuses to go on a cruise to the Bahamas with his spouse due to fearing that the cruise ship will sink and all will drown. Using a cognitive theory perspective, how should a nurse explain to the spouse the etiology of this fear?

Select one of the following:

  • A. "Your spouse may be unable to resolve internal conflicts which result in projected anxiety."

  • B. "Your spouse may be experiencing a distorted and unrealistic appraisal of the situation."

  • C. "Your spouse may have a genetic predisposition to overreacting to potential danger."

  • D. "Your spouse may have high levels of brain chemicals that may distort thinking."

  • E. "Your spouse doesn't want to see you in a bathing suit because you are old and saggy"

Explanation

Question 5 of 25

1

How would a nurse differentiate a client diagnosed with obsessive-compulsive disorder (OCD) from a client diagnosed with obsessive-compulsive personality disorder?

Select one of the following:

  • A. Clients diagnosed with OCD experience both obsessions and compulsions, and clients diagnosed with obsessive-compulsive personality disorder do not.

  • B. Clients diagnosed with OCD experience only obsessions, and clients diagnosed with obsessive-compulsive personality disorder experience only compulsions.

  • C. Clients diagnosed with obsessive-compulsive personality disorder experience only obsessions, and clients diagnosed with OCD experience only compulsions.

Explanation

Question 6 of 25

1

A cab driver, stuck in traffic, suddenly is lightheaded, tremulous, diaphoretic, and experiences tachycardia and dyspnea. This continues to happen several times over the next couple of months. An extensive workup in an emergency department reveals no pathology. Which medical diagnosis is suspected, and what nursing diagnosis takes priority?

Select one of the following:

  • A. Generalized anxiety disorder and a nursing diagnosis of fear

  • B. Altered sensory perception and a nursing diagnosis of panic disorder

  • C. Pain disorder and a nursing diagnosis of altered role performance

  • D. Panic disorder and a nursing diagnosis of anxiety

Explanation

Question 7 of 25

1

A client diagnosed with panic disorder states, "When an attack happens, I feel like I am going to die." Which is the most appropriate nursing reply?

Select one of the following:

  • A. "I know it's frightening, but try to remind yourself that this will only last a short time."

  • B. "Most people who experience panic attacks have feelings of impending doom."

  • C. "Tell me why you think you are going to die every time you have a panic attack."

Explanation

Question 8 of 25

1

Which medication is used to treat anxiety, acutely at the panic stage most effectively?

Select one of the following:

  • Buspirone (BuSpar)

  • Clonazepam (Klonopin)

  • Doxepin (Sinequan)

  • Clozapine (Clozaril)

Explanation

Question 9 of 25

1

A family member is seeking advice about an elderly parent who seems to worry unnecessarily about everything. The family member states, "Should I seek psychiatric help for my mother?" Which is an appropriate nursing reply?

Select one of the following:

  • A. "My mother also worries unnecessarily. I think it is part of the aging process."

  • B. "Anxiety is considered abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning."

  • C. "From what you have told me, you should get her to a psychiatrist as soon as possible."

  • D. "Anxiety is a complex phenomenon and is effectively treated only with psychotropic medications."

Explanation

Question 10 of 25

1

A client is experiencing a severe panic attack. Which nursing intervention would meet this client's immediate need?

Select one of the following:

  • A. Teach deep breathing relaxation exercises

  • B. Take vitals signs to ensure safety

  • C. Stay with the client and offer reassurance of safety

  • D. Administer the ordered prn buspirone (BuSpar)

Explanation

Question 11 of 25

1

A college student is unable to take a final examination due to severe test anxiety. Instead of studying, the student relieves stress by attending a movie. Which priority nursing diagnosis should a campus nurse assign for this client?

Select one of the following:

  • A. Noncompliance R/T test taking

  • B. Ineffective role performance R/T helplessness

  • C. Altered coping R/T anxiety

  • D. Powerlessness R/T fear 

Explanation

Question 12 of 25

1

A client living on the beachfront seeks help with an extreme fear of crossing bridges which interferes with daily life. A psychiatric nurse practitioner decides to try systematic desensitization. Which explanation of this therapy should the nurse convey to the client?

Select one of the following:

  • C. "Through a series of increasingly anxiety-provoking steps, we will gradually increase your tolerance to anxiety."

  • B. "Because anxiety and relaxation are mutually exclusive states, we can attempt to substitute a relaxation response for the anxiety response."

  • D. "In one intense session, you will be exposed to a maximum level of anxiety that you will learn to tolerate."

  • A. "Using your imagination, we will attempt to achieve a state of relaxation that you can replicate when faced with crossing a bridge."

Explanation

Question 13 of 25

1

A client diagnosed with obsessive-compulsive disorder is admitted to a psychiatric unit. The client has an elaborate routine for toileting activities. Which would be an appropriate initial client outcome during the first week of hospitalization?

Select one of the following:

  • A. The client will refrain from ritualistic behaviors during daylight hours.

  • B. The client will wake early enough to complete rituals prior to breakfast.

  • C. The client will participate in three unit activities by day 3.

  • D. The client will substitute a productive activity for rituals by day 1.

Explanation

Question 14 of 25

1

A client diagnosed with an obsessive-compulsive disorder spends hours bathing and grooming. During a one-on-one interaction, the client discusses the rituals in detail but avoids any feelings that the rituals generate. Which defense mechanism should the nurse identify?

Select one of the following:

  • Sublimation

  • Dissociation

  • Rationalization

  • Intellectualization

Explanation

Question 15 of 25

1

A nursing student questions an instructor regarding the order for fluvoxamine (Luvox) 300 mg daily for a client diagnosed with obsessive-compulsive disorder

Select one of the following:

  • A. "High doses of tricyclic medications will be required for effective treatment of OCD."

  • B. "Selective serotonin reuptake inhibitor (SSRI) doses, in excess of what is effective for treating depression, may be required for OCD."

  • C. "The dose of Luvox is low due to the side effect of daytime drowsiness and nighttime insomnia."

  • D. "The dosage of Luvox is outside the therapeutic range and needs to be questioned."

Explanation

Question 16 of 25

1

A nurse has been caring for a client diagnosed with post-traumatic stress disorder. What short-term, realistic, correctly written outcome should be included in this client's plan of care?

Select one of the following:

  • Client will have no flashbacks

  • client will be able to feel a full range of emotions by discharge.

  • client will not require zolpidem (ambien) to obtain adequate sleep by discharge.

  • client will refrain from discussing the traumatic event

Explanation

Question 17 of 25

1

How should a nurse best describe the major maladaptive client response to panic disorder?

Select one of the following:

  • A. Clients overuse medical care due to physical symptoms.

  • B. Clients use illegal drugs to ease symptoms.

  • C. Clients perceive having no control over life situations.

  • D. Clients develop compulsions to deal with anxiety.

Explanation

Question 18 of 25

1

A nursing student has been diagnosed with generalized anxiety disorder (GAD). Which of the following symptoms should the instructors expect her to exhibit? (Select all that apply.)

Select one or more of the following:

  • Fatigue

  • anorexia

  • hyperventilation

  • insomnia

  • irritability

Explanation

Question 19 of 25

1

A nurse has been caring for a client diagnosed with generalized anxiety disorder (GAD). Which of the following nursing interventions would address this client's symptoms? (Select all that apply, which is all but one.)

Select one or more of the following:

  • A. Encourage the client to recognize the signs of escalating anxiety.

  • B. Encourage the client to avoid any situation that causes stress.

  • C. Encourage the client to employ newly learned relaxation techniques.

  • D. Encourage the client to cognitively reframe thoughts about situations that generate anxiety.

  • E. Encourage the client to avoid caffeinated products.

Explanation

Question 20 of 25

1

A client who is a veteran of the Gulf War is being assessed by a nurse for post-traumatic stress disorder (PTSD). Which of the following client symptoms would support this diagnosis? (Select all that apply,)

Select one or more of the following:

  • A. The client has experienced symptoms of the disorder for 2 weeks.

  • B. The client fears a physical integrity threat to self.

  • C. The client feels detached and estranged from others.

  • D. The client experiences fear and helplessness.

  • E. The client is lethargic and somnolent.

Explanation

Question 21 of 25

1

A client experiencing a panic attack would display which physical symptom?
1. Fear of dying.
2. Sweating and palpitations.
3. Depersonalization.
4. Restlessness and pacing.

Select one of the following:

  • 1.

  • 2.

  • 3.

  • 4.

Explanation

Question 22 of 25

1

A client diagnosed with obsessive-compulsive disorder is newly admitted to an inpatient psychiatric unit. Which cognitive symptom would the nurse expect to assess?
1. Compulsive behaviors that occupy more than 4 hours per day.
2. Excessive worrying about germs and illness.
3. Comorbid abuse of alcohol to decrease anxiety.
4. Excessive sweating and an increase in blood pressure and pulse.

Select one of the following:

  • 1

  • 2

  • 3

  • 4

Explanation

Question 23 of 25

1

A client recently diagnosed with generalized anxiety disorder is prescribed clonazepam (Klonopin), buspirone (BuSpar), and citalopram (Celexa). Which assessment related to the concurrent use of these medications is most important?

Select one of the following:

  • signs and symptoms of worsening depression and suicidal ideation.

  • changes in mental status, diaphoresis, tachycardia, and tremor r/t serotonin syndrom

  • hyperpyresis, dystonia, and muscle rigidity.

  • spasms of face, legs, and neck and for bizarre facial movements.

Explanation

Question 24 of 25

1

Which of the following symptoms are seen when a client abruptly stops taking diazepam (Valium)? Select all that apply.
1. Insomnia.
2. Tremor.
3. Delirium.
4. Dry mouth.
5. Lethargy.

Select one of the following:

  • Tremor, delirium and lethargy

  • insomnia tremor and delirium

  • dry mouth, lethargy, insomnia and delirium

  • tremor, delirium and lethargy

Explanation

Question 25 of 25

1

A client diagnosed with social phobia has an outcome that states, "Client will voluntarily participate in group activities with peers by day 3." Which would be an appropriate intrapersonal intervention by the nurse to assist the client to achieve this outcome?

Select one of the following:

  • 1. Offer PRN lorazepam (Ativan) 1 hour before group begins.

  • 2. Attend group with client to assist in decreasing anxiety.

  • 3. Encourage discussion about fears related to socialization.

  • 4. Role-play scenarios that may occur in group to decrease anxiety.

Explanation