130 Exam 2 ANXIETY
An important question to ask during the assessment of a client diagnosed with anxiety disorder is "How often do you hear voices?" "Have you ever considered suicide?" "How long has your memory been bad?" "Do your thoughts always seem jumbled?"
"Have you ever considered suicide?"
Which action should the nurse take to monitor the effects of an acute stressor on a hospitalized patient? Assess for bradycardia. Ask about epigastric pain. Observe for increased appetite. Check for elevated blood glucose levels. Monitor for a decrease in respiratory rate.
B, C, D
A patient with type 2 diabetes is experiencing a lot of work-related stress and is fearful of losing his job. In addition, his wife is threatening divorce. His blood sugar is elevating, and his doctors want him to attend some stress-management classes. He says, "My blood sugar can't be high because of my work stress." What causes blood glucose to rise during stress? Increases in antidiuretic hormone (ADH) Increases in cortisol Increases in aldosterone Increases in adrenocorticotropic hormone (ACTH) Increases in epinephrine
B, D, E
A patient has begun smoking again and drinks six alcoholic beverages per day since experiencing the loss of his job. The nurse recognizes that the patient is exhibiting symptoms of which type of stress? Psychological Emotional Physiological Behavioral
Behavioral
Which approach to reducing client stress is most effective in people with low to moderate hypnotic ability? Meditation Breathing exercises Journal keeping Biofeedback
Biofeedback
Hallie's father, Brent, has now been diagnosed with PTSD as well as Hallie. Which of the following symptoms would lead a provider to suspect PTSD? Select all that apply. Visiting the scene of the accident over and over Talking with strangers about the events of the accident Flashbacks of the accident Hypervigilance Irritability Difficulty concentrating Mania
C, D, E, F
A possible outcome criterion for a client diagnosed with anxiety disorder is: Client demonstrates effective coping strategies. Client reports reduced hallucinations. Client reports feelings of tension and fatigue. Client demonstrates persistent avoidance behaviors.
Client demonstrates effective coping strategies.
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. Which of the following are appropriate responses or actions of the nurse? "I know another patient whose colon cancer was cured by surgery." Straighten the patient's bed and room "Have you thought about how you are going to tell your family?" "Would you like for me to sit down with you for a few minutes so you can talk about this?" Sit quietly with the patient
D, E
The nurse should document which physiological stressor after performing a screening assessment on a patient? Dementia Caregiving of parent Divorce Death of friend
Dementia
A patient who is having difficulty managing his diabetes mellitus responds to the news that his hemoglobin A1C, a measure of blood sugar control over the past 90 days, has increased by saying, "The hemoglobin A1C is wrong. My blood sugar levels have been excellent for the last 6 months." Which defense mechanism is the patient using? Denial. Conversion. Dissociation. Displacement.
Denial.
Which behavior would be characteristic of an individual who is displacing anger? Lying Stealing Slapping Procrastinating
Procrastinating
When describing the results of the fight or flight response, the nursing students require further teaching when making which statement? Pupils constrict when a patient is anxious. The heart races when a patient experiences anxiety. Peristalsis slows as the patient decides whether to fight back. The patient may complain of dry mouth when anxious.
Pupils constrict when a patient is anxious.
A nurse has begun working in a new unit with high-acuity patients who are scheduled for numerous diagnostic tests before being transferred to the appropriate medical or surgical unit. She also has care responsibilities for her children and her aging parents. The nurse is experiencing signs of being overwhelmed. What counsel might the nurse manager share with the nurse to help her cope with work stress? Take some time off to decide if she really wants to be a nurse. Encourage her to catch up on her documentation responsibilities while taking her lunch break. Enlist the help of other family members in the care of her children so she can focus on work. Request that another nurse help her focus on essential aspects of care rather than optional aspects of care.
Request that another nurse help her focus on essential aspects of care rather than optional aspects of care.
When teaching a patient about the negative feedback response to stress, the nurse includes which of the following to describe the benefits of this stress response? Results in neurophysiological response Reduces body temperature Causes a person to be hypervigilant Reduces level of consciousness to conserve energy.
Results in neurophysiological response
The nurse plans care for a 16-year-old male, taking into consideration that stressors experienced most commonly by adolescents include which of the following? Loss of autonomy caused by health problems Physical appearance, family, friends, and school Self-esteem issues, changing family structure Search for identity with peer groups and separation from family
Search for identity with peer groups and separation from family
Working to help the client view an occurrence in a more positive light is called flooding. desensitization. response prevention. cognitive restructuring.
cognitive restructuring.
Stress reduction is not likely to result in reduced pain. lower blood pressure. decreased cognitive functions. decreased gastrointestinal problems.
decreased cognitive functions
Generally, ego defense mechanisms: often involve some degree of self-deception. are rarely used by mentally healthy people. seldom make the person more comfortable. are usually effective in resolving conflicts.
often involve some degree of self-deception.
Delusionary thinking is a characteristic of chronic anxiety. acute anxiety. severe anxiety. panic level anxiety.
panic level anxiety.
he nurse is assessing the coping abilities of a patient recently diagnosed with a degenerative neuromuscular disease with no known cure. Which statement by the patient alerts the nurse that more intervention is needed? "I have decided to take some art lessons at the community center." "I am sleeping much better when I have two drinks and smoke before bed." "I am scheduling a family reunion for the upcoming holiday." "I have decided to sell my house and move into an apartment with my son."
"I am sleeping much better when I have two drinks and smoke before bed."
Which statement by a patient who has been taught cognitive reframing indicates that the teaching was successful? "I do not have the ability to handle that job." "I can be successful if I do all the things required to learn the job." "I may be fired from the job but eventually I will find something else to do with my life." "I can never learn all there is to know for the job."
"I can be successful if I do all the things required to learn the job."
A client who is experiencing great stress associated with a disturbing new diagnosis asks the nurse, "Do you think saying a prayer would help?" The answer the nurse should give is "Of course you may pray if you wish. I'll leave you alone." "At the moment we should continue the stress assessment." "Shall I call the chaplain for you?" "If you find comfort in prayer, I'd encourage you to pray."
"If you find comfort in prayer, I'd encourage you to pray."
A patient has come to the health clinic for an annual checkup. He reports an increase of stress at work and having to work a lot of mandatory overtime hours. He has not been able to do his usual daily exercise for several weeks. What is the best response by the nurse? "There are other ways you can reduce your stress, such as cutting back on your work hours." "Have you considered a medication to help you sleep at night?" "Including exercise in your schedule will just increase the stress from work." "Regular exercise would be good because it helps the body deal with stress."
"Regular exercise would be good because it helps the body deal with stress."
Myla, a 29-year-old patient admitted with anxiety, states, "my counselor keeps talking about my stressors. What exactly are stressors?" Your best response to the patient would be: "Stressors are events that happen that threaten your current functioning and require you to adapt." "Stressors are complicated neuro stimuli that cause mental illness." "It's best if you ask questions like that of your provider for a complete answer." "Instead of focusing on what stressors are, let's explore your coping skills."
"Stressors are events that happen that threaten your current functioning and require you to adapt."
When discussing the symptoms of PTSD, the nurse correctly states "The symptoms can occur almost immediately or can take years to manifest." "PTSD causes agitation and hypervigilance but rarely chronic depression." "When experiencing a flashback, the client generally experiences a slowing of responses." "PTSD is an emotional response that does not cause significant changes in brain chemistry."
"The symptoms can occur almost immediately or can take years to manifest."
A 34-year-old single father who is anxious, tearful, and tired from caring for his three young children tells the nurse that he feels depressed and doesn't see how he can go on much longer. Which of the following would be the nurse's best response? "Are you thinking of suicide?" "You've been doing a good job raising your children. You can do it!" "Is there someone who can help you during the evenings and weekends?" "What do you mean when you say you can't go on any longer?"
"What do you mean when you say you can't go on any longer?"
A nurse is teaching a client about stress-reduction techniques. Which of the following client statements indicated understanding of the teaching? "Cognitive reframing will help me change my irrational thoughts to something positive." "Progressive muscle relaxation uses a mechanical device to help me gain control over my pulse rate." "Biofeedback causes my body to release endorphins so that I feel less stress and anxiety." "Mindfulness allows me to prioritize the stressors that I have in my life so that I have less anxiety."
(A) "Cognitive reframing will help me change my irrational thoughts to something positive."
A nurse is planning care for a client who has body dysmorphic disorder. Which of the following actions should the nurse plan to take first? Assessing the clients risk for self-harm Instilling hope for positive outcomes Encouraging the client to participate in group therapy sessions Encouraging the cline to participate in treatment decisions
(A) Assessing the clients risk for self-harm
A nurse is preparing to provide an educational seminar on stress to other nursing staff. Which of thee following information should the nurse include in the discussion? Excessive stressors cause the client to experience distress The body's initial adaptive response to stress if denial Absence of stressors results in homeostasis Negative, rather than positive, stressor produce a biological response
(A) Excessive stressors cause the client to experience distress
A nursing is caring for a client who has acute stress disorder and is experiencing severe anxiety. Which of the following statement actions should the nurse make? Tell me how you feel right now You should focus on the positive things in your life to decrease anxiety Why do you believe you are experiencing this anxiety Let's discuss the medications your provider is prescribing to decreased you anxiety
(A) Tell me how you feel right now
A client says that she is experiencing increased stress because her significant other is "pressuring me and my kids to go live with him. I love him, but I'm not ready to do that." Which of the following recommendations should the nurse make to promote a change in the client's situation? Learn to practice mindfulness Use assertiveness techniques Exercise regularly Rely on the support of a close friend
(B) Use assertiveness techniques
A nurse observes a client who has OCD repeatedly applying, removing, and then reapplying makeup. The nurse identifies that repetitive behavior in a client who has OCD is due to which of the underlying reasons? Narcissistic behavior Fear from rejection from staff Attempt to reduce anxiety Adverse effect of antidepressants medication
(C) Attempt to reduce anxiety
A nurse is caring for a client who is experiencing a panic attack. Which of the following actions should the nurse take? Discuss new relaxation techniques Show the client how to change his behavior Distract the client with a TV show Stay with the client and remain quiet
(D) Stay with the client and remain quiet
A nurse is collect and admission history for a client who has acute stress disorder (ASD). Which of the following information should the nurse expect to collect? The client remembers many details about the traumatic incident The client expresses heightened elation about what is happening The client states he first noticed manifestations of the disorder 6 weeks after the traumatic incident occurred The client expresses a sense of unreality about the traumatic incident
(D) The client expresses a sense of unreality about the traumatic incident
A nurse is caring for a client who states, "I'm so stressed at work because of my coworker. He expects me to finish his work because he's too lazy!" When discussing effective communication, which of the following statements by the client to his coworker indicates client understanding? "You really should complete your own work. I don't think it's right to expect me to complete your responsibilities." "Why do you expect me to finish your work? You must realize that I have my own responsibilities." "It is not fair to expect me to complete your work. If you continue, then I will report your behavior to our supervisor." "When I have to pick up extra work, I feel very overwhelmed. I need to focus on my own responsibilities."
(D)"When I have to pick up extra work, I feel very overwhelmed. I need to focus on my own responsibilities."
A 10-year-old girl was playing on a slide at a playground during a summer camp. She fell and broke her arm. The camp notified the parents and took the child to the emergency department according to the camp protocol for injuries. The parents arrive at the emergency department and are stressed and frantic. The 10-year-old is happy in the treatment room, eating a Popsicle and picking out the color of her cast. What is the correct order for the nurse's discussion with the parents? 1. "Can I contact someone to help you?" 2. "Your daughter is happy in the treatment room, eating a Popsicle and picking out the color of her cast." 3. "I'll have the doctor come out and talk to you as soon as possible." 4. "Let me help you two calm down a bit so I can take you to your daughter." 2, 4, 3, 1 4, 2, 1, 3 3, 1, 4, 2 2, 3, 4, 1
2, 4, 3, 1
Which of the following examples illustrates eustress? A college student fails an exam. A bride is planning for her wedding. A man is laid off from his job. An adolescent gets into a fight at school.
A bride is planning for her wedding.
What can be said about the comorbidity of anxiety disorders? Anxiety disorders generally exist alone. A second anxiety disorder may coexist with the first. Anxiety disorders virtually never coexist with mood disorders. Substance abuse disorders rarely coexist with anxiety disorders.
A second anxiety disorder may coexist with the first.
When assessing an older adult who is showing symptoms of anxiety, insomnia, anorexia, and mild confusion, one of the first assessments includes which of the following? The amount of family support A 3-day diet recall A thorough physical assessment Threats to safety in her home
A thorough physical assessment
A staff nurse is talking with the nursing supervisor about the stress that she feels on the job. Which of the following are true about work-related stress? Job-related stress can affect the quality of patient care. Stress can affect nurses' efficiency and decision making. Nurses who talk about feeling stress are unprofessional and should calm down. Nurses frequently experience stress with the rapid changes in health care technology. Nurses cannot resolve job-related stress.
A, B, D
A diabetic patient who is hospitalized asks the nurse what factors are associated with increased blood glucose while in the hospital. Which response(s) by the nurse are appropriate? Blood sugar may be higher in the hospital due to the increased bed rest. Stressors such as illness cause the release of hormones that increase blood sugar. Increased blood sugar occurs because the kidneys are not able to metabolize glucose as well during stressful times. A patient's diet is different here in the hospital than at home, and that is the most likely because of the increased glucose level. Medications such as steroids may increase glucose levels.
A, B, E
During the assessment interview of an older woman who is recently widowed, the nurse suspects that this woman is experiencing a developmental crisis. Which of the following questions provide information about the impact of this crisis? With whom do you talk on a routine basis? What do you do when you feel lonely? How is having diabetes affecting your life? I know this must be hard for you. Let me tell you what might help. Do you have any changes in lifestyle habits: sleeping, eating, smoking, and drinking?
A, B, E
A crisis intervention nurse is working with a mother whose Down syndrome child has been hospitalized with pneumonia and who has lost her child's disability payment while the child is hospitalized. The mother worries that her daughter will fall behind in special-school classes during hospitalization. Which strategies are effective in helping this mother cope with these stressors? Referral to social service process reestablishing the child's disability payment Sending the child home in 72 hours and having the child return to school Coordinating hospital-based and home-based schooling with the child's teacher Teaching the mother signs and symptoms of a respiratory tract infection Telling the mother that the stress will decrease in 6 weeks when everything is back to normal
A, C, D
A nurse working on an acute mental health unit is caring for a client who has PTSD. Which of the following findings should the nurse expect? (SELECT ALL THAT APPLY) Difficult concentrating on tasks Obsessive need to talk about the dramatic event Negative self-image Recurring nightmares Diminished reflexes
A, C, D
The nurse is assessing a patient's anxiety related to stress. Which changes reflect the short-term physiological response to stress? Cortisol is released, increasing glycogenesis and reducing fluid loss. Immune system functioning decreases, and the risk of cancer increases. Corticosteroid release increases stamina and impedes digestion. Muscular tension, blood pressure, and triglyceride levels increase. Epinephrine is released, increasing the heart and respiratory rates. Risk of depression, autoimmune disorders, and heart disease increases.
A, C, D, E
Which of the following statements is true regarding anxiety? Anxiety is a response to stress. Anxiety is uncommon in women. Anxiety can cause elevations in blood pressure and heart rate. Many conditions are exacerbated by stress and anxiety. Patients with anxiety respond well to relaxation techniques. Children are at the highest risk for anxiety.
A, C, D, E
Which nursing interventions are likely to help the patient to cope by addressing the mediators of stress? "A divorce, while stressful, can be the beginning of a new, better phase of life." "You said you used to jog; getting back to aerobic exercise could be helpful." "Journaling gives one more awareness of how experiences have affected them." "Perhaps a short-term loan from your father will make your layoff less stressful." "Slowing your breathing by counting to three between breaths will calm you." "I have found a support group for newly divorced persons in your neighborhood."
A, C, D, F
A nurse is assessing a client who has generalized anxiety disorder (GAD). Which of the following findings should the nurse expect? (SELCT ALL THAT APPLY) Excessive worry for 6 months Impulsive decision making Delayed reflexes Restlessness Need for reassurance
A, D, E
A grandfather living in Japan worries about his two young grandsons who disappeared after a tsunami. This is an example of: A situational crisis A development crisis An adventitious crisis A maturation crisis
An adventitious crisis
The nurse is completing a care plan for a patient who is exhibiting poor coping after receiving a serious medical diagnosis. Which interventions would the nurse consider? Recommend a glass of wine before dinner each night for relaxation. Compile a list of activities that are of interest to the patient. Review pamphlets about treatment options with the patient. Identify positive aspects of the illness, such as the chance to spend more time with family. Reinforce the fact that the medical team can make treatment decisions, so the patient does not need to worry.
B, C, D
A nurse is discussing acute vs. prolonged stress with a client. Which of the following effects should the nurse identify as an acute stress response? (SELECT ALL THAT APPLY) Chronic pain Depressed immune system Increased BP Panic attacks Unhappiness
B, C, E
A nurse it involved in a serious and prolonged mass casualty incident in the ED. Which of the following strategies should the nurse use to help prevent developing a trauma-related disorder? (SELECT ALL THAT APPLY) Avoid thinking about the incident when it is over Take breaks during the incident for food and water Debrief with others following the incident Hold emotions in check in the days following the incident Take advantage of offered counseling
B, C, E
A nurse is caring for a client who is experiencing moderate anxiety. Which of the following actions should the nurse take when trying to give necessary information to the client (SELECT ALL THAT APPLY) Reassure the client that everything will be okay. Discuss prior use of coping mechanisms with the client. Ignore the clients anxiety so that she will not be embarrassed. Demonstrate a calm manner while using simple and clear directions. Gather information from the client using closed-ended questions.
B, D
The nurse is evaluating the coping success of a patient experiencing stress from being newly diagnosed with multiple sclerosis and psychomotor impairment. Which of the following statements indicate that the patient is beginning to cope with the diagnosis? "I'm going to learn to drive a car so I can be more independent." "My sister says she feels better when she goes shopping, so I'll go shopping." "I'm going to let the occupational therapist assess my home to improve efficiency." "I've always felt better when I go for a long walk. I'll do that when I get home." "I'm going to attend a support group to learn more about multiple sclerosis."
C, E
The nurse is interviewing a patient in the community clinic and gathers the following information about her: she is intermittently homeless, a single parent with two children who have developmental delays, and is suffering from chronic asthma. She does not laugh or smile, does not volunteer any information, and at times appears close to tears. She has no support system and does not work. She is experiencing an allostatic load. As a result, which of the following would be present during complete patient assessment? Posttraumatic stress disorder Rising hormone levels Chronic illness Return of vital signs to normal Depression
C, E
A nurse is caring for a client who smokes and has lung cancer. The client reports, "I'm coughing because I have that cold that everyone has been getting." The nurse should identify that the client is using which of the following defense mechanisms? Reaction formation Denial Displacement Sublimation
Denial
What would a client experience during a progressive relaxation session? Instruction in sequential tensing and relaxing of various muscle groups until the entire body is relaxed Being attached to a machine that monitors a physical parameter and receiving audible feedback about the state of that parameter Having a nurse enter the client's energy field to rebalance it and bring harmony Being led into a positive imaginary sensory experience
Instruction in sequential tensing and relaxing of various muscle groups until the entire body is relaxed
Jerry is a 72-year-old patient with Parkinson's disease and anxiety. He is living by himself and has had several falls lately. His provider orders lorazepam, 1 mg PO bid, for anxiety. You question this order because: Jerry may become addicted faster than younger patients. Jerry is at risk for falls. Jerry has a history of nonadherence with medications. Jerry should be treated with cognitive therapies rather than medication because of his advanced age.
Jerry is at risk for falls.
What tool might be useful in assessing the amount of stress a client has experienced in the past year? NANDA Handbook DSM-IV-TR Quick Mental Status Assessment Life-Changing Event Questionnaire
Life-Changing Event Questionnaire
A nurse is providing preoperative teaching for a client who was just informed that she requires emergency surgery. The client, has a respiratory rate 30/min, and says, "This is difficult to comprehend. I feel shaky and nervous." The nurse should identify that the client is experiencing which of the following levels of anxiety? Mild Moderate Severe Panic
Moderate
Which behavior best supports the diagnosis of posttraumatic stress disorder (PTSD) in a 4-year-old child? Overeating Hypervigilance A drive to be perfect Passivity
PTSD in preschool children may manifest as irritability, aggressive or self-destructive behavior, sleep disturbances, problems concentrating, and hypervigilance
The nurse is trying a nonpharmacological intervention for a patient with anxiety. Which of the following would most likely benefit this patient? Increasing caffeine intake Decreasing physical activity Limiting noise or music in the room Performing abdominal breathing exercises
Performing abdominal breathing exercises
Melissa, whose friend recently committed suicide, asks you some ways she could cope with her stress regarding the event. Which of the following options would be appropriate to discuss with Melissa? Isolation for a short time so that the pain isn't reinforced by explaining her feelings over and over Antianxiety medication to help her relax Starting a hobby to keep her mind off the troubling event Talking with friends and attending a loss support group
Talking with friends and attending a loss support group
What factor exerts the greatest influence on the degree to which various life events upset a specific individual? The individual's perception of the event The individual's degree of spirituality The effect of the individual's health-sustaining behaviors The amount of social support available to the individual
The individual's perception of the event
The nurse is assessing a patient's coping abilities related to expected placement in a long-term care facility. Which risk factor is of most concern to the nurse? The patient's family members all live several hours away. The patient is a retired police officer. The patient was recently diagnosed with Alzheimer's disease. The patient will need assistance in moving from his home.
The patient was recently diagnosed with Alzheimer's disease.
An obsession is defined as thinking of an action and immediately taking the action. a recurrent, persistent thought or impulse. an intense irrational fear of an object or situation. a recurrent behavior performed in the same manner.
a recurrent, persistent thought or impulse.
The first stage of the general adaptation syndrome can be characterized as eustress. adaptive. maladaptive. psychological.
adaptive.
The defense mechanisms that can only be used in healthy ways include suppression and humor. altruism and sublimation. idealization and splitting. reaction formation and denial.
altruism and sublimation.
The initial nursing action for a newly admitted anxious client is to assess the client's use of defense mechanisms. assess the client's level of anxiety. limit environmental stimuli. provide antianxiety medication.
assess the client's level of anxiety.
An advantage of the Holmes and Rahe updated life event and social readjustment scale is that it focuses on the presenting symptoms. identifies the client's perception of events. considers the client's various mediating factors. assesses stress threshold and potential for future illness.
assesses stress threshold and potential for future illness
A nurse who is caring for traumatized children of various cultural backgrounds must first become familiar with the various cultures. gain the children's trust. become aware of any personal biases. convince the parents that their children require care.
become aware of any personal biases.
It can be said that the onset of most anxiety disorders occurs before the age of 20 years. before the age of 40 years. after the age of 40 years. scattered throughout the life span.
before the age of 40 years.
A client with hypertension uses an automatic cycling blood pressure cuff with audible changing tones. The client uses relaxation techniques to lower her blood pressure and is informed of her ongoing success by the tone. This process describes biofeedback. guided imagery. therapeutic touch. assertiveness training.
biofeedback.
A child who was physically and sexually abused is at great risk for depression. suicide attempts. bullying and abusing others. becoming active in a gang.
bullying and abusing others.
Lana is out of surgery and on the medical-surgical unit for recovery. You visit her the day after her surgical procedure. While you are in the room, Lana becomes visibly anxious and short of breath, and she states, "I feel so anxious! Something is wrong!" Your best action is to: reassure Lana that she is experiencing normal anxiety and do deep breathing exercises with her. use the call light to inquire whether Lana has any prn anxiety medication. call for help and assess Lana's vital signs. tell Lana you will stay with her until the anxiety subsides.
call for help and assess Lana's vital signs.
The individual initially thinks, "I'll never get through this huge assignment," but then amends the thought to "I can get through the assignment by breaking it into small portions and doing them one by one." This thought process is an example of rationalization. wishful thinking. simple assertion. cognitive reframing.
cognitive reframing
A nurse teaches a client a technique for examining negative thoughts and restating them in positive ways. This technique is called guided imagery. cognitive reframing. wishful thinking. confrontational assertion.
cognitive reframing.
A man continues to speak of his wife as though she were still alive, 3 years after her death. This behavior suggests the use of altruism. denial. undoing. suppression.
denial.
The primary purpose of performing a physical examination before beginning treatment for any anxiety disorder is to protect the nurse legally. establish the nursing diagnoses of priority. obtain information about the client's psychosocial background. determine whether the anxiety is primary or secondary in origin.
determine whether the anxiety is primary or secondary in origin.
An effective stress-reduction technique a nurse might teach an individual with performance anxiety is assertiveness. journal keeping. diaphragmatic breathing. restructuring and setting priorities.
diaphragmatic breathing
A symptom commonly associated with panic attacks is obsessions. apathy. fever. fear of impending doom.
fear of impending doom.
One effect of stress can be attributed to the stimulation of the hypothalamus-pituitary-adrenal cortex, causing a short-term increase in the heart rate. triglycerides. gluconeogenesis. brain norepinephrine.
gluconeogenesis
Stress can be attributed to stimulation of the hypothalamus-pituitary-adrenal cortex, and over the long term it can result in insulin resistance. a high resting heart rate. digestive problems. chronic muscle tension.
insulin resistance.
The major distinction between fear and anxiety is that fear is a universal experience; anxiety is neurotic. enables constructive action; anxiety is dysfunctional. is a psychological experience; anxiety is a physiological experience. is a response to a specific danger; anxiety is a response to an unknown danger.
is a response to a specific danger; anxiety is a response to an unknown danger.
Empathic listening is therapeutic because it focuses on enhancing self-esteem. lessening feelings of isolation. reducing anxiety. encouraging resilience.
lessening feelings of isolation.
Selective inattention is first noted when experiencing anxiety that is mild. moderate. severe. panic.
moderate.
You are providing teaching to Lana, a preoperative patient just before surgery. She is becoming more and more anxious as you talk. She begins to complain of dizziness and heart pounding, and she is trembling. She seems confused. Your best response is to: reinforce the preoperative teaching by restating it slowly. have Lana read the teaching materials instead of verbal instruction. have a family member read the preoperative materials to Lana. not attempt any teaching at this time.
not attempt any teaching at this time.
Inability to leave one's home because of avoidance of severe anxiety suggests the anxiety disorder of panic attacks with agoraphobia. obsessive-compulsive disorder. posttraumatic stress response. generalized anxiety disorder.
panic attacks with agoraphobia.
The relaxation response calls upon sympathetic activation. parasympathetic activation. brainstem deactivation. increased cortisol production by the adrenals.
parasympathetic activation.
Jacob is a college student whose friend recently committed suicide. Jacob rates his stress as low. Melissa was also friends with the person who committed suicide, but she rates her stress as high. The difference in how Jacob and Melissa rate their stress may be explained by: projection. denial. perception. repression.
perception.
Hallie, 4 years old, is referred to the outpatient mental health clinic after being in a severe car accident during which her father was driving and her mother died. Her father states she is withdrawn, not sleeping, having nightmares, and acts out the car accident over and over again when playing. Hallie states to you, "It's my fault because I'm bad." You suspect: adjustment disorder. dissociative identity disorder. posttraumatic stress disorder (PTSD). acute stress disorder (ASD).
posttraumatic stress disorder (PTSD).
Meditation is successful in promoting stress reduction because it prevents endorphin release. changes the client's energy field. quiets the sympathetic nervous system. activates the parasympathetic nervous system.
quiets the sympathetic nervous system.
A person who recently gave up smoking and now talks constantly about how smoking fouls the air, causes cancer, and "burns" money that could be better spent to feed the poor is demonstrating projection. rationalization. reaction formation. undoing.
reaction formation.
High-quality social support relationships have attributes that include constructive criticism. minor conflict. continuous feedback. reciprocal closeness.
reciprocal closeness.
A 20-year-old was sexually molested at age 10, but he can no longer remember the incident. The ego defense mechanism in use is projection. repression. displacement. reaction formation.
repression.
A child who is able to regain mental stability after a traumatic event is said to be autonomous. resilient. mature. independent.
resilient.
Self-help groups are useful for reducing stress because they provide the individual with the stress mediator identified as social support. cultural support. life satisfaction. cognitive reframing.
social support.
An Asian client would be most likely to respond to stress by the subjective experience of anxiety. somatic complaints. memory deficiencies. sensory perceptual alterations.
somatic complaints
The physiologic basis for the success of guided imagery is β-endorphin release raises the pain threshold. imagery raises the body level of cortisol and epinephrine. the sympathetic nervous system is stimulated to produce a quiet state. brain catecholamines are less available to transmit pain impulses.
β-endorphin release raises the pain threshold.
