NURS 124 TH 9-3

A new nurse asks the charge nurse why the client with body dysmorphic disorder is always looking at their nose in the mirror. Which of the following would be an appropriate response?

"Clients with body dysmorphic disorder are preoccupied with perceived defects in their appearance."w

A 40-year-old client is admitted for a surgical biopsy of a suspicious lump in the left breast. The client is tearfully writing a letter to the client's two children and tells the nurse, "I want to leave this for my children in case anything goes wrong today." Which response by the nurse would be most therapeutic?

"In case anything goes wrong? What are your thoughts and feelings right now?"

A nurse is giving a presentation on mental health promotion to college students. One student asks the nurse to explain the difference between normal anxiety and an anxiety disorder. Which response is best?

"People with anxiety disorders generally find that the anxiety interferes with daily activities."

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."

The nurse has completed teaching a client about alprazolam. Which statement by the client will the nurse document as evidence of successful teaching?

"This medication carries a risk of dependence."

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

After learning that a roommate is HIV-positive, a client asks a nurse about moving to another room on the psychiatric unit because the client no longer feels "safe." What should the nurse do first?

Ask the client to describe the fears.

The nurse is teaching a client prescribed the antianxiety agent chlordiazepoxide. The nurse should incorporate which instruction into the teaching plan?

Avoid taking antianxiety drugs with alcohol.

Which medication classifications used in the treatment of panic disorder can cause physical dependence?

Benzodiazepines

When discussing various types of anxiolytic medications with a client, the nurse recognizes that which medication has the lowest potential for abuse?

Buspirone

A nurse is providing care for a client vulnerable to panic attacks who is acutely anxious. The client currently has a respiratory rate of 28 breaths/min and a heart rate of 110 beats/min. What action does the nurse perform first?

Coach the client on performing slow, deep breaths.

A client comes in for a therapy session and begins to have a panic attack. The therapist asks the client to relax 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?

Deep breathing

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?"

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

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

In teaching a client who has been prescribed a benzodiazepine for panic disorder, the nurse must be certain to do what?

Educate the client that this medication has a high risk for withdrawal symptoms, and the client should not discontinue without a doctor's supervision.

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 with generalized anxiety disorder states that the client is worried about the client's job. The client never feels like the client has control over the client's responsibilities, even though the client puts in extra hours. The client adds that the client is afraid the client will be fired. Which response by the nurse is most therapeutic?

Has something changed at work that is causing you to worry?"

While conducting a class on anxiety and stress reduction, a nurse describes the symptoms of anxiety (including panic), informing the class that the physical symptoms of a panic attack can mimic what?

Heart attack

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

The nurse is caring for a client with a panic attack. Which nursing intervention is most helpful for this client?

Stay with the client and remaining calm, confident, and reassuring.

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 30-year-old client who has been unemployed secondary to anxiety disorder states that the client would like to have a job where the client is alone and no one needs to evaluate the client's work. The nurse interprets these comments as an indicator of what?

Social phobia

A client presents to the nurses' station with symptoms of a panic attack, including shortness of breath, dizziness, trembling, and nausea. Which is the nurse's first intervention?

Stay with the client, and offer support.

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

A client is worried and states, "I just know I won't be able to sleep before my surgery." What sleeping pattern would the nurse anticipate?

The client will likely not be able to sleep

A patient tells the nurse, "I was straining to have a bowel movement and felt like I was going to faint. I took my pulse and it was so slow." What does the nurse understand occurred with this patient?

The patient had a vagal response.

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

Touching the client in an attempt to comfort the client

Which is one characteristic that differentiates generalized anxiety disorder (GAD) and panic disorder?

W/ GAD, the person usually does not experience eruptions of acute anxiety.

A group of students is reviewing information about anxiety disorders in preparation for a class examination. The students demonstrate understanding of the material when they state what?

Women experience anxiety disorders more often than do men.

A client periodically has acute panic attacks. These attacks are unpredictable and have no apparent association with a specific object or situation. During an acute panic attack, the client may experience:

a decreased perceptual field.

A client on the behavioral health unit reports palpitations, trembling, and nausea while traveling alone, outside the home. These symptoms have severely limited the client's ability to function and have caused the client to avoid leaving home whenever possible. The nurse recognizes that this client has symptoms of what disorder?

agoraphobia

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 notices that a client with obsessive-compulsive disorder washes the hands for long periods each day. How should the nurse respond to this compulsive behavior?

by setting aside times during which the client can focus on the behavior

A client on the behavioral health unit spends several hours per day organizing and reorganizing the closet. The client repeatedly checks to see if the clothing is arranged in the proper order. What term is commonly used to describe this behavior?

compulsion

A client who recently developed paralysis of the arms is diagnosed with functional neurologic symptom disorder after tests fail to uncover a physical cause for the paralysis. Which intervention should the nurse include in the care plan for this client?

exercising the client's arms regularly

A client is scheduled to undergo surgical creation of an ileal conduit. The primary nurse educates the client about surgery and the postoperative period. The nurse informs the client that many members of the health care team (including a mental health practitioner) will see him. A mental health practitioner should be involved in the client's care to:

help the client cope with the anxiety associated with changes in body image.

A nurse discovers that a client with obsessive-compulsive disorder (OCD) is attempting to resist the compulsion. Based on this finding, the nurse should assess the client for:

increased anxiety

A client admitted to the unit is visibly anxious. The nurse documents what assessment finding as an expected finding in a client experiencing mild to moderate anxiety?

increased heart rate

A client is diagnosed with obsessive-compulsive disorder. Which intervention should the nurse include when developing the care plan for this client?

initially giving the client time to perform rituals and gradually limiting the time

Buspirone has been prescribed for a client with anxiety. When providing health education, the nurse should describe what benefit of this medication over other anxiolytics?

less central nervous system depression

Which level of anxiety helps the client focus the client's attention to learn, problem solve, think, act, feel, and protect himself or herself?

mild

A client who is a painter recently fractured a tibia and can't work. The client worries about finances. To treat the client's anxiety, the physician orders buspirone, 5 mg by mouth three times per day. Which drugs interact with buspirone?

monoamine oxidase (MAO) inhibitors

The nurse has been waiting until after the administration of a toddler's anesthesia before removing the child's clothing and applying monitoring equipment. Doing these actions after the administration of anesthesia will:

prevent anxiety.

A client has become increasingly afraid to ride in elevators. While in an elevator one morning, the client experiences shortness of breath, palpitations, dizziness, and trembling. A physician can find no physiological basis for these symptoms and refers the client to a psychiatric clinical nurse specialist for outpatient counseling sessions. Which type of therapy is most likely to reduce the client's anxiety level?

systematic desensitization