Anxiety Disorders Practice Questions

A client is admitted to the psychiatric unit for the fourth time after she cut her wrists, requiring sutures. She does not remember cutting herself. She is diagnosed with dissociative identity disorder. The best nursing short-term outcome would be: The client will A. Inform staff when she has the urge to harm herself. B. Not "switch" personalities within 7 days. C. Discuss her childhood issues that relate to her anxiety. D. Assume a decision-making role for her own health care needs.

A. Inform staff when she has the urge to harm herself. -Safety is the most important issue. The others are long-term goals.

A patient was admitted with a diagnosis of agoraphobia with panic attacks. Which of the following symptoms would the nurse expect the patient to experience during a panic attack? A. Paresthesias B. Constipation C. Feigned fears D. Hypotension

A. Paresthesias -Paresthesias are abnormal sensations - common during a panic attack.

Identify the priority nursing intervention for a client who begins to hyperventilate associated with panic attack. A. Provide a calm environment B. Administer a sedative immediately C. Initiate oxygen at 2 liters per nasal cannula D. Encourage the client to speak with a counselor

A. Provide a calm environment

A client diagnosed with agoraphobia is suddenly forced into the middle of the room while participating in a function at the psychiatric facility. How will the client most likely respond? A. Purposeless activity, confusion, palpitations B. Fast rate of speech, improved concentration, fearful look C. Inability to communicate, daydreams, insomnia D. Hyperactivity, emotional control, "butterflies" in the stomach

A. Purposeless activity, confusion, palpitations -The client will not have control and will not be calm. The client will have increased level of panic.

Which of the following would be the best nursing action for a client who is having a panic attack? A. Remain with the client. B. Teach the client to recognize signs of a panic attack. C. Instruct the client to remain alone until the symptoms subside. D. Ask the client to describe what was happening before the anxiety began.

A. Remain with the client.

A client has been prepared for discharge after hospitalization for a panic disorder. Which statement about level 4 anxiety indicates that teaching has been effective? A. "I can call my therapist whenever I feel stressed." B. "Fear of leaving my house might mean I need to stop and think about what's going on emotionally." C. "I can take an extra Xanax when I feel anxious." D. "I should increase my Luvox if I start feeling "hyper."

B. "Fear of leaving my house might mean I need to stop and think about what's going on emotionally." -Panic disorder is often accompanied by agoraphobia. Treatment is often based on Cognitive-behavioral therapy and medications (SSRI's). Thinking about emotions is a good start.

A client is admitted with obsessive-compulsive disorder (OCD). Which client behavior should the nurse instruct the assistant to report immediately? A. Agrees to follow the unit policies B. Becomes fixated on the health of grandparents C. Expects meals at the same time every day D. Requests a private room

B. Becomes fixated on the health of grandparents -The client is obsessing, which will interfere with daily activities like eating, sleeping, etc.

The nursing assessment indicates that a client is experiencing a panic attack. The client is unable to understand directions and is preoccupied with thoughts of danger. Which of the following would be the most appropriate nursing diagnosis? A. Ineffective health maintenance B. Impaired thought processes C. Risk for noncompliance D. Impaired communication.

B. Impaired thought processes

Identify the age of onset of most anxiety disorders. A. before age 20 years B. before age 30 years C. after age 40 years D. scattered throughout the lifespan

B. before age 30 years

How does the defense mechanism of "undoing" protect the person using it? A. Allows a person to overcome weakness and achieve success B. Protects a person from behaving in irrational, impulsive ways C. Allows a person to appease guilty feelings and atone for mistakes D. Helps a person cope with the inability to meet goals or standards

C. Allows a person to appease guilty feelings and atone for mistakes -Undoing is a defense mechanism in which a person tries to 'undo' an unhealthy, destructive or otherwise threatening thought or action by engaging in contrary behaviour.

Which is the best nursing intervention for the client diagnosed with an obsessive compulsive disorder who has morning rituals? A. Wake the client at the usual time, permit the rituals, let the client miss breakfast B. Stop the rituals by locking the bathroom door, and escort the client to breakfast C. Arrange an earlier rising, permit the rituals, and let the client go to breakfast D. Confront the client with the reasons for the rituals, then send the client to breakfast.

C. Arrange an earlier rising, permit the rituals, and let the client go to breakfast -Rituals are dealt with over a period of time. Rituals need not interfere with daily requirements (like breakfast).

Which of the following is a criterion for evaluation of the anxiety level of a patient with an anxiety disorder? A. Ability to be assertive B. Ability to determine appropriateness of own behavior C. Attention span and concentration D. Sleep pattern

C. Attention span and concentration -Attention span and concentration are used to determine anxiety levels.

A 30-year-old clients comes to the clinic restless, pacing, and having difficulty concentrating. She complains of insomnia and fatigue. She verbalizes that she worries about her children to the point that she doesn't want them to play outside for fear that they will get hurt. The nurse determines the client is experiencing: A. Panic disorder B. Obsessive-compulsive disorder C. Generalized anxiety disorder D. Posttraumatic stress disorder

C. Generalized anxiety disorder

A client with OCD is being discharged from the partial hospitalization unit. What will the nurse teach about SSRI medications used for OCD? A. The client can increase the dosage when obsessive thoughts become overwhelming. B. They are given on a short-term basis due to the fact that they are habit-forming. C. SSRI's can be effective when taken on a scheduled basis in combination with cognitive behavioral therapy. D. They are most effective as p.r.n. medications for OCD

C. SSRI's can be effective when taken on a scheduled basis in combination with cognitive behavioral therapy. -SSRI's are the most frequently used medication for OCD because they are effective. Fluvoxamine (Luvox), paroxetine (Paxil), and escitalopram (Lexapro) are most used for anxiety.

A 24-year-old client seeks outpatient therapy after being raped 2 weeks earlier. She complains of insomnia, decreased appetite, depression, and anxiety when she is outside of her home. The most appropriate initial nursing intervention would be: A. Refer her to a support group for victims of rape B. Suggest that she attend a self-defense class C. Validate her feelings, use active listening, and ensure that she is safe to build a trusting relationship D. Teach her relaxation techniques

C. Validate her feelings, use active listening, and ensure that she is safe to build a trusting relationship -The first thing is to listen and validate feelings. Later, you might teach her relaxation techniques and refer to a support group.

Appropriate discharge criteria for a patient with chronic anxiety disorder are that the patient will: A. experience no more anxiety. B. suppress anxiety symptoms and focus on the future. C. identify situations and events that trigger anxiety. D. recognize the need to take medication for life to control anxiety.

C. identify situations and events that trigger anxiety. -It is impossible to not experience anxiety ever. It is important to learn to recognize triggers to anxiety or panic.

When the nurse has diagnosed a patient as experiencing panic-level anxiety, an intervention that should be implemented immediately is to A. teach relaxation techniques. B. place the patient in 4-point restraints. C. reduce stimuli. D. gather a show of force.

C. reduce stimuli.

Which statement by a patient who washes his or her hands compulsively identifies the thinking of a typical patient with obsessive-compulsive disorder? A. "I know I'll get my hands clean eventually; it just takes time." B. "I need a milder soap that won't damage my hands so much." C. "I feel so much better when my hands are clean. I can get on to other things." D. "I feel driven to wash my hands, although I don't like doing it."

D. "I feel driven to wash my hands, although I don't like doing it." -Remember, anxiety disorders are dystonic - they feel uncomfortable.

Which piece of subjective data obtained during the nurse's psychiatric assessment of a patient experiencing severe anxiety would indicate the possibility of posttraumatic stress disorder? A. "I keep washing my hands over and over." B. "My legs feel weak most of the time." C. "I'm afraid to go out in public." D. "I keep reliving the rape."

D. "I keep reliving the rape."

A client asks why a beta blocker medication has been prescribed for anxiety. When answering this question, the nurse should explain that this medication class is effective for treatment of which symptoms associated with anxiety? A. Cognitive dissonance and confusion B. Depression and suicidal ideations C. Insomnia and nightmares D. Palpitations and rapid heart rate.

D. Palpitations and rapid heart rate.

Before a newly admitted anxious client begins treatment with benzodiazepines, it is most important for the nurse to assess the client's: A. Level of motivation for treatment. B. Situational and social support. C. Stressors and use of coping mechanisms. D. Recent use of alcohol or other depressants.

D. Recent use of alcohol or other depressants.

The nurse is working with a client who is anxious. Which nursing diagnosis has the highest priority at this time? A. Defensive coping. B. Ineffective denial. C. Risk for loneliness. D. Risk for self-directed violence.

D. Risk for self-directed violence.

A client is being discharged after being treated for the first time for panic disorder. What instructions should be included in the discharge plan? A. Calling the therapist when a panic attack is impending. B. How to manage hallucinations and delusions. C. When it is safe to stop taking medication. D. Safe administration of anti-anxiety medication, including therapeutic and side-effects.

D. Safe administration of anti-anxiety medication, including therapeutic and side-effects. -One of the primary goals of psych nsg is to foster independence in clients. This action does not reflect that goal. Hallucinations and delusions are part of psychosis. Stopping medication should not be an independent decision of the ct. Safe client self-admin and understanding of meds is an appropriate discharge goal.

When assessing an apparently anxious client, the nurse ensures that questions related to the clients anxiety are: A. Abstract and nonthreatening. B. Avoided until the anxiety disappears. C. Avoided until the client brings up the subject. D. Specific and direct.

D. Specific and direct.

A 10-year-old boy arrives for his therapy appointment, having been diagnosed with OCD. He is plagued with obsessive thoughts that every time he steps on a crack he hurts his mother and experiences anxiety every time he does step on a crack. An appropriate nursing intervention would be: A. Explain to his parents the symptoms and treatment of the disorder. B. Explain how irrational his thoughts are. C. Give him permission to avoid stepping on cracks because it causes him such increased anxiety. D. Teach cognitive strategies to deal with anxiety.

D. Teach cognitive strategies to deal with anxiety. -The correct answer is the only one that addresses the issue directly with future plans.