Psych PrepU 14
the nurse recognizes that who is the client most likely experiencing generalized anxiety disorder (GAD)?
40-year-old who has reported numerous absence 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 & generalized?
6 months
a biological theory explains anxiety disorder in which way
based in genetics with clinical symptoms being a result of chromosomal influence
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
The overall goals of care for individuals experiencing a stress response are to focus on interventions to develop ...
positive coping skills
The nurse can document correctly that a client diagnosed with an anxiety disorder is experiencing moderate anxiety when the nurse observes the client doing what?
pacing and repeatedly asking staff what time will the doctor be with them
a client responds to bad news regarding test results by crying uncontrollably. what is the term for this response to a stressor?
coping mechanism
the nurse is providing care for a psychiatric mental health client who has a dx 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 ones life"
the nurse is assessing a client who recently experienced her first panic attack while at the grocery store. what question should the nurse ask to identify complications of the disorder?
"do you have any problems going out alone to public places?"
a client with generalized anxiety disorder states that the client is worried about the clients job. the client never feels like the client has control over the clients 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."
which question in the assessment of a client with anxiety is most clinically appropriate?
"how do you feel about everything that is happening in your life right now?"
which question in the assessment of a client with anxiety is most likely clinically appropriate?
"how do you feel about everything that is happening in your life right now?"
a nurse is giving a presentation on mental health promotion to college students. one students 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"
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 they are 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 dx with an anxiety disorder, should trigger the nurses's concern about the client's understanding of the use of defense mechanisms?
"when I have problems, I just deny it until it goes away."
nearly what percentage of adults are affected by anxiety disorders?
25%
all of the following pharmacologic agents are useful in treating anxiety disorders except which ones?
CCBs
Which is one characteristic that differentiates generalized anxiety disorder (GAD) and panic disorder?
In GAD, the person usually does not experience eruptions of acute anxiety.
A client is diagnosed with panic disorder. When considering the neurochemical theory of the disorder, which would the nurse expect to administer as the drug of choice initially? ***
SSRIs
which medication classification has been used to treat social phobia?
SSRIs
the nurse is assessing a client with anxiety. which bx might indicate that the client has moderate anxiety?
a client is nervous and agitated
which client is most likely to be at risk for drug dependence and difficulties withdrawal?
a woman who has been taken lorazepam for several moths after witnessing a traumatic motor vehicle accident
what is the term for the change that takes place in response to a stressor
adaptation
the most important factor in the persons stress response is what?
adaptive coping strategies
A client approaches the nurse on an inpatient psychiatric hospital unit crying, trembling, and feeling nauseous. The client states, "I've tried everything, I still feel so anxious." Which action by the nurse would be most appropriate?
administer the prescribed PRN anxiolytic medication
a client is currently experiencing panic. what action would be most appropriate for the nurse to do?
allow the client to pace
panic disorder is treated with cognitive-bx techniques, deep breathing, and relaxation, in addition to what?
anitdepressants
a client has sought treatment because of the overwhelming anxiety the client experiences regarding the safety of the clients young children. the client admits that the client will not normally let the clients children leave their 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
which medication classification has been found to be effective in reducing or eliminating panic attacks?
antidepressants
which nursing intervention is focused on the primary goal of anxiety management and treatment?
assessing the clients ability to implement stress management techniques effectively
a hospitalized client states that the client is having difficulty resting. which intervention would help promote rest?
assisting the client with deep-breathing exercises
The nurse walks into the client's room and finds the client sobbing uncontrollably. When the nurse asks what the problem is, the client responds, "I am so scared. I have never known anyone who goes into a hospital and comes out alive." On this client's care plan the nurse notes a nursing diagnosis of ineffective coping related to stress. What is the best outcome to be expected for this client?
client will adapt relaxation techniques to reduce stress
clients taking benzodiazepines need education about what?
concomitant use of alcohol
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
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
when assessing an elderly client who has newly been dx with an anxiety disorder, the mental health nurses priority is to carry out which task?
determine the clients risk for self harm or harm to others
a nurse is assessing a client and determines that the client is experiencing severe anxiety based on which finding?
distorted sensory awareness
A client diagnosed with anxiety disorder has been prescribed benzodiazepine drugs. The nurse is explaining the possible side effects of the medications. Which side effects of the drug explained by the nurse is correct? Select all that apply.
dry mouth blurred vision constipation
a client states that the client has just had an argument with the clients spouse over the phone. what can the nurse expect the clients sympathetic nervous system has stimulated the clients adrenal gland to release?
epinephrine
nursing intervention for physical stress related illness should include what?
establishing daily routine of meals and sleeping
which assessment question is most likely to allow the nurse to differentiate between anxiety disorder due to a general medical condition and psychological factors affecting a medical condition?
establishing whether the clients anxiety preceded the medical problem or whether the medical problem appeared first
a 21-year-old client has been recently dx with agoraphobia. which situation is most likely to cause the client anxiety?
going to a crowded, outdoor market independently.
which is considered a TCA used in the treatment of clients with panic disorder?**
imipramine
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 the body responds to stress. which is an immediate response to stress the nurse would expect to see in this client?
increased blood pressure
During the admission assessment of a 27-year-old client who has been diagnosed with an anxiety disorder, the nurse observes that the client is becoming increasingly restless and agitated. How should the nurse respond to this development?
inform the client that the assessment can be postponed if the client is finding it overwhelming
A group of students are reviewing information about the etiology of generalized anxiety disorder (GAD). The students demonstrate understanding of this information when they identify which as representing the bases for this disorder?
intense worry about stress about work or simple family life
when a client is experiencing panic, which is the priority intervention?
move the client to a quiet environment
a nursing role in providing client education regarding panic disorders includes which of the following? (select all that apply)
introduction of appropriate coping skills identification of alternate tx modalities involving family and support persons when appropriate providing feedback to support the client
an adolescent 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 conductive to concentration and problem solving
a client dx with panic disorder has been receiving medication therapy, which is being discontinued. a nurse would be alert for possible withdrawal symptoms if client was receiving what?
lorazepam
a client reports the client is beginning a new job and is feeling anxious about the clients performance. the nurse can explain which type of anxiety can actually improve functioning?
mild
during which type of anxiety does a persons perceptual field actually increase?
mild
the mental health nurse is gathering a health history on a new client. the client is constantly pacing the floor and is concerned only with stating that the client is about to die. the nurse would classify this level of anxiety as what?
moderate
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 should be included in a teaching plan for a client prescribed a BENZO?
rise slowly from a lying or sitting position
30 year old client who has been unemployed secondary to an anxiety disorder states that the client would like to have a job where the client is alone and no one need to evaluate the client's work. the nurse interprets these comments as an indicator of what?
social phobia
which condition involves a persistent, irrational fear attached to an object or situation that objectively does NOT pose a danger?
specific phobia
A client who has been diagnosed with panic disorder visits the clinic and experiences a panic attack. The client tells the nurse, "I'm so nervous. My hands are shaking, and I'm sweating. I feel as if I'm having a stroke right now." What would be the priority intervention at this time?
stay with the client while remaining calm
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 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 bx intervention for this type of anxiety?
systemic desensitization
all except which are considered clinical symptoms of anxiety
tearfulness and sadness
a client reports the client has been experiencing increased stress at work. the client has been managing the stress by drinking 2-3 glasses of wine per evening. despite the nurse recommending that drinking alcohol is not an effective way to manage the stress, the client reports it is unlikely that the client will be able to stop. which statement explains why this will be difficult for the client?
the client has no adaptive coping mechanisms
a nurse assess a client and determines that the client is experiencing mild anxiety based on what?
the client is aware and alert
which factor has the least influence on achieving mental health for the client who has anxiety disorder?
the client is often late to school and makes poor grades in most of the clients subjects
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."
The nurse is caring for a client diagnosed with anxiety disorder. The client is demonstrating difficulty concentrating and is preoccupied with feelings of helplessness. When creating the plan of care, which goal would be most appropriate for this client?
the client will display ability to cope with anxiety
In speaking with a client with moderate anxiety, the client becomes tangential discussing unrelated topics. To help the client's attention from wandering, which is an effective intervention?
the nurse should speak in short and simple sentences
a nurse is talking with a client who has experienced panic attacks. the client asks the nurse "what causes these attacks?" which information would the nurse most likely integrate into the response about etiology of panic disorders?
there is evidence of a substantial familial predisposition to panic disorder
after teaching a group of mental health nursing students about the care of a client experiencing a panic attack, the instructor determines that additional teaching is required when the students identify which as an appropriate intervention?
touching the client in an attempt to comfort the client
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 identifiable treatment modalities involving family for support providing supportive feedback
a group of students are reviewing info about anxiety disorders in preparation for a class exam. the students demonstrate understanding of the material when they state what?
women experience anxiety disorders more often then men do