Mental Health

The nurse is assisting with the development of a plan of care for a client with generalized anxiety disorder (GAD). Which intervention is important to include?

Encourage the client to use a diary to record when anxiety occurred, its cause, and which interventions may have helped.

The nurse is caring for a client with posttraumatic stress disorder (PTSD) and the family informs the nurse that loud noises cause a serious anxiety response. Which explanation by the nurse would help the family understand the client's response?

Environmental triggers can cause the client to react emotionally."

A 49-year-old painter who recently fractured his tibia worries about his finances because he can't work. To treat his anxiety, his physician prescribes buspirone, 5 mg by mouth three times per day. During buspirone therapy, the client should avoid which of the following drugs?

Monoamine oxidase (MAO) inhibitors

A client reports having a difficult time settling down for sleep in the evening. What nursing intervention would assist the client in achieving a positive outcome?

Reinforce progressive muscle relaxation.

Parents of an adolescent are concerned that their child has been irritable, hasn't been sleeping for 6 months, and is not engaging in social activities. Which outcome developed by the health care team would be appropriate for this client?

The client will obtain appropriate mental health services.

The nurse educator is discussing a case regarding a client with obsessive-compulsive disorder who tells the nurse that he or she must check the lock on his or her apartment door 25 times before leaving for an appointment. The nurse educator includes which information about what this behavior represents?

The client's attempt to reduce anxiety

Lorazepam is often given along with a neuroleptic agent, such as haloperidol. What is the purpose of administering the drugs together?

To reduce anxiety and potentiate the sedative action of the neuroleptic

A nurse is assisting with discharge instructions for a client who is prescribed sertraline. The nurse should monitor the client for which adverse drug effects? Select all that apply.

agitation sleep disturbance dry mouth

A client is admitted for abrupt onset of paralysis in the left arm. Although no physiologic cause has been found, the symptoms are exacerbated when the client speaks about losing custody of children in a recent divorce. The nurse determines these findings are characteristic of what disorder?

functional neurologic symptom disorder

The nurse is assigned to reinforce insulin administration education for a client with diabetes who is anxious. During which stage should the nurse reinforce education for the client?

mild stage of anxiety

Which reason best accounts for the physical symptoms in a client with a somatic symptom disorder?

to prevent or relieve symptoms of anxiety

A nurse is reinforcing education for a client who has been prescribed buspirone for long-term treatment of anxiety. The nurse determines that the education has been effective when which statement is made by the client?

"I will not take the medicine with grapefruit juice."

A client undergoing treatment for an anxiety disorder is being cared for by a nursing student. The nursing faculty asks the student When is such a disorder considered chronic and generalized? What timeframe does the student provide about the existence of the client's "excessive anxiety and worry about two or more life circumstances"?

6 months

The nurse notices that a client with obsessive-compulsive disorder washes his or her hands for long periods each day. What nursing intervention should the nurse implement in response to this compulsive behavior?

Designate times during which the client can focus on the behavior

A client admitted to the psychiatric unit for treatment of repeated panic attacks comes to the nurses' station in obvious distress. After observing that the client is short of breath, dizzy, trembling, and nauseated, which action should the nurse first implement?

Escort the client to a quiet area and suggest using a relaxation exercise that he or she has been taught.

The nurse is reinforcing education for a client with generalized anxiety disorder (GAD). What statement made by the client indicates the education has been understood by the client?

I've stopped drinking so much diet cola."

A client, age 40, is admitted for a surgical biopsy of a suspicious lump in her left breast. When the nurse comes to take her to surgery, she is tearfully finishing a letter to her two children. She tells the nurse, "I want to leave this for my children in case anything goes wrong today." Which response by the nurse would be most therapeutic?

In case anything goes wrong? What are your thoughts and feelings right now?

A client is diagnosed with illness anxiety disorder. When assisting with the plan of care, which intervention should be included?

Teach the client adaptive coping strategies.

A woman, age 18, is highly dependent on her parents and fears leaving home to go away to college. Shortly before the fall semester starts, she complains that her legs are paralyzed and is rushed to the emergency department. When physical examination rules out a physical cause for her paralysis, the physician admits her to the psychiatric unit where she is diagnosed with functional neurologic symptom disorder. The client asks the nurse, "Why has this happened to me?" What is the most appropriate response?

Your problem is real but there is no physical basis for it. We'll work on what is going on in your life to find out why it's happened."

The nurse is caring for a client who is agitated and is trying to get out of bed. What should the nurse do first to keep the client free of injury?

Ask the unlicensed assistive personnel to sit with the client.