Behavioral PrepU Chapter 18: Anxiety & Panic Disorders

A nurse is conducting a group session in the behavioral health unit for three clients on the topic of anxiety. The nurse determines that the session was successful based on which statement by the clients?

"Anxiety cannot be completely eliminated from my life."

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 educating a client with generalized anxiety disorder about nutrition as a supporting factor in controlling the disorder. Which client statement indicates that further education is required?

"I should only drink tea or coffee and avoid cola products."

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."

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."

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."

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."

The client has an order for an anxiolytic agent, lorazepam (Ativan). Which of the following statements by the client would indicate that client education about this medication has been effective?

"This medication will relax me so I can focus on problem solving."

A nurse visits a client at home for an assessment after discharge from an inpatient behavioral health unit. The client informs the nurse about experiencing chest pain, shortness of breath, and sweating whenever leaving home unable to go to work. Which is the best response by the nurse?

"This sounds like you may have a fear of open spaces when you leave home called agoraphobia."

A client is currently experiencing a panic attack. Which is the most therapeutic response by the nurse?

"You are safe. Take a deep breath."

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. -Quality of life is reported as satisfactory. -There are decreased episodes of panic. -The client has mastered five coping mechanisms. -The client verbalizes their medication purpose. -The client participates in flooding treatment.

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

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 -Using restraint when panic develops -Providing supportive feedback

-Using appropriate coping skills -Identifying treatment modalities -Involving family for support, if appropriate -Providing supportive feedback

When traveling alone and away from home, a client experiences trembling and palpitations. These symptoms have impeded the client from leaving her home. The nurse would correctly note that these are symptoms of which type of phobia?

Agoraphobia

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

Allow the client to pace

Linn is a 42-year-old woman who is in the process of moving house after her divorce. She reports experiencing bouts of increased anxiety recently. How can the nurse best explain the physiological adaptation that occurs during fight or flight to this client?

An increase in blood flow to the muscles

Panic disorder is treated with cognitive-behavioral techniques and deep breathing and relaxation, in addition to which of the following?

Antianxiety medications

The mental health nurse knows that which medication classification has been found to be effective in reducing or eliminating panic attacks?

Antidepressants

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

Antidepressants

A client who was discharged from the inpatient facility is sitting in the dayroom waiting for their transportation. Suddenly the client starts throwing papers and stomping their feet. Which initial action is appropriate?

Assess the use of defense mechanisms.

The nurse is caring for a client who is prescribed alprazolam for acute anxiety. Which will the nurse include when educating the client about the medication?

Avoid alcoholic beverages while taking the medication.

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

Benzodiazepines

When teaching a client with generalized anxiety disorder, the nurse instructs the client to avoid which of the following?

Caffeine

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

Decrease the client's anxiety level

Which term describes feelings of being disconnected from oneself as seen in a panic attack?

Depersonalization

Which term describes feelings of being disconnected from oneself, as seen in a panic attack?

Depersonalization

A client with an anxiety disorder spends most free time alone. Which strategy would the nurse suggest to develop a sense of connection with others?

Engage in recreational activity

Nursing interventions for physical stress related illness should include what?

Establishing daily routines of meals and sleeping

The nurse is assessing a client and finds two enlarged supraclavicular lymph nodes. The nurse asks the client how long these enlarged nodes have been there. The client states, "I can't remember. A long time I think. Do I have cancer?" The nurse is aware that that body responds to stress. Which is an immediate physiologic response to stress the nurse would expect to see in this client?

Increase blood pressure

A nurse is assessing a client and notes that the client is exhibiting affective mainfestations of anxiety. Which manifestation would the nurse most likely assess?

Irritability

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

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

A client with a history of panic disorder tells the nurse, "When I feel anxious and panicky, I say to myself, 'I can handle these symptoms.'" The nurse interprets this statement as which of the following?

Positive self-talk

A nurse is creating a plan of care prior to working with a client learning to cope with anxiety and stress. Which outcome does the nurse include in the plan of care for the client?

Reactions to stressors will change

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.

When developing a plan of care for a client diagnosed with panic disorder, which nursing diagnosis would be considered the priority?

Risk for Self-Directed violence

Which medication classification has most commonly been used to treat social phobia?

Selective serotonin reuptake inhibitors (SSRIs)

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 states to the nurse, "I just can't talk in front of the group." The client begins pacing with muscles tightening and irritability. Which action by the nurse will address this level of anxiety?

Stay with the client and speak in a low, calming voice

When a parent observes the parent's young child heading toward a busy road the parent becomes stressed, feeling the parent's heart pounding, breathing heavily, and hands becoming wet with perspiration. Which physiological system is activated with the parent's "fight or flight" reaction to this danger?

Sympathetic nervous system

A client experiences panic attacks when confronted with riding in elevators. The nurse is teaching the client ways to relax while incrementally exposing the client to getting on an elevator. Which technique will the nurse employ to assist the client with overcoming the phobia?

Systematic desensitization

The nurse is creating an education plan for a client with diabetes mellitus to address the dietary modifications to manage the disease. Which characteristic identified by the nurse indicates that the client is prepared for the education?

The client has a heightened focus

A nurse assesses a client and determines that the client is experiencing mild anxiety based on what?

The client is aware and alert

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.

The nurse is assessing a client who has panic disorder. When assessing the client's risk for suicide, the nurse should prioritize what assessment finding?

The client's history reveals social isolation for the past 2 years.

Which of the following is inconsistent with panic-level anxiety?

This level of anxiety can be sustained indefinitely.

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 client is prescribed a serotonin-norepinephrine reuptake inhibitor. The nurse would identify that which of the following is most commonly prescribed?

Venlafaxine

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 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

Client states they constantly worry about money, employment, health of children, and time constraints. Client reports bilateral leg muscle aches and experiences episodes of diarrhea and constipation; states they "can't remember" the last time they slept through the night. 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

An adolescent who is seeing the school health nurse states, "I won't be able to hang out with my friends on Friday night because I have two essays due Monday." What level of anxiety is the adolescent experiencing?

mild

The nurse is with a client while having a magnetic resonance imaging (MRI) study when the client begins to have a panic attack. Which is the primary concern for this client that the nurse will immediately address?

moving off the MRI table

Client is a 30 year old female seeking care for a sudden onset of palpitations, chest pain, nausea, dizziness, and shortness of breath. Client states the symptoms started after learning several friends were injured in an automobile accident and one friend died. Client states, "I feel like I'm going to die." The nurse reviews the information documented in a client's medical record in the emergency department. Which mental health condition would the nurse anticipate planning care for this client?

panic attack

An adult client diagnosed with panic disorder is being counseled in the clinic. The nurse teaches the client that when they are experiencing severe anxiety or panic, instead of thinking, "I am going to die," the client learns to think, "This is anxiety, and it will go away." Which technique is the nurse utilizing with the client?

positive reframing

A school health nurse is meeting with the parents of a 6-year-old child who has been selectively mute. The nurse is offering the parents education regarding this problem. The nurse can tell the parents that what is true about selective mutism?

selective mutism is associated with social anxiety