PN PASSPOINT (Anxiety Disorders)

The nurse is preparing to administer diazepam to a client. Which teaching about this drug will the nurse provide to the client?

"Do not drive while taking this medication."

A nurse is reinforcing education for a client who has been prescribed buspirone for long-term treatment of anxiety. The nurse determines that the education has been effective when which statement is made by the client?

"I will not take the medicine with grapefruit juice."

The nurse is gathering data from a client that arrives in the clinic with generalized anxiety disorder (GAD). What statement made by the client does the nurse determine correlates with this diagnosis?

"I worry about things all of the time that I have no control over."

A client with borderline personality disorder tells the nurse, "You're the only nurse who really understands me. The others are mean." The client then asks the nurse for an extra dose of antianxiety medication because of increased anxiety. What is the appropriate nursing response?

"I'll discuss your request with the team. Let's talk about what you think is increasing your anxiety."

A client, age 40, is admitted for a surgical biopsy of a suspicious lump in her left breast. When the nurse comes to take her to surgery, she is tearfully finishing a letter to her two children. She 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?"

During the client-teaching session, which instruction should the nurse give to a client receiving alprazolam?

"Inform the physician if you become pregnant or intend to do so."

A client with obsessive-compulsive disorder (OCD) and type 1 diabetes was admitted to the medical unit 5 days ago for the treatment of diabetic ketoacidosis. The client's blood glucose is stable, but the client is unable to successfully demonstrate self-management due to compulsions interfering with blood glucose monitoring and insulin administration scheduling. What action(s) should the nurse take? Select all that apply.

1) Speak to the client about the past successful treatment strategies used for OCD. 2) Advocate for the client to receive an immediate consult for psychiatric assessment.

The nurse is caring for a client diagnosed with a psychotic disorder. The nurse will monitor the client to limit water consumption to how many liters daily?

3

A client with obsessive compulsive disorder reports to the nurse that the routine of having the night-light on was not followed on the night shift. What would be the nurse's best course of action?

Ask the night nurse about the experience of caring for the client the previous night.

The nurse is caring for a client who is agitated and is trying to get out of bed. What should the nurse do first to keep the client free of injury?

Ask the unlicensed assistive personnel to sit with the client.

A client asks about how various medications are prescribed to treat anxiety disorders. What is the best response by the nurse?

Benzodiazepines are the treatment of choice for short-term management of acute anxiety.

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 plan of care?

Exercising the client's arms regularly

Which nursing intervention is appropriate to include when assisting with the plan of care for a client with panic disorder?

Institute suicide precautions.

A 49-year-old painter who recently fractured his tibia worries about his finances because he can't work. To treat his anxiety, his physician prescribes buspirone, 5 mg by mouth three times per day. During buspirone therapy, the client should avoid which of the following drugs?

Monoamine oxidase (MAO) inhibitors

A client is exhibiting anxiety, which is evidenced by muscle tension, distractibility, and increased heart rate and blood pressure. Which nursing intervention has priority?

Remain with the client and use a soft voice and reassuring approach.

A competent client with obsessive-compulsive disorder wishes to go out on a pass. However, the health care provider has denied the client any passes until the client agrees to complete all the requested assessments. Staff have explained the reasons for the assessments, but the client still refuses to complete them. What is the nurse's priority action?

Speak to the health care provider and advocate for the client to be allowed to go on the pass.

A preparing to assist a client in coping with stress? What nursing interventions will be effective? Select all that apply.

Teach relaxation exercises. Minimize environmental stimuli. Encourage verbalization of feelings. Establish a trusting relationship.

A client diagnosed as having panic disorder is admitted to the inpatient psychiatric unit. Until admission, he or she had been a virtual prisoner in the house for 5 weeks because of agoraphobia, afraid to go outside even to buy food. The nurse, when planning care for this client, determines which action as this client's overall goal?

To help the client function effectively in his or her environment

The nurse is caring for a client with a panic disorder. Which panic attack does the nurse document as uncued?

Upon awaking from a peaceful nap, the client reports shortness of breath.

Which factor should the nurse be most concerned about when caring for a client taking an antianxiety medication?

abrupt withdrawal

Change question to: A client is prescribed alprazolam therapy. Which dose related adverse reactions should the nurse have the client report to the health care provider? Select all that apply.

ataxia drowsiness

The nurse is obtaining data from a client with obsessive-compulsive disorder who reports not getting much sleep at night. What behavior does the nurse anticipate?

checking the door locks multiple times

A client is admitted to the acute psychiatric care unit after 2 weeks of increasingly erratic behavior. The client is unkempt, has lost approximately 9 lb (4 kg), has been sleeping poorly, and exhibits hyperactivity. The client loudly denies the need for hospitalization. What priority intervention will the nurse apply?

decreasing environmental stimulation

A nurse is conducting discharge teaching for a client with an anxiety disorder about the caffeine content of various common beverages. In which order, from highest caffeine concentration (per fluid ounce or mL) to lowest, will the nurse list the beverages? All options must be used.

espresso brewed coffee green tea regular cola chocolate milk

The nurse is preparing medications for a client newly prescribed lorazepam 3 mg PO. Which laboratory finding causes the nurse to contact the health care provider to discuss this order?

glomerular filtration rate 70 mL/min/1.73 m

The nurse is assigned to reinforce insulin administration education for a client with diabetes who is anxious. During which stage should the nurse reinforce education for the client?

mild stage of anxiety

The nurse is preparing to care for a client who has periodic panic attacks. The nurse should be prepared to provide care for an attack if the client suddenly reports or exhibits what signs or symptoms? Select all that apply.

nausea flushing chest pain diaphoresis

The nurse is caring for a client with a diagnosis of conversion disorder. Which clinical symptoms does the client demonstrate that correlate with this diagnosis?

neurologic symptoms associated with psychological conflict or need

The nurse is caring for a client with posttraumatic stress disorder (PTSD) experiencing a frightening flashback. The nurse can best offer reassurance of safety and security through which nursing action?

staying with the client

The nurse is providing group therapy for a group of adolescents who witnessed the violent death of a peer. Which outcome would best meet the needs of the students?

to discuss the effect of the trauma on their lives