A nursing instructor is teaching about specific phobias. Which student statement should indicate that learning has occurred?
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."
How would a nurse differentiate a client diagnosed with panic disorder from a client diagnosed with generalized anxiety disorder (GAD)?
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.
Which 2 treatments should a nurse identify as most appropriate for clients diagnosed with generalized anxiety disorder (GAD)?
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
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?
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"
How would a nurse differentiate a client diagnosed with obsessive-compulsive disorder (OCD) from a client diagnosed with obsessive-compulsive personality disorder?
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.
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?
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
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?
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."
Which medication is used to treat anxiety, acutely at the panic stage most effectively?
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?
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."
A client is experiencing a severe panic attack. Which nursing intervention would meet this client's immediate need?
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)
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?
A. Noncompliance R/T test taking
B. Ineffective role performance R/T helplessness
C. Altered coping R/T anxiety
D. Powerlessness R/T fear
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?
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."
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?
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.
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?
A nursing student questions an instructor regarding the order for fluvoxamine (Luvox) 300 mg daily for a client diagnosed with obsessive-compulsive disorder
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."
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?
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
How should a nurse best describe the major maladaptive client response to panic disorder?
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.
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.)
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.)
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.
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,)
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.
A client experiencing a panic attack would display which physical symptom?
1. Fear of dying.
2. Sweating and palpitations.
4. Restlessness and pacing.
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.
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?
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.
Which of the following symptoms are seen when a client abruptly stops taking diazepam (Valium)? Select all that apply.
4. Dry mouth.
Tremor, delirium and lethargy
insomnia tremor and delirium
dry mouth, lethargy, insomnia and delirium
tremor, delirium and lethargy
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?
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.