NRS 321 Chapter 18

A nurse is conducting a group session in the behavioral health unit for three clients on the topic of anxiety. The nurse determines that the session was successful based on which statement by the clients?

"Anxiety cannot be completely eliminated from my life."

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."

The nurse is educating a client with generalized anxiety disorder about nutrition as a supporting factor in controlling the disorder. Which client statement indicates that further education is required?

"I should only drink tea or coffee and avoid cola products."

The nurse reviews techniques to enhance cognitive functioning for a client with a panic disorder. Which client statement indicates that teaching has been effective?

"I will use positive coping statements that I have prepared."

The nurse is caring for a client that begins crying uncontrollably and states, "I am so scared to be here, what if I die?" Which is the best response by the nurse?

"Let's perform some breathing exercises to reduce your anxiety."

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."

The nurse is educating a client that is experiencing mild anxiety. Which statement made by the client indicates that the education is effective?

"Some degree of anxiety is beneficial for learning."

A client diagnosed with panic disorder is being admitted to the psychiatric-mental health unit for panic attacks. Which client outcome would be appropriate in the immediate phase of care?

"The client will respond to relaxation techniques with staff assistance and demonstrate a decreased anxiety level within 2 to 3 days."

A client is participating in cognitive-behavioral therapy for symptoms of anxiety. During an episode of anxiety, the nurse assesses the effectiveness of this therapy as successful when the client makes which statement?

"This is just like before; I just need to breathe."

The client has an order for an anxiolytic agent, lorazepam (Ativan). Which of the following statements by the client would indicate that client education about this medication has been effective?

"This medication will relax me so I can focus on problem solving."

A client is currently experiencing a panic attack. Which is the most therapeutic response by the nurse?

"You are safe. Take a deep breath."

The nurse recognizes that which client is 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 client is currently experiencing panic. Which action would be most appropriate for the nurse to do?

Allow the client to pace

Panic disorder is treated with cognitive-behavioral techniques and deep breathing and relaxation, in addition to which of the following?

Antianxiety medications

Which medication classification has been found to be effective in reducing or eliminating panic attacks?

Antidepressants

A client who was discharged from the inpatient facility is sitting in the dayroom waiting for their transportation. Suddenly the client starts throwing papers and stomping their feet. Which initial action is appropriate?

Assess the use of defense mechanisms.

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

Benzodiazepines

An adult client being admitted to the psychiatric-mental health unit is experiencing severe anxiety. What is the nurse's priority action for the client?

Decrease the client's anxiety level.

Which term describes feelings of being disconnected from oneself as seen in a panic attack?

Depersonalization

Which term describes feelings of being disconnected from oneself, as seen in a panic attack?

Depersonalization

Nursing interventions that are appropriate for all clients with anxiety disorders are to reduce anxiety and ...

Develop alternative responses to anxiety-provoking situations

Nursing interventions for physical stress related illness should include what?

Establishing daily routines of meals and sleeping

A nurse is caring for an adult client diagnosed with an anxiety disorder. Which intervention(s) would be appropriate for the nurse to implement for the client? Select all that apply.

Help the client focus on deep breathing. Teach the client to use relaxation techniques. Provide a safe environment. Engage the client to explore how to decrease stressors.

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 that body responds to stress. Which is an immediate physiologic response to stress the nurse would expect to see in this client?

Increased blood pressure

A client with a blood injection injury phobia requires an intravenous (IV) catheter for fluids and medications. Which action would the nurse take to ensure for this client's safety?

Insert the IV catheter with the client in bed.

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

A client diagnosed with panic disorder has been receiving medication therapy, which is being discontinued. A nurse would be alert for possible withdrawal symptoms if the client was receiving what?

Lorazepam

A client is diagnosed with a panic disorder. Which action will the nurse take when the client arrives for an appointment in the community clinic?

Provide a list of community resources.

The nurse observes a client that is attending their first group therapy session, exhibiting anxious behaviors. Which is the priority action for the nurse to take to promote comfort when attending the session?

Remain calm when approaching and encouraging the client to attend.

When developing a plan of care for a client diagnosed with panic disorder, which nursing diagnosis would be considered the priority?

Risk for Self-Directed Violence

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?

Selective serotonin reuptake inhibitors

Which medication classification has most commonly been used to treat social phobia?

Selective serotonin reuptake inhibitors (SSRIs)

A client has been unemployed related to frequent absences due to an anxiety disorder and informs the nurse they would like to have a job working alone without someone evaluating their performance. How will the nurse interpret this comment?

Social anxiety disorder is the cause for the client's behavior.

Which condition involves a persistent, irrational fear attached to an object or situation that objectively does not pose a significant danger?

Specific phobia

A client states to the nurse, "I just can't talk in front of the group." The client begins pacing with muscles tightening and irritability. Which action by the nurse will address this level of anxiety?

Stay with the client and speak in a low, calming voice.

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 experiences panic attacks when confronted with riding in elevators. The nurse is teaching the client ways to relax while incrementally exposing the client to getting on an elevator. Which technique will the nurse employ to assist the client with overcoming the phobia?

Systematic desensitization

The nurse is creating an education plan for a client with diabetes mellitus to address the dietary modifications to manage the disease. Which characteristic identified by the nurse indicates that the client is prepared for the education?

The client has a heightened focus.

A client reports experiencing increased stress at work. The client has been managing the stress by drinking 2 or 3 glasses of wine per evening. Despite the nurse recommending that drinking alcohol is not an effective way to manage the stress, the client feels it will be difficult to stop drinking. Which statement explains why this will be difficult for the client?

The client has insufficient adaptive coping mechanisms.

A nurse assesses a client and determines that the client is experiencing mild anxiety based on what?

The client is aware and alert

The nurse is assessing clients in the behavioral health unit. For which client will the nurse identify that a prn medication should be administered to control anxiety?

The client with a high anxiety level experiencing disorganized thoughts.

The nurse is assessing a client who has panic disorder. When assessing the client's risk for suicide, the nurse should prioritize what assessment finding?

The client's history reveals social isolation for the past 2 years.

Which of the following is inconsistent with panic-level anxiety?

This level of anxiety can be sustained indefinitely.

The nurse explains the purpose of a daily goals sheet to a client experiencing moderate anxiety. Which action would the nurse implement in consideration of the client's level of anxiety?

Use short, simple terms to explain the purpose of the activity.

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

An adult client is being treated in the outpatient clinic for anxiety related to endocrine dysfunction. Which disorder will the nurse document in the client's medical record?

anxiety disorder due to another medical condition

The nurse finds a client pacing the hallway with an anxious expression. Which automatic physical assessment data would the nurse expect to see?

dilated pupils

A client with a specific phobia of spiders is seeing a therapist for the first session of treatment. The therapist hands the client a clear container with a large house spider inside. This activity is repeated continuously until the client's fear subsides. Which strategy is being used to treat the client's specific phobia?

flooding

The nurse reviews the notes for a 30-year-old female client experiencing episodes of anxiety and worry. For which condition would the nurse create a plan of care for this client?

generalized anxiety disorder

A client has been diagnosed with obsessive-compulsive personality disorder. Which finding(s) would the nurse identify as being consistent with this diagnosis? Select all that apply.

lacks the flexibility to allow for compromise preoccupied with order and perfection conscientious and highly organized

During which type of anxiety does a person's perceptual field actually increase?

mild

The nurse reviews the information documented in a client's medical record in the emergency department. Which mental health condition would the nurse anticipate planning care for this client?

panic attack

An adult client diagnosed with panic disorder is being counseled in the clinic. The nurse teaches the client that when they are experiencing severe anxiety or panic, instead of thinking, "I am going to die," the client learns to think, "This is anxiety, and it will go away." Which technique is the nurse utilizing with the client?

positive reframing

The nurse is caring for a client with a panic disorder. For which first-line medication would the nurse prepare teaching for this client?

selective serotonin reuptake inhibitors (SSRIs)

A school health nurse is seeing a child. The teacher has described this child as being self-isolating and nonparticipatory in class while their grades remain acceptable. What would the nurse suspect is occurring with this child?

social phobia

After a client has been prescribed on fluoxetine (Prozac) for a diagnosis of anxiety disorder, which of the following information should the nurse be sure to include in the client teaching?

sometimes in the first week of treatment, the client may experience heightened feelings of anxiety, but these will pass when you become accustomed to the new medication.