Psychiatric and Mental Health Nursing - Anxiety Disorders
When performing a physical examination on an anxious client, a nurse should expect to find which effect produced by the parasympathetic nervous system? hyperactive bowel sounds decreased urine output constipation muscle tension
hyperactive bowel sounds The parasympathetic nervous system would produce increased GI motility, resulting in hyperactive bowel sounds, possibly leading to diarrhea. Decreased urine output, constipation, and muscle tension would result from sympathetic nervous system stimulation.
A client with obsessive-compulsive disorder reveals that he was late for his appointment "because of my dumb habit. I have to take off my socks and put them back on 41 times! I can't stop until I do it just right." The nurse interprets the client's behavior as most likely representing which factor? relief from anxiety. control of his thoughts. attention from others. safe expression of hostility.
relief from anxiety.
A client with an anxiety disorder is admitted to the psychiatric unit because of panic attacks. What statement by the nurse is the most appropriate? "I will wait to ask you any questions until you feel a little more comfortable on the unit." "I want to help you feel better, please come and talk with me when you are ready." "I am going to ask you some questions to help me understand the anxiety you are experiencing." "When you start feeling anxious, I will ask you some simple questions to better understand what you are going through."
"I am going to ask you some questions to help me understand the anxiety you are experiencing."
A nurse notices that a client with obsessive-compulsive disorder dresses and undresses several times each day. Which comment by the nurse would be most therapeutic? "I saw you change clothes several times today. Do you find this tiring?" "It might be helpful if you dress only once per day so you will not be so tired." "It must really bother you to change your clothes so often. How can I help?" "I see that you are a perfectionist about the clothes you wear."
"I saw you change clothes several times today. Do you find this tiring?"
The nurse has completed teaching a client about alprazolam. Which statement by the client will the nurse document as evidence of successful teaching? "This medication carries a risk of dependence." "I won't become addicted if I take it as prescribed." "I should drive carefully until I know whether this causes dizziness." "I should take it at bedtime to feel calm in the morning."
"This medication carries a risk of dependence."
A client describes anxiety attacks that usually occur shortly after work when he is preparing his evening meal. Which question would be most appropriate for the nurse to ask the client first in an effort to learn how he can be helped? "Have you tried walking to ease your anxiety?" "What are you thinking about before you start to prepare supper?" "Do you think taking several slow, deep breaths would help?" "What do you do when you're anxious to help yourself feel better?"
"What are you thinking about before you start to prepare supper?"
A client is a military soldier who returned home from a 1-month tour of relief duty following a natural disaster. The client is exhibiting symptoms of insomnia, irritability, and anxiety. The client tells the nurse, "I just can't get the sight of those dead bodies out of my head. When I was at the disaster, I tried not to think about what I was doing; now I think about it all the time." Which assessment question would be most relevant for this client? "How did you cope with the stress while you were there?" "Do you know when you will be deployed again?" "What more can you tell me about what is happening now?" "How many years have you been in the military?"
"What more can you tell me about what is happening now?"
A nurse is caring for a client diagnosed with panic disorder. The client begins to hyperventilate. How should the nurse respond initially? Stay with the client during the anxiety attack. Teach the client to use cognitive restructuring techniques. Teach the client to perform relaxation exercises. Help the client to focus on deep breathing.
Stay with the client during the anxiety attack.
A nurse is formulating a short-term goal for a client suffering from a severe obsessive-compulsive disorder (OCD). The nurse documents what short-term goal as appropriate for a 1-week time frame? The client will stop performing all rituals. The client will participate in a daily exercise group. The client will identify three underlying reasons for the rituals. The client will verbalize that the rituals are irrational.
The client will participate in a daily exercise group.
An 18-year-old pregnant college student presented at the prenatal clinic for an initial visit at 14 weeks' gestation. The client's history revealed that she has taken fluoxetine 20 mg orally daily for posttraumatic stress disorder (PTSD) and depression. Her medication was recently increased to 40 mg daily because of reports of increased stress and suicide ideation. Which side effect of fluoxetine would the nurse judge to be the greatest risk for the client and her developing fetus at this stage in her pregnancy? insomnia nausea/anorexia headache decreased libido
nausea/anorexia
A client reports that before he leaves home to go anywhere, he counts the money in his wallet as many as 12 times. The nurse judges this behavior to indicate which client need? the need to channel excessive sexual energy into an appropriate habit the need to compensate for not having had enough money to spend as a child the need to avoid the embarrassment of having a shortage of funds on hand the need to channel emotions unacceptable to him with an acceptable activity
the need to channel emotions unacceptable to him with an acceptable activity
A client takes diazepam while establishing a therapeutic dose of antidepressants for generalized anxiety disorder. Which instruction should the nurse give to this client? Select all that apply. to consult with his health care provider before he stops taking the drug to avoid eating cheese and other tyramine-rich foods to take the medication on an empty stomach not to use alcohol while taking the drug to stop taking the drug if he experiences swelling of the lips and face and difficulty breathing
to consult with his health care provider before he stops taking the drug not to use alcohol while taking the drug to stop taking the drug if he experiences swelling of the lips and face and difficulty breathing
A new nurse asks the charge nurse why the client with body dysmorphic disorder is always looking at their nose in the mirror. Which of the following would be an appropriate response? "Clients with body dysmorphic disorder are encouraged to face their fears by focusing on their appearance." "Clients with body dysmorphic disorder use repetitive compulsions to reduce their anxiety." "Clients with body dysmorphic disorder are preoccupied with perceived defects in their appearance." "Clients with body dysmorphic disorder focus on their appearance to have a feeling of control."
"Clients with body dysmorphic disorder are preoccupied with perceived defects in their appearance."
A young school-age girl whose mother and aunt have been diagnosed as having bipolar disorder and whose father is diagnosed with depression is brought to the clinic because of problems with behavior and attention in school and inability to sleep at night. The child says, "My brain does not turn off at night." The child is diagnosed as experiencing attention deficit hyperactivity disorder (ADHD) with a possibility of bipolar disorder as well. What should the nurse say to the father to explain what the provider said? Select all that apply. "Your child was diagnosed as having ADHD because of her attention and behavior problems at school." "ADHD involves difficulty with attention, impulse control, and hyperactivity at school, home, or in both settings." "Your provider does not know how to diagnose your child's illness since she has symptoms of both bipolar disorder and ADHD." "The child's description of her inability to sleep is irrelevant to diagnosing her condition since she stays up late." "Your provider is considering a bipolar diagnosis because of your child's family history of bipolar disorder and her sleep issues."
"Your child was diagnosed as having ADHD because of her attention and behavior problems at school." "ADHD involves difficulty with attention, impulse control, and hyperactivity at school, home, or in both settings." "Your provider is considering a bipolar diagnosis because of your child's family history of bipolar disorder and her sleep issues."
