Chapter 25: Anxiety Disorders: Management of Anxiety & Panic

The nurse recognizes that who is the client most likely experiencing generalized anxiety disorder (GAD)?

40-year-old who has reported numerous absences from work, muscle aches, and difficulty falling asleep for the last 8 months

A client asks the nurse, "Why do I have to go to counseling? Why can't I just take medications?" The best response by the nurse would be:

"Medications combined with therapy help you change how well you function."

The client has an order for an anxiolytic agent, lorazepam (Ativan). Which of the following statements by the client would indicate that client education about this medication has been effective?

"This medication will relax me so I can focus on problem solving."

The nurse is providing care for a psychiatric-mental health client who has a diagnosis of anxiety. Which statement by the nurse is likely the most therapeutic intervention?

"Anxiety is a feeling that is experienced by everyone at some point and it can never be completely removed from one's life."

A client is currently experiencing a panic attack. Which is the most appropriate response by the nurse?

"You are safe. Take a deep breath."

Which client is most likely to be at risk for drug dependence and difficulties with withdrawal?

A woman who has been taking lorazepam for several months after witnessing a traumatic motor vehicle accident

Panic disorder is treated with cognitive-behavioral techniques, deep breathing, and relaxation, in addition to what?

Antidepressants

The mental health nurse knows that which medication classification has been found to be effective in reducing or eliminating panic attacks?

Antidepressants

A client receiving benzodiazepine therapy as treatment for panic disorder comes to the emergency department for evaluation. The nurse suspects the client is experiencing benzodiazepine withdrawal based on which of the following findings? Select all that apply.

Apprehension Irritability Agitation

All of the following pharmacological agents are useful in treating anxiety disorders except which ones?

Calcium channel blockers

Clients taking benzodiazepines need education about what?

Concomitant use of alcohol

The client has been defensive toward communication with the nurse today. Which can be a positive outcome of using defense mechanisms?

Defense mechanisms can help a person to reduce anxiety

A client is experiencing a panic attack. Which term describes sensing that things are not real?

Derealization

The nurse is conducting an admission assessment of a client who has a history of generalized anxiety disorder. After gauging the client's level of anxiety, what other assessment should the nurse prioritize?

Determining whether there is potential for the client to harm himself or herself or others

Nursing interventions for physical stress related illness should include what?

Establishing daily routines of meals and sleeping

A nurse is assessing the vital signs of a client in the cardiac clinic. The nurse observes the client's blood pressure and heart rate are higher than what is normally expected for this client. The client tells the nurse, "I'm always so nervous when I come to the clinic." The nurse interprets the client's statement and vital signs as reflecting which situation?

Fight-or-flight response

A client asks how the client's prescribed alprazolam helps the client's anxiety disorder. The nurse explains while teaching the client about medications that antianxiety medications such as alprazolam affect the function of which neurotransmitter that is believed to be dysfunctional in anxiety disorders?

Gamma-aminobutyric acid (GABA)

The nurse plans to teach a client about dietary modifications to manage diabetes. Teaching would be most effective if the client displayed which characteristic?

Heightened focus

An adolescent client reveals that she is about to take a math test from her tutor. Nursing assessment reveals mild anxiety. The nurse explains that this level of anxiety does what?

Is conducive to concentration and problem solving

Anxiety has both healthy and harmful aspects depending on its degree and duration as well as on how well the person copes with it. Which level of anxiety helps the client focus attention to learn, problem solve, think, act, feel, and protect himself or herself?

Mild

When a client is experiencing panic, which is the priority intervention?

Move the client to a quiet environment.

Which are cognitive-behavioral therapy techniques that may be used effectively with anxious clients? Select all that apply.

Positive reframing Decatastrophizing Assertiveness training

A nursing instructor is describing the care of a client with acute anxiety to a class of nursing students. The instructor determines that more education is necessary when the students identify which intervention as appropriate?

Providing the client with a comforting touch

Relaxation techniques help clients with anxiety disorders because they can promote what?

Reduction of autonomic arousal

A psychiatric-mental health nurse is conducting a program for a group of young adults at a community center about anxiety. The nurse determines that the teaching was successful when the group identifies which aspect about anxiety?

Relief behaviors can prevent anxiety from increasing

A nurse is providing care to a client with social anxiety disorder. Based on the nurse's understanding of pharmacotherapy, which medication would the nurse anticipate being used as part of the treatment plan?

Selective serotonin reuptake inhibitors (SSRIs)

A client can protect himself from the negative effects of stress with which of the following?

Social and emotional resources

The nurse enters the client's room and finds the client anxiously pacing the floor. The client begins shouting at the nurse, "Get out of my room!" The best intervention by the nurse would be to

Stand at the doorway and say, "You seem upset."

The nurse knows that which statement is true about stress and anxiety?

Stress is the wear and tear that life causes on the body

A client who experiences panic anxiety around dogs is sitting in a room with a dog and the client's nurse therapist. The nurse therapist is using which behavioral intervention for this type of anxiety?

Systematic desensitization

Which is a cardiovascular response of the sympathetic nervous system?

Tachycardia

A client reports the client has been experiencing increased stress at work. The client has been managing the stress by drinking 2-3 glasses of wine per evening. Despite the nurse recommending that drinking alcohol is not an effective way to manage the stress, the client reports it is unlikely that the client will be able to stop. Which statement explains why this will be difficult for the client?

The client has no adaptive coping mechanisms

Which of the following is inconsistent with panic-level anxiety?

This level of anxiety can be sustained indefinitely

After teaching a group of mental health nursing students about the care of a client experiencing a panic attack, the instructor determines that additional education is required when the students identify which as an appropriate intervention?

Touching the client in an attempt to comfort the client

A nurse is preparing a plan of care for a client with anxiety. Which would the nurse likely include? Select all that apply.

Using appropriate coping skill Identifying treatment modalities Involving family for support, if appropriate Providing supportive feedback

Which statement about the assessment of persons with anxiety and anxiety disorders is most accurate?

When an elder person has an onset of anxiety for the first time in his or her life, it is possible that the anxiety is associated with another condition

Which nursing intervention is focused on the primary goal of anxiety management and treatment?

assessing the client's ability to implement stress management techniques effectively

When a psychiatrist prescribes alprazolam for acute anxiety experienced by a client with agoraphobia, health teaching should include which instructions?

avoid alcoholic beverages

A nurse is seeing a client who is having severe to panic level anxiety after a physical assault months previously. The client tells the nurse, "When the panic starts I feel like I am watching myself through a window." The nurse can most accurately describe this experience as:

depersonalization

A client is seeking treatment for a specific phobia. The nurse in the anxiety disorders clinic documents that the client's anxiety is related to exposure to the phobic object. Which is a realistic outcome for anxiety self-control in this situation?

practice relaxation techniques and report decreased physiological sensations associated with thoughts of the feared object

A nurse detects that a client is experiencing panic-level anxiety. Which intervention should be immediately implemented?

provide calm, brief, directive communication