Test 2, 211 (Anxiety, Immunity- Anaphylaxis, Organ Transplant, HIV/ AIDS, SLE)

The nurse has completed discharge teaching for a client with an anxiety disorder. Which client statement indicates that client teaching about respiratory alkalosis has been effective? A) "I will see my counselor on a regular basis." B) "I will breathe faster when I am feeling anxious." C) "I will eat more bananas at breakfast." D) "I will not take antacids when I have heartburn."

A) "I will see my counselor on a regular basis."

For a client with obsessive-compulsive disorder with contamination obsessions, what nursing assessment is essential to development of an effective client care plan? A) Assessment for skin integrity B) Assessment for sexual activity C) Assessment for tics D) Assessment for religious beliefs

A) Assessment for skin integrity

A client states to the nurse, "I experience shortness of breath and dizziness every time I get into an elevator." Which actions by the nurse are appropriate based on this data? Select all that apply. A) Assist the client to rethink the degree of anxiety associated with elevators. B) Ask the client how he has survived in life so far with elevators. C) Instruct the client in deep breathing exercises. D) Suggest that the client should avoid elevators. E) Tell the client that elevators are completely safe.

A) Assist the client to rethink the degree of anxiety associated with elevators. C) Instruct the client in deep breathing exercises.

Which assessment findings indicate to the nurse that a client is experiencing stress? Select all that apply. A) Chewing on a fingernail B) Checking cellular phone C) Reading a magazine D) Talking with others E) Tapping foot

A) Chewing on a fingernail E) Tapping foot

A client witnessed a violent bank robbery. Which assessment findings would indicate that the client is experiencing posttraumatic stress disorder (PTSD)? Select all that apply. A) Difficulty sleeping B) Hypovigilance C) Alcohol abuse D) Aggressive behavior E) Hair pulling

A) Difficulty sleeping C) Alcohol abuse D) Aggressive behavior

When caring for a client newly diagnosed with obsessive-compulsive disorder, which action by the nurse is appropriate? A) Do not interrupt the ritual. B) Interrupt the ritual. C) Teach about antianxiety foods. D) Teach ritual interruption skills.

A) Do not interrupt the ritual.

A client worries every day about personal health and states, "I may not have enough medication if the weather takes a turn for the worse." This client is exhibiting a sign of which alteration in stress and coping? A) Generalized anxiety disorder B) Phobia C) Obsessive-compulsive disorder D) Panic disorder

A) Generalized anxiety disorder

The nurse is admitting a client suffering a panic attack to the behavioral health unit. Which clinical manifestations would indicate that the client's anxiety is at a panic level of severity? Select all that apply. A) Inability to focus B) Dilated pupils C) Feelings of doom D) Self-absorption E) Rapid speech

A) Inability to focus B) Dilated pupils C) Feelings of doom

Which is the priority nursing action when providing care to a client who demonstrates signs of escalating anxiety? A) Isolate the client in a safe, quiet, and protective environment. B) Leave the client alone in a room. C) Provide a benzodiazepine. D) Phone the physician.

A) Isolate the client in a safe, quiet, and protective environment.

A client with what level of anxiety would be most receptive to learning tools that would help the client recognize triggers? A) Mild B) Moderate C) Severe D) Panic

A) Mild

The nurse suspects a client is experiencing posttraumatic stress disorder when which are noted during the assessment process? Select all that apply. A) Observed family member being raped and murdered B) Restores antique automobiles as a hobby C) Lives with spouse and has a garden D) Has a history of anxiety disorder E) Recently terminated from employment

A) Observed family member being raped and murdered D) Has a history of anxiety disorder E) Recently terminated from employment

The client with an anxiety disorder is ready to be discharged from the unit. What should the nurse plan to teach this client and family in preparation for discharge? Select all that apply. A) Refer the client for counseling. B) Instruct the client to eat foods high in acid. C) Teach the client the signs of impending panic attack. D) Advise the client to breathe into a paper bag when feeling anxious. E) Instruct the client to breathe slowly.

A) Refer the client for counseling. C) Teach the client the signs of impending panic attack. E) Instruct the client to breathe slowly.

The nurse is instructing a client with an anxiety disorder on behavioral tools to help with coping. Which tools to help with coping should the nurse include in the teaching session? Select all that apply. A) Relaxation techniques B) Thought stopping C) Journaling D) Distraction E) Practicing yoga

A) Relaxation techniques C) Journaling E) Practicing yoga Other two are considered cognitive coping tools.

The nurse is assessing a 4-year-old child. Which assessment finding indicates to the nurse that the child might have suffered a traumatic event? A) The child refuses to talk or answer questions when previously the child chatted constantly. B) The child draws pictures of family when previously the child drew pictures of animals. C) The child complains of a stomachache and has a fever. D) The child plays quietly in a corner when previously the child sat on his mother's lap.

A) The child refuses to talk or answer questions when previously the child chatted constantly.

Which finding would indicate that treatment for a client with obsessive-compulsive disorder is effective? A) The client watches television while eating meals and engages in conversation with a roommate. B) The client conducts ritualistic hand washing every hour. C) While walking, the client counts 13 steps and then reverses the direction and repeats the process. D) The client folds and refolds clothing in a drawer before each meal.

A) The client watches television while eating meals and engages in conversation with a roommate.

A 72-year-old client presents to the clinic with complaints of restlessness, muscle tension, and increased perspiration. Her vital signs are P 112, R 23, BP 131/85, and T 97.8°F. The nurse recognizes these manifestations as signs and symptoms of moderate anxiety. However, the client reports that she does not feel anxious about anything and has never before been diagnosed with an anxiety disorder. What other factor must the nurse consider based on this client's age? A) These manifestations could instead be related to a medical illness. B) These manifestations could be related to an overdose of antianxiety medications. C) These manifestations could indicate a change in the client's cognitive functioning. D) These manifestations could be related to drug-drug interactions between selective serotonin reuptake inhibitors (SSRIs) and other medications.

A) These manifestations could instead be related to a medical illness.

A client complains about the stress of having to work long hours and missing daily exercise routines. Which response by the nurse is appropriate? A) "There are other ways to reduce stress, such as meditation." B) "Exercise helps reduce the impact of stress on the body and would be a good thing." C) "Drinking a small glass of wine each day does help reduce stress." D) "Maybe exercising, with all of the work, would be too much for your body anyway."

B) "Exercise helps reduce the impact of stress on the body and would be a good thing."

The nurse is assessing two clients: a 23-year-old man who recently returned from overseas deployment with the military and a 68-year-old man who served in the military during the Vietnam War. Both clients have been diagnosed with posttraumatic stress disorder (PTSD). Which statement did the nurse likely record from the 68-year-old man? A) "I startle at every sudden noise I hear, whether it is loud or quiet." B) "I haven't had much of an appetite lately, and I keep forgetting important things." C) "I just want to go out and hit someone." D) "I feel so guilty that I came home and three of my good buddies didn't."

B) "I haven't had much of an appetite lately, and I keep forgetting important things."

The nurse is evaluating medication teaching for a client who recently started taking fluoxetine (Prozac) for anxiety. Which statement by the client indicates appropriate understanding of the information presented? A) "My medication will take 1 week to become effective." B) "My medication will take 4 weeks to become effective." C) "My medication will become effective immediately after I start taking it." D) "My medication will not begin to work for 12 weeks."

B) "My medication will take 4 weeks to become effective."

The mother of a 12-year-old child with obsessive-compulsive disorder (OCD) tells the nurse that the child tends to get angry and throw a fit when the parents prevent him from performing compulsions in public. She tells the nurse that they don't have this problem at home because they just let him perform his rituals. The mother asks the nurse why he has these. What is the best response by the nurse? A) "It would be best if you don't take your child out in public until he can learn to control himself." B) "Rage attacks by children with OCD are often made worse if the parents accommodate the OCD behaviors." C) "The best way to prevent the rage attacks is to reinforce the OCD behaviors, especially when in public." D) "When he has rage attacks, you need to discipline him immediately and remove him from the area."

B) "Rage attacks by children with OCD are often made worse if the parents accommodate the OCD behaviors."

Which hormone is one of the primary mediators of stress? A) Glucagon B) Cortisol C) Serotonin D) Somatostatin

B) Cortisol

The nurse is concerned that a client is demonstrating signs of obsessive-compulsive disorder. Which clinical manifestations and risk factors identified during the nursing assessment caused the nurse's concern? Select all that apply. A) Not making eye contact with the nurse B) Female age 25 C) Client checking the contents of a purse several times within minutes D) Client repeating the words "third floor" E) Client asking to use the bathroom in the middle of the assessment

B) Female age 25 C) Client checking the contents of a purse several times within minutes D) Client repeating the words "third floor"

The nurse is caring for a client who was diagnosed with posttraumatic stress disorder 4 months ago. Which should the nurse include in the client's plan of care? A) Guidelines on conducting activities of daily living B) Information on the treatments available C) Referral to local employment agency D) Information on the need for adequate exercise

B) Information on the treatments available

A mother says to the nurse, "I think my teenage son is showing signs of obsessive-compulsive disorder, just like his father." Which risk factors in the client's medical history would support this diagnosis? Select all that apply. A) Lives with parents B) Male gender C) Unemployed D) History of chronic illnesses E) Family history

B) Male gender E) Family history

A client is brought to the emergency department (ED) with rapid breathing after learning of a family member being killed in a house fire. What should the nurse do first to help this client? A) Coach to slow the breathing. B) Move to a quiet, calm environment. C) Provide a sedative. D) Ask for a psychiatric consultation.

B) Move to a quiet, calm environment.

A client is admitted with a diagnosis of posttraumatic stress disorder (PTSD). During a review of the client's history, the nurse is made aware that the client suffers from depression and suicidal thoughts. While interviewing the client, the client tells the nurse he is feeling extremely irritable and that the main reason he is there is because he has been having frequent nightmares. Based on the assessment findings, which medication prescription does the nurse anticipate for this client? A) Propranolol (Inderal) B) Prazosin (Minipress) C) Risperidone (Risperdal) D) Fluvoxamine (Luvox)

B) Prazosin (Minipress)

Which nursing interventions would be appropriate for a client demonstrating extreme anxiety related to posttraumatic stress disorder (PTSD)? Select all that apply. A) Encourage the client to discuss what caused the syndrome to develop. B) Provide a calm, quiet environment. C) Give the client paperwork to complete while waiting to be assessed. D) Ask the client what is causing the anxiety. E) Reassure the client that the environment is safe.

B) Provide a calm, quiet environment. E) Reassure the client that the environment is safe.

A client, who is experiencing anxiety, is trembling and complaining of dizziness and palpitations. The client is having a hard time following the nurse's instructions. Based on this data, which level of anxiety is the client likely experiencing? A) Panic B) Severe C) Moderate D) Mild

B) Severe

The nurse is reviewing the effectiveness of care provided to a client diagnosed with posttraumatic stress disorder. Which outcomes would indicate the interventions in the plan of care have been effective? Select all that apply. A) The client takes a sedative at least four times a day. B) The client has been sleeping throughout the night. C) The client keeps all of the lights on at home. D) The client verbalizes future plans with family and friends. E) The client will not enter a car with fewer than three people.

B) The client has been sleeping throughout the night. D) The client verbalizes future plans with family and friends.

A client diagnosed with obsessive-compulsive disorder (OCD) is being admitted as an inpatient. The client is obsessed with thoughts of symmetry. Which compulsive behaviors does the nurse anticipate when performing the admission assessment? Select all that apply. A) The client repeatedly washes his hands. B) The client repeatedly taps both wrists on the bedside table. C) The client avoids shaking the nurse's hand D) The client begins counting the floor tiles. E) The client repeatedly cleans the top of the bedside table.

B) The client repeatedly taps both wrists on the bedside table. D) The client begins counting the floor tiles.

During the assessment, the nurse observes a client who was a victim of a home invasion abruptly stand up and begin to run out of the room in response to hearing a loud bang. Which should the nurse assume regarding the client's behavior? A) The client thought there was an earthquake. B) The client was reacting to the loud noise as a form of a flashback. C) The client wanted to check the cause of the loud noise. D) The client thought the assessment was concluded.

B) The client was reacting to the loud noise as a form of a flashback.

A nurse is providing care to a woman who recently got married and would like to try to become pregnant. The woman has been on an antianxiety medication, paroxetine (Paxil), for the past year. The woman feels that she needs to continue receiving treatment for anxiety, especially if she gets pregnant. What information should the nurse provide regarding treatment options during pregnancy? A) The woman should consider switching to a different SSRI such as fluoxetine (Prozac). B) The woman should consider switching to cognitive-behavioral therapy (CBT) rather than medication. C) The woman should consider stopping all medications immediately. D) The woman should consider gradually decreasing medication until she finds out she is pregnant.

B) The woman should consider switching to cognitive-behavioral therapy (CBT) rather than medication.

A 68-year-old female client was recently diagnosed with depression and subclinical obsessive-compulsive symptoms. What does the nurse need to consider when planning care for this client? A) This client will not need treatment for the OCD symptoms because they are subclinical. B) This client may take longer to meet goals than a younger client with similar symptoms. C) This client will need to be assessed frequently for signs of dementia. D) This client may need a higher dose of medication than a younger client.

B) This client may take longer to meet goals than a younger client with similar symptoms.

What important fact should the nurse relay to the young adult who was just diagnosed with obsessive-compulsive disorder? A) Not acting on compulsions is the best cure. B) Treatment is essential to remission. C) Recognizing the obsessions as false will lessen their impact. D) The disorder will gradually get better over time.

B) Treatment is essential to remission.

The most common disorder that increases a client's risk for respiratory alkalosis is: A) a respiratory disorder. B) an anxiety disorder. C) a cardiovascular disorder. D) a congenital disorder.

B) an anxiety disorder.

A nurse on the behavioral health unit is leading a group regarding risk factors for anxiety. At the completion of group work, which comment made by a client would indicate the need for further teaching? A) "A lack of social interaction places me at risk for anxiety." B) "My personality could place me at risk for anxiety because I am shy." C) "Chronic illness is not a risk factor unless I am also unemployed." D) "I experienced a traumatic event that placed me at risk for having this anxiety disorder."

C) "Chronic illness is not a risk factor unless I am also unemployed."

A nurse is evaluating the plan of care for a client diagnosed with obsessive-compulsive disorder (OCD). Which client statement indicates a positive outcome for the plan of care? A) "Instead of washing my hands several times a day I use hand sanitizer several times a day." B) "I am still hand washing frequently, and even though it is less than before I am a failure." C) "I am still hand washing frequently but it is less often than before. I think I am improving." D) "I don't know why I can't wash my hands several times a day; I have nothing else to do anyway."

C) "I am still hand washing frequently but it is less often than before. I think I am improving."

A nurse is providing discharge instructions to a client recently diagnosed with obsessive-compulsive disorder (OCD) and prescribed fluvoxamine (Luvox). Which statement made by the client indicates to the nurse that the client understands the instructions? A) "I am glad the physician chose this medication because it does not have any side effects." B) "I should continue taking this medication and in 1-2 years I can stop taking it." C) "I should continue taking this medication and in 1-2 years my physician may taper me off gradually." D) "Even though I don't think this medication is for my OCD, I will take it because the physician wants me to."

C) "I should continue taking this medication and in 1-2 years my physician may taper me off gradually."

The nurse is discharging a client diagnosed with general anxiety disorder (GAD). The client is prescribed a selective serotonin reuptake inhibitor (SSRI). Which statement made by the client would indicate to the nurse a need for further education? A) "This medicine could make me feel like I have the jitters." B) "I may experience some nausea while on this medication." C) "My doctor will start me off on a high dose and then decrease the dose." D) "This medicine alters the levels of the neurotransmitter serotonin in the brain."

C) "My doctor will start me off on a high dose and then decrease the dose."

A malfunction in what system is thought to contribute to the development of obsessive-compulsive disorder? A) Frontal-subcortical circuit B) Hypothalamic-pituitary-adrenal axis C) Cortico-striato-thalamo-cortical circuit D) Microbiome-gut-brain axis

C) Cortico-striato-thalamo-cortical circuit

A client tells a nurse that he believes he has an anxiety disorder because his mom and sister both have anxiety disorders. The nurse recognizes that the client believes in which theory related to the etiology of anxiety disorders? A) Neurochemical theories B) Neurobiological theories C) Genetic theories D) Humanistic theories

C) Genetic theories

A nurse on the behavioral health unit is caring for a client diagnosed with depression who just lost a spouse in a motor vehicle crash. The client states to the nurse, "My wife would not have wanted to live if she were disabled." Based on this statement, which defense mechanism is the client using? A) Identification B) Denial C) Intellectualization D) Displacement

C) Intellectualization

A client, who was recently laid off from work, is scheduled for a biopsy to evaluate a site for malignancy. When planning this client's care, which does the nurse include? A) Reasons to delay the biopsy B) Medicate around the clock for pain C) Interventions to address anxiety D) Social services to aid with financial planning

C) Interventions to address anxiety

Free-floating anxiety is often connected to what stimulus? A) Elevators B) Airplanes C) No specific stimulus D) Water

C) No specific stimulus

A client tells the nurse about continually reliving a situation of being robbed and shot by a gunman. Which nursing diagnosis is the priority for this client? A) Fear B) Anxiety C) Post-Trauma Syndrome D) Ineffective Coping

C) Post-Trauma Syndrome

The nurse is caring for the client with a history of anxiety who is experiencing chest pain, palpitations, and dyspnea. Which intervention would be a priority for this client? A) Providing educational material for the client's medical diagnosis B) Ordering a regular diet for the client C) Reassuring the client that symptoms will resolve D) Asking Respiratory Therapy to set up a mechanical ventilator

C) Reassuring the client that symptoms will resolve

The client is admitted to the emergency department (ED) with symptoms of a panic attack, including hyperventilation. Based on this data, the nurse plans care for which health problem? A) Hypoventilation B) Vomiting C) Respiratory alkalosis D) Memory loss

C) Respiratory alkalosis

A client is prescribed fluoxetine (Prozac) for treatment of obsessive-compulsive disorder. During the latest office visit, the client washes the hands while counting to 10 and repeats the process every 5 minutes. Which is the priority assessment for the nurse to complete for this client? A) The amount of medication the client is taking B) Side effects from the medication the client is experiencing C) Whether the client is taking the medication as prescribed D) Foods that may be interacting with the client's medication

C) Whether the client is taking the medication as prescribed

Which instruction by the nurse to a client prescribed diazepam (Valium) for anxiety and stress is appropriate? A) "This medication will be good to take for a long time." B) "Take this medication every time feelings of stress become overwhelming." C) "This medication works best if taken with a meal." D) "This medication is good to use for the short term only."

D) "This medication is good to use for the short term only."

A client states, "I haven't left my house for 6 years." Based on this data, which diagnosis does the nurse anticipate for this client? A) Hematophobia B) Social anxiety disorder C) Pathophobia D) Agoraphobia

D) Agoraphobia

The nurse is providing care to a client who is diagnosed with obsessive-compulsive disorder. Which nursing intervention is most appropriate when providing care to this client? A) Confront the client and ask what purpose the behavior serves. B) Tell the client that the behavior is unacceptable and must end. C) Interrupt the ritualistic behavior when observed. D) Discuss the need to incorporate the behavior with other hospital routines.

D) Discuss the need to incorporate the behavior with other hospital routines.

Which form of therapy might be used to help an individual with posttraumatic stress disorder (PTSD) visit the location where a traumatic event occurred? A) Cognitive-behavioral therapy B) Dual attention stimulus therapy C) EMDR therapy D) Exposure therapy

D) Exposure therapy

Which individual has the highest risk of developing PTSD? A) Victim of assault B) Natural disaster survivor C) Motor vehicle crash survivor D) Military veteran

D) Military veteran

A nurse is developing a plan of care for a client diagnosed with posttraumatic stress disorder (PTSD) who was admitted to the hospital for suicidal ideations and sleep disturbance due to frequent nightmares. Which is the priority nursing diagnosis for this client? A) Disturbed Sleep Pattern B) Post-Trauma Syndrome C) Risk for Other-Directed Violence D) Risk for Self-Directed Violence

D) Risk for Self-Directed Violence

A nurse is developing a plan of care for a client diagnosed with posttraumatic stress disorder (PTSD). The client was recently admitted to the hospital for suicidal ideations and sleep disturbance due to frequent nightmares. Which is the priority goal to include in the client's plan of care? A) The client will report a reduction in or cessation of nightmares. B) The client will report a decreased perception of anxiety. C) The client will discuss emotions related to traumatic experiences. D) The client will remain free from injury or harm.

D) The client will remain free from injury or harm.

The home care nurse observes a client scrubbing areas throughout the house over and over, especially areas where the family gathers. Prior to planning care for this client, which must the nurse assess? A) If the client is forgetful B) If the client does not clean thoroughly C) How frequently the client cleans the house D) The impact of symptoms on the family system

D) The impact of symptoms on the family system

. A patient had five emergency room visits in the past month and reports, "I feel so nervous. I think I'm having heart attacks." The patient is diagnosed with panic attacks. Which comment by the nurse shows understanding of treatment for panic attacks? a. "Selective serotonin reuptake inhibitors (SSRIs) are often helpful for long-term treatment and prevention of panic attacks." b. "Benzodiazepine tranquilizers are therapeutic for long-term treatment and prevention of panic attacks." c. "No medications are particularly helpful for panic attacks. Let's work on some strategies to help you manage your fears." d. "Panic attacks result from an instability of the neurotransmitter acetylcholine. Meditation will be more helpful than drugs."

a. "Selective serotonin reuptake inhibitors (SSRIs) are often helpful for long-term treatment and prevention of panic attacks."

A patient who has been taking a benzodiazepine for panic attacks is to be started on buspirone. Which instruction should the nurse provide? a. "Take decreasing doses of the benzodiazepine for several days until the buspirone becomes effective." b. "Stop taking the benzodiazepines immediately. Wait 2 days, and then start the buspirone." c. "You should take buspirone only once a day. More frequent dosing can cause dependency." d. "Tolerance to buspirone may develop in about a month, requiring larger doses to be prescribed

a. "Take decreasing doses of the benzodiazepine for several days until the buspirone becomes effective."

A patient takes a psychotropic medication that affects serotonin receptors. The patient complains of anxiety, insomnia, and loss of appetite. What effect is the drug having on the serotonin receptors? a. Activation b. Antagonism c. Paradoxical d. Inhibition

a. Activation

What is the nurse's initial action when working with a patient with diagnosed with posttraumatic stress disorder (PTSD)? a. Assure the patient that the nurse can be trusted. b. Work with the patient to find a way to reduce stress. c. Encourage verbalization rather than physical acts to address anger. d. Support the patient's ability to evaluate past behaviors as either effective or noneffective.

a. Assure the patient that the nurse can be trusted.

A patient has taken clonazepam for years to manage panic attacks but impulsively stopped the drug. Thirty hours later, the patient comes to the emergency room in distress. What is the nurse's priority action? a. Begin seizure precautions. b. Refer the patient for addiction counseling. c. Institute a behavior modification program. d. Prepare to administer flumazenil.

a. Begin seizure precautions.

After a mass transit disaster many injured patients are expected at the emergency room. The nurse prepares to plan interventions for which likely mental health assessment findings? a. Dissociative symptoms, numbing, detachment, and derealization b. Auditory hallucinations and other perceptual distortions including paranoia c. Somatic neurologic disorders and amnesia d. Exaggerated mood including both depression and manic-related elation

a. Dissociative symptoms, numbing, detachment, and derealization

An adult recently diagnosed with a mental illness is hospitalized with pneumonia. The patient and family are very anxious. What outcome should the nurse add to the plan of care for this family to meet their immediate needs? a. Identify and describe effective coping methods. b. Describe the stages of the anticipatory grieving process. c. Recognize the ways dysfunctional communication is expressed in the family. d. Examine previously unexpressed feelings related to the patient's sexuality

a. Identify and describe effective coping methods.

. A patient is hospitalized with somatic blindness. The patient is unconcerned about the blindness and says, "I'm sure things will turn out all right." Which term best describes this reaction? a. La belle indifference b. Trance c. Dissociation d. Fugue

a. La belle indifference

A patient who experiences frequent panic attacks asks the nurse, "Why does this happen to me?" The nurse should explain that the problem might relate to a deficit of which brain chemical? a. Noradrenaline b. Serotonin c. Dopamine d. Glutamate

a. Noradrenaline

1. A patient diagnosed with posttraumatic stress disorder (PTSD) has frequent flashbacks and persistent hyperarousal symptoms. Which nursing interventions should be planned to effectively need the patient's needs? (Select all that apply.) a. Offer empathy and support. b. Encourage relaxation activities. c. Encourage verbalization of anger. d. Set limits when the patient begins to tell of the story of the traumatic incident. e. Help the patient associate current feelings and behaviors with trauma experience.

a. Offer empathy and support. b. Encourage relaxation activities. c. Encourage verbalization of anger. e. Help the patient associate current feelings and behaviors with trauma experience.

. The nurse administers a medication that potentiates the action of noradrenaline. Which finding would be expected? a. Reduced anxiety b. Improved memory c. More organized thinking d. Fewer sensory perceptual alterations

a. Reduced anxiety

A patient diagnosed with social phobia begins propranolol. The nurse should teach the patient to expect what reaction to this therapy? a. Sympathetic nervous system symptoms of anxiety will be reduced. b. A sense of euphoria for 30 minutes after taking the drug. c. Experience amnesia for the social situations that are most intimidating. d. Feeling a little drowsy but having no orthostatic hypotension.

a. Sympathetic nervous system symptoms of anxiety will be reduced.

When a nurse uses the interpersonal model as a basis for practice, which goal is most appropriate for the patient care plan? a. The patient will develop mature, satisfying relationships that are relatively free of anxiety. b. The patient will rid himself of irrational beliefs, including "shoulds," "oughts," and "musts." c. The patient will learn to meet basic needs responsibly. d. The patient will manage stress adaptively.

a. The patient will develop mature, satisfying relationships that are relatively free of anxiety.

A patient tells the nurse, "I was raped a month ago. Since then I've felt anxious and have been unable to talk normally to my husband. I've had frequent thoughts about cutting my wrists." What is the priority nursing concern regarding this patient? a. The risk for self-directed violence b. The development of rape traumatic syndrome c. The damage that could result in poor self-esteem d. The demonstration of signs and symptoms of acute anxiety

a. The risk for self-directed violence

Which statement by a patient diagnosed with somatic symptom disorder indicates that goals for treatment are being achieved? a. "I need to be very careful about what I eat." b. "I can focus on things other than my symptoms." c. "I understand that my doctor is not an expert in everything." d. "I try to figure out my diagnosis by reading articles on the Internet."

b. "I can focus on things other than my symptoms."

Which statement demonstrates a nurse's understanding of the first intervention when caring for a patient experiencing severe anxiety over an impending divorce? a. "Let me you solve the biggest problem the divorce will cause you." b. "I want you know I'll be here to keep you safe." c. "Please tell me what today's date is." d. "You can go into your room and close the door when you need privacy."

b. "I want you know I'll be here to keep you safe."

A patient seeking treatment for anxiety says, "I can't think. My job depends on my ability to think. I need medicine, but the drugs I took a few years ago made me too sleepy. I could lose my job." What information is most important for the nurse to consider when formulating a response? a. All antianxiety medication has sedating properties. b. Buspirone alleviates anxiety without sedation or cognitive clouding. c. The patient's description of anxiety does not warrant treatment with medication. d. The patient may be trying to manipulate the nurse to assist with getting the desired prescription.

b. Buspirone alleviates anxiety without sedation or cognitive clouding.

The nurse is assigned to care for a patient with moderate anxiety (+2). Which intervention will best manage the patient's signs and symptoms? a. Appropriate use of time-out b. Initiating problem-solving techniques c. Planning care to include firm guidance and control d. Assessing the need for a parenteral antianxiety drug

b. Initiating problem-solving techniques

Which patient would benefit most from closed, process-oriented group therapy? a. Adult with disorganized schizophrenia admitted to an acute psychiatric unit b. Outpatient living independently with chronic low self-esteem and anxiety c. Patient receiving treatment in an assertive community treatment program d. Resident of a group home attending a partial hospitalization program

b. Outpatient living independently with chronic low self-esteem and anxiety

A nurse is assigned to care for a patient diagnosed with moderate (+2) anxiety. Which assessment findings are most likely? a. Distorted perceptions, disorientation, and defensiveness b. Poor concentration, narrow perceptions, and irritability c. Irrational reasoning and loss of contact with reality d. Alertness, attentiveness, and accurate perceptions

b. Poor concentration, narrow perceptions, and irritability

When interacting with patients, it is important for the nurse to recognize that defense mechanisms are used for what outcome? a. Keep id impulses from gaining control. b. Protect the ego from excessive anxiety. c. Access unconscious feelings and memories. d. Prevent conflict among the id, ego, and superego.

b. Protect the ego from excessive anxiety.

A patient diagnosed with obsessive-compulsive disorder (OCD) experiences improvement after beginning treatment with a selective serotonin reuptake inhibitor (SSRI). This phenomenon supports the theory that OCD is associated with what neurotransmitter issue? a. Norepinephrine deficiency b. Serotonin dysregulation c. Dopamine excess d. GABA deficiency

b. Serotonin dysregulation

A patient started diazepam 5 mg twice daily 6 months ago. Now, the patient requires 10 mg to achieve the same effect. What phenomenon is responsible for this situation? a. Addiction b. Tolerance c. Dependence d. Disinhibition

b. Tolerance

What medication information should the nurse provide the patient newly prescribed buspirone? a. Produces profound sedation. b. Will be effective in 7 to 10 days. c. Has a high risk for development of dependence. d. Is often associated with cross-tolerance with other CNS depressants.

b. Will be effective in 7 to 10 days.

If a patient's threshold set point for anxiety is lowered, the nurse can expect subsequent stressors to: a. have a lesser effect. b. easily reactivate the anxiety response. c. produce marked personality disorganization. d. be easily managed using familiar coping strategies

b. easily reactivate the anxiety response.

A patient has taken diazepam for 1 week for back spasms. The patient reports "feeling sleepy all the time." Which response will best address the patient's concern? a. "The dosage probably needs to be decreased." b. "Drowsiness indicates a paradoxical reaction to the drug." c. "Tolerance to the sedative effect of the drug will develop quickly." d. "Sleepiness is an unavoidable side effect of nonbenzodiazepine drugs."

c. "Tolerance to the sedative effect of the drug will develop quickly."

What is the most prevalent psychopathologic condition diagnosed in the United States? a. Schizophrenia b. Mood disorder c. Anxiety disorder d. Alcohol dependency

c. Anxiety disorder

Which patient behavior should the nurse identify as the greatest risk for overdose with a benzodiazepine? a. Taking the drug with antacids b. Taking the drug before meals c. Combining the drug with alcohol d. Experiencing depression as well as anxiety

c. Combining the drug with alcohol

Which principle best applies to care of a patient diagnosed with conversion disorder? a. Structure care to provide time for rituals. b. Facilitate progressive review of the trauma. c. Give attention to the patient, not the symptom. d. Permit dependence while the symptoms are acute

c. Give attention to the patient, not the symptom.

1. A soldier was diagnosed with posttraumatic stress disorder (PTSD). The soldier's spouse reports that when a telephone rings during the night, the soldier rolls out of bed and assumes an aggressive stance. How will the nurse document this finding? a. Flashback b. Avoidance c. Hyperarousal d. Re-experiencing

c. Hyperarousal

When working with a patient diagnosed with dissociative amnesia, the nurse should begin the care by implementing which intervention? a. Setting mutual goals for behavioral changes b. Instituting measures to prevent identity diffusion c. Identifying and supporting the patient's strengths d. Helping the patient develop a realistic self-concept

c. Identifying and supporting the patient's strengths

A patient diagnosed with agoraphobia took alprazolam 0.5 mg three times daily for 3 months and then discontinued it. The next day the patient called the nurse reporting insomnia, shakiness, and sweating. What should be the focus of the nurse's assessment questions? a. Whether the patient may have also been drinking alcohol or taking antihistamines. b. The possibility that the patient has built up tolerance to alprazolam and needs an increased dose. c. The likelihood that the patient is having withdrawal symptoms from abrupt discontinuation of the drug. d. Whether the patient has progressed to panic attacks and needs a nonbenzodiazepine medication.

c. The likelihood that the patient is having withdrawal symptoms from abrupt discontinuation of the drug.

A patient's family member died in the 9/11 World Trade Center explosion. The patient says, "I can't go into tall buildings because I get sweaty, my heart races, and I can't breathe. I get terrifying feelings the building will explode." Which response demonstrates the nurse's understanding of this symptoms/signs? a. "What rituals do you preform to control your anxiety?" b. "Have you ever been diagnosed with generalized anxiety disorder (GAD)?" c. "Your symptoms/signs suggest possible acute stress disorder (ASD)." d. "It appears you are experiencing a specific phobia associated with your family's tragedy."

d. "It appears you are experiencing a specific phobia associated with your family's tragedy."

Which statement made by an individual diagnosed with PTSD best indicates that treatment was effective? a. "I'm drinking less now that I've faced my problems." b. "I feel like the accident happened to someone else." c. "I sleep for 3 to 4 hours a night without nightmares." d. "My artwork distracts me and eases my anxiety."

d. "My artwork distracts me and eases my anxiety."

A patient states, "I have the same thoughts over and over. I feel compelled to count all my footsteps." The nurse can expect the health care provider to prescribe what medication? a. Alprazolam b. Propranolol c. Clonazepam d. Clomipramine

d. Clomipramine

9. Which term describes the final stage in the normal process of anxiety? a. Panic b. Crisis c. Disorganization d. Coping

d. Coping

A patient is demonstrating severe (+3) anxiety. Nursing interventions should center around which patient need? a. Encouraging ventilation and refocusing attention b. Discussing possible sources of anxiety c. Taking control to guide the patient d. Decreasing stimuli and pressure

d. Decreasing stimuli and pressure

The patient is tense, hypervigilant, and reports, "My heart is racing." The nurse understands that the client is experiencing what sympathetic nervous system reaction? a. Hypothalamic-pituitary-adrenal axis b. Split-brain syndrome c. Blood brain barrier d. Fight or flight

d. Fight or flight

A patient diagnosed with panic attacks frequently awakens from sleep and is diaphoretic and hyperventilating. What instruction should the nurse provide the patient to help manage this situation in the future? a. Immediately use one of the various relaxation techniques they've learned. b. Immediately use the call bell to alert staff of the panic attack. c. Get out of bed immediately and watch television as a distraction. d. Immediately breathe into a paper bag kept in the nightstand.

d. Immediately breathe into a paper bag kept in the nightstand.

A patient says, "I have the same continuous and intrusive thoughts that my house is contaminated with lethal bacteria. I spend hours cleaning the walls, floors, and furniture." These symptoms are most consistent with which diagnosis? a. Social phobia b. Panic disorder c. Somatoform disorder d. Obsessive compulsive disorder (OCD)

d. Obsessive compulsive disorder (OCD)

A patient diagnosed with obsessive-compulsive disorder (OCD) paces up and down the corridor counting every floor tile. How should the nurse address the patient's behavior? a. Offer to play cards with the patient in the dayroom as a distraction. b. Encourage the patient to focus by asking, "Why are you pacing and counting?" c. Interrupt the behavior by taking the patient's arm and escort the patient to a quiet area. d. Permit the patient to pace and count while monitoring for safety

d. Permit the patient to pace and count while monitoring for safety

A driver was trapped in a car for several hours after an earthquake caused a bridge to collapse. A year later this person still has nightmares and re-experiences feelings of fear associated with being trapped in the car. The assessment findings are consistent with symptoms of which mental health diagnosis? a. Agoraphobia b. Panic attacks c. Generalized anxiety disorder (GAD) d. Posttraumatic stress disorder (PTSD)

d. Posttraumatic stress disorder (PTSD)

By what mechanism does lorazepam reduce anxiety? a. Increasing serotonin levels b. Blocking dopamine receptors c. Depressing norepinephrine levels d. Potentiating gamma-aminobutyric acid (GABA)

d. Potentiating gamma-aminobutyric acid (GABA)

An emergency room patient was very anxious after a serious car accident. Lorazepam 2 mg intramuscularly was administered. One hour later, which finding indicates to the nurse that the medication was effective? a. Improved problem-solving skills b. Increased alertness c. Increased verbalization d. Reduced environmental scanning

d. Reduced environmental scanning