EAQs Anxiety and Mood & Affect

A 65-inch (165 cm) tall 15-year-old girl weighing 80 lb (36.3 kg) is admitted to a mental health facility with a diagnosis of anorexia nervosa. The nurse recognizes that her problem most likely is caused by what? 1 A desire to control her life 2 The wish to be accepted by her peers 3 The media's emphasis on the beauty of thinness 4 A delusion in which she believes that she must be thin

1 A desire to control her life

On the day after admission a suicidal client asks a nurse, "Why am I being watched around the clock, and why can't I walk around the whole unit?" Which reply is most appropriate? 1 "Why do you think we're observing you?" 2 "What makes you think we're observing you?" 3 "We're concerned that you might try to harm yourself." 4 "We're following your primary healthcare provider's instructions, so there must be a reason."

3 "We're concerned that you might try to harm yourself."

How can a nurse minimize agitation in a disturbed client? 1 By ensuring constant staff contact 2 By increasing environmental sensory stimulation 3 By limiting unnecessary interactions with the client 4 By discussing the reasons for the client's suspicions

3 By limiting unnecessary interactions with the client

Which drug is a high-potency medication used to treat schizophrenia? 1 Loxapine 2 Thioridazine 3 Fluphenazine 4 Perphenazine

3 Fluphenazine

What is the nurse's primary outcome goal when managing the care of a client diagnosed with generalized anxiety disorder (GAD)? 1 Creating an anxiety-free environment for the client 2 Assisting the client with the development of healthy, adaptive coping mechanisms 3 Identifying the triggers that produce anxiety in the client 4 Providing reinforcement that the client's anxiety issues can be eliminated

3 Identifying the triggers that produce anxiety in the client

A client with depression is to be given fluoxetine. What precaution will the nurse consider when initiating treatment with this drug? 1 It must be given with milk and crackers to prevent hyperacidity and discomfort. 2 Eating cheese or pickled herring or drinking wine may cause a hypertensive crisis. 3 The blood level may not be sufficient to cause noticeable improvement for 2 to 4 weeks. 4 The blood level should be checked weekly for 3 months to monitor for an appropriate level.

3 The blood level may not be sufficient to cause noticeable improvement for 2 to 4 weeks.

A client who consented to electroconvulsive therapy (ECT) is being prepared for the second session. The client tells the nurse, "I've decided that I don't want this treatment." What is the best response by the nurse? 1 "It's too late to stop the treatment now." 2 "We'll discuss the advantages after the treatment." 3 "You need more than one treatment for it to be successful." 4 "I'll tell your psychiatrist that you don't want the treatment."

4 "I'll tell your psychiatrist that you don't want the treatment."

A depressed client whose spouse recently died attends an inpatient group therapy session in which the nurse is a co-leader. When another client talks about being divorced and the resulting feelings of abandonment, the nurse notices that tears are running down the depressed client's face. What should the nurse do to support this client? 1 Ask group members to return to discuss this client's feelings. 2 Have another client stay and spend time talking with the client. 3 Observe the client's behavior carefully during the next several hours. 4 Accompany the client to his or her room and encourage a discussion of his or her feelings.

4 Accompany the client to his or her room and encourage a discussion of his or her feelings.

A client who has been experiencing excessive stress is hospitalized because of an inability to walk. After a physiologic cause for the problem is ruled out, a diagnosis of somatoform disorder, conversion type, is made. What does the nurse conclude is the cause of the client's paralysis? 1 Nondisabling illness 2 Way to get attention 3 Loss of contact with reality 4 Result of intrapsychic conflict

4 Result of intrapsychic conflict

When assessing the development of a school-age child, the nurse concludes that the child has normal development according to Fowler's spiritual development. Which behavior helped the nurse reach this conclusion?

4 The child believes God will punish bad behavior and reward good behavior.

A nurse is accompanying a client with a diagnosis of anxiety disorder who is pacing the halls and crying. When the client's pacing and crying worsen, the nurse suddenly feels uncomfortable and experiences a strong desire to leave. What is the most likely reason for what the nurse is experiencing? 1 An empathic communication of anxiety 2 A fear of the client becoming assaultive 3 A desire to go off duty after a busy workday 4 An inability to tolerate any more bizarre behavior

1 An empathic communication of anxiety

A nursing assistant interrupts the performance of a ritual by a client with obsessive-compulsive disorder. What is the most likely client reaction? 1 Anxiety 2 Hostility 3 Aggression 4 Withdrawal

1 Anxiety

When planning nursing care for a client with severe agoraphobia, what should the nurse do first? 1 Determine the client's degree of impairment. 2 Support the client's self-esteem through verbal interactions. 3 Expose the client gradually to anxiety-provoking situations. 4 Teach the client biofeedback techniques for reducing anxiety.

1 Determine the client's degree of impairment.

A client is diagnosed with cancer of the pancreas and is apprehensive and restless. Which nursing action should be included in the plan of care? 1 Encouraging expression of concerns 2 Administering antibiotics as prescribed 3 Teaching the importance of getting rest 4 Explaining that everything will be all right

1 Encouraging expression of concerns

A client is found to have a borderline personality disorder. What is a realistic initial intervention for this client? 1 Establishing clear boundaries 2 Exploring job possibilities with the nurse 3 Initiating a discussion of feelings of being victimized 4 Spending 1 hour twice a day discussing problems with the nurse

1 Establishing clear boundaries

Which antidepressant drug is a selective monoamine oxidase-B inhibitor? 1 Selegiline 2 Phenelzine 3 Isocarboxazid 4 Tranylcypromine

1 Selegiline

At 10:00 pm a client with a personality disorder is in the lounge playing cards. When the nurse enters, the client requests a sleeping pill. The nurse responds, "First go to bed and try to sleep." What is the nurse's response directed toward? 1 Setting limits 2 Reality testing 3 Routinizing care 4 Conditioning behavior

1 Setting limits

A client who has been taking the prescribed dose of zolpidem for 5 days returns to the clinic for a follow-up visit. When interviewing the client, the nurse identifies that the medication has been effective when the client makes which statement? 1 "I have less pain." 2 "I have been sleeping better." 3 "My blood glucose is under control." 4 "My blood pressure is coming down."

2 "I have been sleeping better."

A nurse admits a client with the long-standing obsessive-compulsive behavior of washing the hands and body to the psychiatric unit. What should the initial treatment plan include? 1 Determining the purpose of the ritual 2 Allowing enough time for the ritualistic behavior 3 Distracting the client from the ritualistic behavior with unit activities 4 Suggesting a variety of symptom substitutions to refocus the ritualistic behavior

2 Allowing enough time for the ritualistic behavior

A client is diagnosed with thrombophlebitis. The client states, "I am worried about getting a clot in my lungs that will kill me." Which should be the nurse's initial response? 1 Clarify the misconception 2 Discuss the client's concerns 3 Explain measures to prevent pulmonary emboli 4 Teach recognition of early symptoms of pulmonary emboli

2 Discuss the client's concerns

A client in a psychiatric hospital with the diagnosis of major depression is tearful and refuses to eat dinner after a visit with a friend. What is the most therapeutic nursing action? 1 Allowing the client to skip the meal 2 Offering an opportunity to discuss the visit 3 Reinforcing the importance of adequate nutrition 4 Providing the client with adequate quiet thinking time

2 Offering an opportunity to discuss the visit

Which nursing intervention is indicated for a client with an anxiety disorder? 1 Encouraging suppression of anger by the client 2 Promoting verbalization of feelings by the client 3 Limiting involvement of the client's family during the acute phase 4 Explaining why the client should accept the psychological factors that are precipitating the anxiety

2 Promoting verbalization of feelings by the client

A female client who is severely incapacitated by obsessive-compulsive behavior has been admitted to the mental health hospital. The client's compulsive ritual involves changing her clothing eight to 12 times a day. She continually asks the nurse for advice regarding her problems but then ignores it. What conflict is this an example of? 1 Apathy versus anger 2 Trust versus mistrust 3 Intimacy versus isolation 4 Dependence versus independence

4 Dependence versus independence

Why are hospitalization or day-treatment centers often indicated for the treatment of clients with obsessive-compulsive disorder? 1 These settings prevent the client from completing rituals. 2 They allow the staff to exert control over the client's activities. 3 These settings resolve the client's anxiety because decision making is minimal. 4 They provide the neutral environment the client needs to work through conflicts.

4 They provide the neutral environment the client needs to work through conflicts.