Chapter 14: Anxiety and Anxiety Disorders

The nurse recognizes that who is the client most likely experiencing generalized anxiety disorder (GAD)?

40-year-old who has reported numerous absences from work, muscle aches, and difficulty falling asleep for the last 8 months

A patient with anxiety disorder has excessive anxiety and worries about multiple life circumstances. For how long would this patient experience these feelings before the anxiety disorder would be considered chronic and generalized?

6 months

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 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."

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?"

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."

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."

A client comes to the emergency department because the client thinks the client is having a heart attack. Further assessment determines that the client is not having a heart attack but is having a panic attack. When beginning to interview the client, which question would be most appropriate for the nurse to ask?

"What did you experience just before and during the attack?"

Which statement, made by a client diagnosed with an anxiety disorder, should trigger the nurse's concern about the client's understanding of the use of defense mechanisms?

"When I have a problem, I just deny it until it goes away."

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

Allow the client to pace

A client has sought treatment because of the overwhelming anxiety the client experiences regarding the safety of the client's young children. The client admits that the client will not normally let the client's children leave the client's sight for fear that they will be abducted, abused, or injured. The client is unable to function at work as a result of this anxiety. The nurse would recognize that this client experiences which condition?

Anticipatory anxiety

A hospitalized client states that the client is having difficulty resting. Which intervention would help promote rest?

Assisting the client with deep-breathing exercises

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

Benzodiazepines

All of the following pharmacological agents are useful in treating anxiety disorders except which ones?

Calcium channel blockers

Clients taking benzodiazepines need education about what?

Concomitant use of alcohol

A client responds to bad news regarding test results by crying uncontrollably. What is the term for this response to a stressor?

Coping mechanism

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

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.

Nursing interventions for physical stress related illness should include what?

Establishing daily routines of meals and sleeping

A 21-year-old client has been recently diagnosed with agoraphobia. Which situation is most likely to cause the client anxiety?

Going to a crowded, outdoor market independently

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 has read in a client's admission record that the client has been taking propranolol for psychiatric, rather than medical, reasons. The nurse should recognize that the client likely has a history of which mental health condition?

Panic disorder

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

Which medication classification has been used to treat social phobia?

Selective serotonin reuptake inhibitors (SSRIs)

A nurse determines that a client who is experiencing anxiety is using relief or primitive survival behaviors. The nurse determines that the client is experiencing which degree of anxiety?

Severe

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

Which is a cardiovascular response of the sympathetic nervous system?

Tachycardia

A group of nursing students are reviewing signs and symptoms of anxiety. The students demonstrate a need for additional review when they identify what?

Tearfulness

A nurse is caring for a client who has panic attack. The nurse takes the client in a small, isolated room. How would this intervention benefit the client? Choose the best answer.

The client would have an enhanced sense of security.

All except which are considered clinical symptoms of anxiety?

Tearfulness and sadness

The nurse is assessing a client with anxiety. Which behavior might indicate that the client has moderate anxiety?

The client is nervous and agitated.

The nurse can be confident that the admitted client diagnosed with an anxiety disorder will respond well to treatment when the client which of the following conditions are present?

The client states, "I understand what I need to do, and I'm ready to do it so I'm back to normal."

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

Touching the client in an attempt to comfort the client

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

A nurse is seeing a client who is having severe to panic level anxiety after a physical assault months previously. The client tells the nurse, "When the panic starts I feel like I am watching myself through a window." The nurse can most accurately describe this experience as:

depersonalization.