Menta Health Chapter 14

A client asks the nurse, "How can I tell if what I am experiencing is an anxiety disorder and not regular worrying?" Which is the nurse's best response?

"Anxiety disorders impair your ability to function occupationally and socially."

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."

The nurse is assessing a client who recently experienced their first panic attack while at the grocery store. What question will the nurse ask to identify complications of the disorder?

"Do you have any problems going out alone to public places?"

Which question in the assessment of a client with anxiety is most clinically appropriate?

"How do you feel about everything that is happening in your life right now?"

The nurse reviews techniques to enhance cognitive functioning for a client with a panic disorder. Which client statement indicates that teaching has been effective?

"I will use positive coping statements that I have prepared."

The nurse is caring for a client that begins crying uncontrollably and states, "I am so scared to be here, what if I die?" Which is the best response by the nurse?

"Let's perform some breathing exercises to reduce your anxiety."

The nurse is educating a client that is experiencing mild anxiety. Which statement made by the client indicates that the education is effective?

"Some degree of anxiety is beneficial for learning."

Which statement by the nurse demonstrates an understanding of the role automatisms have in a panic attack?

"The client taps her fingers very rapidly when she is feeling anxious."

A client diagnosed with panic disorder is being admitted to the psychiatric-mental health unit for panic attacks. Which client outcome would be appropriate in the immediate phase of care?

"The client will respond to relaxation techniques with staff assistance and demonstrate a decreased anxiety level within 2 to 3 days."

Nearly what percentage of adults are affected by anxiety disorders?

25%

The nurse recognizes that which client is 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 patient with anxiety disorder has excessive anxiety and worries about multiple life circumstances. For how long would this patient experience these feelings before the anxiety disorder would be considered chronic and generalized?

6 months

What is the term for the change that takes place in response to a stressor?

Adaptation

The most important factor in the person's stress response is what?

Adaptive coping strategies

A client is currently experiencing panic. Which action would be most appropriate for the nurse to do?

Allow the client to pace

A client has sought treatment because of the overwhelming anxiety the client experiences regarding the safety of the client's young children. The client admits that the client will not normally let the client's children leave the client's sight for fear that they will be abducted, abused, or injured. The client is unable to function at work as a result of this anxiety. The nurse would recognize that this client experiences which condition?

Anticipatory anxiety

Which medication classification has been found to be effective in reducing or eliminating panic attacks?

Antidepressants

When explaining the difference between anxiety and fear, the mental health nurse shares what? Select all that apply.

Anxiety involves experiencing subjective, uncomfortable feelings resulting from unknown causes Fear results in objective, physical responses caused by real danger Anxiety is likely to result from an attempt to overcome stress

A biologic theory explains anxiety disorders in which way?

Based in genetics with clinical symptoms being a result of chromosomal influence

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

Calcium channel blockers

The nurse is teaching shoulder exercises to a client recovering from a mastectomy. The nurse might view the client's mild anxiety during the session positively, because mild anxiety helps what? Select all that apply.

To focus attention to learn To feel and think To motivate to make a change To engage in goal-directed activity

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 client is participating in cognitive-behavioral therapy for symptoms of anxiety. During an episode of anxiety, the nurse assesses the effectiveness of this therapy as successful when the client makes which statement?

"This is just like before; I just need to breathe."

A client comes to the emergency department because they think they are having a heart attack. Further assessment determines that the client is not having a heart attack but is having a panic attack. When beginning to interview the client, which question would be most appropriate for a nurse to ask?

"What did you experience just before and during the attack?"

The client reports that the client feels anxious when interacting socially with others and "never seems to know what to say." Which question indicates the nurse has a sound understanding of interpersonal theory as it relates to anxiety?

"What kind of relationship do you have with your parents?"

A group of new nurses is reviewing information about anxiety disorders in preparation for their first day on the job. The lead nurse providing this information believes that the new nurses demonstrate understanding of the material when they make what statement?

"Women experience anxiety disorders more often than do men."

Generalized anxiety disorder (GAD) is characterized by what criteria?

Excessive worry or anxiety lasting more than 6 months

A nurse is caring for an adult client diagnosed with an anxiety disorder. Which intervention(s) would be appropriate for the nurse to implement for the client? Select all that apply.

Help the client focus on deep breathing. Teach the client to use relaxation techniques. Provide a safe environment. Engage the client to explore how to decrease stressors.

During the admission assessment of a 27-year-old client who has been diagnosed with an anxiety disorder, the nurse observes that the client is becoming increasingly restless and agitated. How should the nurse respond to this development?

Inform the client that the assessment can be postponed if the client is finding it overwhelming.

A client comes in for a therapy session and begins to have a panic attack. The therapist asks the client to sit in the chair and then gently asks the client to imagine the client in a very safe and calm place. This technique, often useful in anxiety disorders, is called what?

Guided imagery

All except which are considered clinical symptoms of anxiety?

Tearfulness and sadness

The nurse finds a client pacing the hallway with an anxious expression. Which automatic physical assessment data would the nurse expect to see?

dilated pupils

A client responds to bad news regarding test results by crying uncontrollably. What is the term for this response to a stressor?

Coping mechanism

An adult client being admitted to the psychiatric-mental health unit is experiencing severe anxiety. What is the nurse's priorityaction for the client?

Decrease the client's anxiety level.

When assessing an older adult client who has newly been diagnosed with an anxiety disorder, the mental health nurse's priorityis to carry out which task?

Determine the client's risk for self-harm or harm to others

A nurse is assessing a client and determines that the client is experiencing severe anxiety based on which finding?

Distorted sensory awareness

A client states that the client has just had an argument with the client's spouse over the phone. What can the nurse expect that the client's sympathetic nervous system has stimulated the client's adrenal gland to release?

Epinephrine

Nursing interventions for physical stress related illness should include what?

Establishing daily routines of meals and sleeping

Which assessment question is most likely to allow the nurse to differentiate between anxiety disorder due to a general medical condition and psychological factors affecting a medical condition?

Establishing whether the client's anxiety preceded the medical problem or whether the medical problem appeared first

A client diagnosed with panic disorder has been receiving medication therapy, which is being discontinued. A nurse would be alert for possible withdrawal symptoms if the client was receiving what?

Lorazepam

During which type of anxiety does a person's perceptual field actually increase?

Mild

The nurse has read in a client's admission record that the client has been taking propranolol for psychiatric, rather than medical, reasons. The nurse should recognize that the client likely has a history of which mental health condition?

Panic disorder

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

The nurse observes a client that is attending their first group therapy session, exhibiting anxious behaviors. Which is the priority action for the nurse to take to promote comfort when attending the session?

Remain calm when approaching and encouraging the client to attend.

Which should be included in a teaching plan for a client prescribed a benzodiazepine?

Rise slowly from a lying or sitting position

The mental health nurse is gathering a health history on a new client. The nurse has difficulty getting the client's attention, and the client is pacing the floor and concerned only with stating that they are about to die. The nurse would classify this level of anxiety as what?

Severe

A client is experiencing a panic attack in the clinic waiting room. Which is the priority action by the nurse?

Sit with the client and let them know they are safe and the attack will be over soon.

A client has been unemployed related to frequent absences due to an anxiety disorder and informs the nurse they would like to have a job working alone without someone evaluating their performance. How will the nurse interpret this comment?

Social anxiety disorder is the cause for the client's behavior.

Which condition involves a persistent, irrational fear attached to an object or situation that objectively does not pose a significant danger?

Specific phobia

A client who has been diagnosed with panic disorder visits the clinic and experiences a panic attack. The client tells the nurse, "I'm so nervous. My hands are shaking, and I'm sweating. I feel as if I'm having a stroke right now." What would be the priorityintervention at this time?

Stay with the client while remaining calm.

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

The client has insufficient adaptive coping mechanisms.

The nurse is assessing a client with anxiety. Which behavior might indicate that the client has moderate anxiety?

The client is nervous and agitated.

The nurse can be confident that the client diagnosed with an anxiety disorder will respond well to treatment when which of the following situations or conditions are present?

The client states, "I understand my symptoms and what I need to do to help myself, and I'm ready to do it so I'm back to normal."

The inpatient psychiatric nurse is reviewing the treatment plan for a client with a diagnosis of panic disorder. Which client behavior(s) demonstrate effective treatment? Select all that apply.

The client verbalizes their medication purpose. There are decreased episodes of panic. Quality of life is reported as satisfactory.

The nurse is caring for a client diagnosed with anxiety disorder. The client is demonstrating difficulty concentrating and is preoccupied with feelings of helplessness. When creating the plan of care, which goal would be most appropriate for this client?

The client will display ability to cope with anxiety.

The nurse is assessing clients in the behavioral health unit. For which client will the nurse identify that a prn medication should be administered to control anxiety?

The client with a high anxiety level experiencing disorganized thoughts.

A nurse is caring for a client who has panic attack. The nurse takes the client in a small, isolated room. How would this intervention benefit the client? Choose the best answer.

The client would have an enhanced sense of security.

Which would not be an initial intervention for the client with acute anxiety?

Touching the client in an attempt to comfort the client

The nurse explains the purpose of a daily goals sheet to a client experiencing moderate anxiety. Which action would the nurse implement in consideration of the client's level of anxiety?

Use short, simple terms to explain the purpose of the activity.

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

Using appropriate coping skills 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 older adult experiences anxiety for the first time in his or her life, the anxiety may be associated with another condition.

An adult client is being treated in the outpatient clinic for anxiety related to endocrine dysfunction. Which disorder will the nurse document in the client's medical record?

anxiety disorder due to another medical condition

During an interview with a nurse, the client reports an intense fear of spiders, stating, "I can't be near them. I get so upset. I start to sweat and hyperventilate if I see one." The nurse documents this as what finding? Select all that apply.

arachnophobia

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

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 with a specific phobia of spiders is seeing a therapist for the first session of treatment. The therapist hands the client a clear container with a large house spider inside. This activity is repeated continuously until the client's fear subsides. Which strategy is being used to treat the client's specific phobia?

flooding

The nurse reviews the notes for a 30-year-old female client experiencing episodes of anxiety and worry. For which condition would the nurse create a plan of care for this client?

generalized anxiety disorder

The nurse is preparing to assess a client with a panic disorder. On which area(s) will the nurse focus this assessment? Select all that apply.

nutrition substance use sleep patterns physical health

A client with a panic disorder reports researching the condition and wants to know more about the neurotransmitters that might be causing the condition. Which neurotransmitter(s) would the nurse include when responding to the client? Select all that apply.

serotonin norepinephrine gamma-aminobutyric acid

A school health nurse is seeing a child. The teacher has described this child as being self-isolating and nonparticipatory in class while their grades remain acceptable. What would the nurse suspect is occurring with this child?

social phobia