Anxiety, Obsessive Compulsion and Related Disorders

A nurse on an inpatient mental health unit is having a conversation with a client who is exhibiting manifestations similar to OCD. Which of the following statements by the nurse reflects appropriate understanding of risk factors for developing manifestations of OCD?

*"I would like to know more about the manifestations that you share with your biological father."* The nurse should recognize that there is a genetic predisposition for developing obsessive-compulsive disorder.

The nurse is reviewing the clients MR. Which of the following findings should the nurse identify as adverse factors impacting the client's mental health?

Ability to manage stress is correct. The client's recent increase in anxiety and panic attacks indicate the client's ability to manage stress is impaired, placing their mental health at risk. Peer relationships is correct. The client's reports of conflict with a peer indicate the client's social circumstances are impaired, placing the client's mental health at risk. Physical safety is correct. The client's experience of a verbal attack and threats on another person impaired the client's sense of physical safety, which has a negative impact on the client's mental health.

A nurse in an outpatient clinic is assessing a client who has OCD. The nurse is reviewing the client's assessment findings. Which of the following findings should the nurse identify as a risk for developing OCD?

When analyzing cues, the nurse should identify that a *history of childhood abuse, tobacco use, and a family member who has OCD* are risk factors for the client developing OCD. OCD is an anxiety disorder that is characterized by compulsive thoughts and repetitive behaviors.

The nurse is reviewing the client's assessment findings and the pathophysiology of anxiety. Select the 4 findings that are associated with over activation of the neural circuits within the limbic system.

When analyzing cues, the nurse should identify that an *increased heart rate, restlessness, increased blood pressure, and irritability* are all manifestations of anxiety. These manifestations are caused by overactivation of the cortico-striato-thalamo-cortical (CSTC) circuit of the limbic system.

A nurse in an outpatient mental health facility is caring for a group of clients. Select the 2 client findings that are manifestations of social anxiety disorder.

When analyzing cues, the nurse should identify that clients who *fear being in groups of people or are concerned with others' opinions of their clothing* are exhibiting manifestations of social anxiety disorder. Clients who have this disorder experience fear and anxiety in social situations and perceived scrutiny from others.

A nurse on a mental health unit is caring for a client. The nurse is continuing to care for the client. Select the 4 findings that require follow-up by the nurse. *need Nurse's notes to really answer question RR Bowel Sounds HR Insomnia Performance of ADLS Headache O2 Sat

When analyzing cues, the nurse should identify that the client's *heart rate, respiratory rate, insomnia, and headache* are all unexpected findings that require follow-up. The nurse should further assess the client and implement interventions to help decrease the client's anxiety.

A nurse on a mental health unit is caring for a newly admitted client. Click to highlight the statements in the nurses' notes that require follow-up by the nurse.

When analyzing cues, the nurse should identify that the client's *restlessness and shaking, statement of feeling like they're going to die, tachypnea, tachycardia, diaphoresis, and rapid and loud speech* are indications the client is experiencing a panic attack. These findings require follow-up by the nurse, such as staying with the client and providing reassurance using therapeutic communication techniques.

A nurse is caring for a client who has panic disorder and wants to know what they can do to better control their panic attacks. Which of the following statements by the nurse addresses modifiable risk factors? "Physical activity can decrease the intensity and frequency of panic attacks." "A family history of anxiety disorder will make controlling your panic attacks more difficult." "Childhood trauma, abuse, and neglect can make you more vulnerable to panic disorders." "Being separated from your birth parents at a young age explains why you have a panic disorder."

*"Physical activity can decrease the intensity and frequency of panic attacks."* The nurse should explain to the client that physical activity is a modifiable risk factor that can decrease the intensity and frequency of panic attacks. B- Genetic vulnerability is a nonmodifiable risk factor. C- Adverse childhood events are nonmodifiable risk factors. D- Parental separation during childhood is a nonmodifiable risk factor.

A nurse in the ED is triaging a client following a MVC. The nurse should identify that which of the following findings is association with the alarm phase of Selye's General Adaption Syndrome framework? Immunocompromised Anxiety Hypothermia Depression

*Anxiety* According to Selye's GAS framework, a client who was recently in a motor-vehicle crash will be in the alarm phase. During this phase, a client can experience tachycardia, tachypnea, and anxiety. A- According to Selye's GAS framework, a client who was recently in a motor-vehicle crash will be in the alarm phase. During the alarm phase, a client can experience bradycardia and bradypnea. Becoming immunocompromised develops in the later phases of resistance and exhaustion. C- According to Selye's GAS framework, a client who was recently in a motor-vehicle crash will be in the alarm phase. Hypothermia is not a finding associated with the alarm phase. D- According to Selye's GAS framework, a client who was recently in a motor-vehicle crash will be in the alarm phase. Depression is not a finding associated with the alarm phase.

A nurse is caring for a client who states, "I have been isolating myself from socializing because I am afraid that I am goint to experience another episode of intense anxiety." This client statement is suggestive of which of the following anxiety-related disorders? Substance/Med-induced anxiety disorder Separation Anxiety Disorder Panic Disorder Generalized Anxiety Disorder

*Panic Disorder* Clients who encounter symptoms of panic disorder experience distinct and extreme periods of physiologic and psychologic hyperarousal, and as a result, may avoid situations that may trigger an anxiety attack. A- Clients who encounter symptoms of anxiety that are determined to be substance- or medication-induced can manifest symptoms of anxiety, fear, and worry in relation to either exposure to or withdrawal from a substance or medication. B-Clients who encounter symptoms of separation anxiety disorder experience developmentally inappropriate and excessive fear or anxiety upon separation from those to whom they are attached. D- Clients who encounter symptoms of generalized anxiety disorder experience excessive anxiety and worry in response to numerous situations and circumstances.

A nurse is caring for an adult client who experiences discrete periods of acute psychological distress that includes heart palpitations, dyspnea, and lightheadedness. The nurse should identify that the client is demo-ing manifestations for which of the following types of anxiety disorders? Separation anxiety disorder Selective mutism Generalized anxiety disorder

*Panic disorder* The nurse should identify that the client is demonstrating manifestations of panic disorder, which includes periods of physiologic and psychologic hyperarousal. A- Clients who experience fear upon separation have separation anxiety. B- Clients who demonstrate consistent failure to speak in specific social situations have selective mutism. C- Clients who experience anxiety and worry in response to numerous situations have generalized anxiety disorder.

A nurse is caring for a client who is experiencing anxiety and OC behaviors. Which of the following chemicals is regulated by psychotropic meds to relieve manifestations of anxiety and OC behaviors? Acetylcholine Serotonin Histamine Vasopressin

*Serotonin* Serotonin affects the neuropathway loop and plays a role in controlling anxiety. Serotonin is one of several neurotransmitters regulated by psychotropic medications. A- Acetylcholine is implicated in learning and is not known to have a direct influence on manifestations of anxiety, worry, and obsessive-compulsive behavior. C- Histamine is implicated in stress reaction and does not have a direct influence on manifestations of anxiety, worry, and obsessive-compulsive behavior. D- Vasopressin is a neurohormone that is implicated in the linkage between sensory stimuli and chemical responses. It does not have a direct influence on manifestations of anxiety, worry, and obsessive-compulsive behavior.

A nurse is caring for a child who demonstrates marked and disproportionate fear in response to the physical presence or representation of an object, such as a balloon. Which of the following do these manifestations suggest? Social Anxiety Disorder Separation Anxiety Disorder Agoraphobia Specific Phobia

*Specific Phobia* These manifestations suggest specific phobia. Clients who experience manifestations related to a specific phobia manifest marked fear and anxiety upon exposure to the specific object or situation. A- Clients who encounter symptoms of social anxiety disorder experience marked fear and anxiety upon exposure to social situations and the potential for scrutiny associated with them. B- Clients who encounter symptoms of separation anxiety disorder experience developmentally inappropriate and excessive fear or anxiety upon separation from those to whom they are attached. C- Clients who encounter symptoms of agoraphobia experience marked fear and anxiety upon exposure to circumstances associated with travel or location.

A nurse is caring for a client who has OCD. The client's behaviors likely originate in which of the following brain circuits? The amygdala-centered circuit The cortico-striato-thalamocortical circuit

*The cortico-striato-thalamocortical circuit* The cortico-striato-thalamo-cortical circuit is associated with manifestations such as worry, apprehension, and obsession. A- The amygdala-centered circuit is associated with manifestations such as fear, panic, and phobia. C- The hypothalamic pituitary adrenal axis is associated with those symptoms associated with trauma response and not obsessive-compulsive symptoms. D- A reflex arc is a neural pathway that controls reflexes and not obsessive-compulsive symptoms.

A nurse in an outpatient mental health clinic is caring for a client who expressed concern about developing a mental illness. According to the MDS model, which of the following explanations best describes one's potential to develop a mental illness? Genetic variables are more likely to increase the potential for developing a mental illness than environmental variables. The dynamic interaction between genetic and environmental variables determines the potential for developing a mental illness. Environmental variables are more likely to increase the potential for developing a mental illness than genetic variables. Neither genetic nor environmental variables influence the potential for developing a mental illness.

*The dynamic interaction between genetic and environmental variables determines the potential for developing a mental illness.* Research over the past decade has illuminated several vulnerability genes that appear to be associated with an increased risk for developing mental illness. For all wrong answers - The dynamic interaction between genetic and environmental variables determines the potential for developing a mental illness.

A nurse is caring for a client who is concerned about developing a MHD. Which of the following statements regarding the relationship between ACEs and PCEs is correct? ACEs and PCEs can effectively neutralize the impact of each other. ACEs and PCEs are mutually exclusive concepts with no recognized impact upon the other. The presence of ACEs outweighs the impact of PCEs.

*The presence of PCEs can provide some degree of symptomatic protection from ACEs in certain instances.* The presence of PCEs provides some degree of symptomatic protection from ACEs among adults who have certain psychiatric manifestations. A- The presence of PCEs provides some degree of symptomatic protection from ACEs among adults who have certain psychiatric manifestations. B- The presence of PCEs provides some degree of symptomatic protection from ACEs among adults who have certain psychiatric manifestations. C- The presence of PCEs provides some degree of symptomatic protection from ACEs among adults who have certain psychiatric manifestations.