PN120 PrepU Chapter 14
A nurse is caring for a client who has panic attack. The nurse takes the client in a small, isolated room. How would this intervention benefit the client? Choose the best answer.
The client would have an enhanced sense of security.
The overall goals of care for individuals experiencing a stress response are to focus on interventions to develop ...
positive coping skills.
A biologic theory explains anxiety disorders in which way?
Based in genetics with clinical symptoms being a result of chromosomal influence
Which level of anxiety helps the client focus the client's attention to learn, problem solve, think, act, feel, and protect himself or herself?
Mild
Which statement, made by a client diagnosed with an anxiety disorder, should trigger the nurse's concern about the client's understanding of the use of defense mechanisms?
"When I have a problem, I just deny it until it goes away."
A nurse is developing a plan of care for a client with panic disorder that will include pharmacologic therapy. Which would the nurse most likely expect to administer?
Selective serotonin reuptake inhibitor (SSRI)
A 25-year-old client tells the nurse that the client has been worried and tearful lately because of pressures at work. The client states, "My partner tells me that it's 'stress' and 'anxiety,' but doesn't everyone have that? What is anxiety anyway?" Which response gives the best information about the nature of anxiety?
"Anxiety is a sense of psychological distress."
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."
A client with generalized anxiety disorder states that the client is worried about the client's job. The client never feels like the client has control over the client's 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?"
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."
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 the client is 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 use?
"What did you experience just before and during the attack?"
Nearly what percentage of adults are affected by anxiety disorders?
25%
What does desensitization refer to?
A systematic way to replace a panic response with a relaxation response
Which client is most likely to be at risk for drug dependence and difficulties with withdrawal?
A woman who has been taking lorazepam for several months after witnessing a traumatic motor vehicle accident
The most important factor in the person's stress response is what?
Adaptive coping strategies
Panic disorder is treated with cognitive-behavioral techniques, deep breathing, and relaxation, in addition to what?
Antidepressants
Which medication classification has been found to be effective in reducing or eliminating panic attacks?
Antidepressants
A hospitalized client states that the client is having difficulty resting. Which intervention would help promote rest?
Assisting the client with deep-breathing exercises
Which medication classifications used in the treatment of panic disorder can cause physical dependence?
Benzodiazepines
When discussing various types of anxiolytic medications with a client, the nurse recognizes that which medication has the lowest potential for abuse?
Buspirone
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.
A client spends hours stacking and unstacking towels. The client is repeatedly checking to make sure that the towels are in order of color. What term is used to identify this behavior?
Compulsion
Clients taking benzodiazepines need education about what?
Concomitant use of alcohol
A client responds to bad news regarding test results by crying uncontrollably. What is the term for this response to a stressor?
Coping mechanism
A young parent tells the nurse, "I can't stop smoking. That is what I do to make myself feel better." What is the term used to describe this behavior?
Coping mechanism
Humans are able to adapt to physiological and psychological threats. Which is key to a person's adaptation to these situations?
Coping mechanisms
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 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
In teaching a client who has been prescribed a benzodiazepine for panic disorder, the nurse must be certain to do what?
Educate the client that this medication has a high risk for withdrawal symptoms, and the client should not discontinue without a doctor's supervision.
A client states that the client has just had an argument with the client's spouse over the phone. What can the nurse expect that the client's sympathetic nervous system has stimulated the client's adrenal gland to release?
Epinephrine
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 client's anxiety preceded the medical problem or whether the medical problem appeared first
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.
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
The nurse is planning a presentation to a group of nursing students on the topic of anxiety disorders. Which would the nurse include when describing panic disorder?
Individuals may believe they are having a heart attack when a panic attack occurs.
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
When a client is experiencing panic, which is the priority intervention?
Move the client to a quiet environment.
The causes of anxiety disorders can be best explained by what?
Neurobiologic vulnerabilities and perception of psychosocial stress
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
A nurse is assessing the vital signs of a client in the cardiac clinic. The nurse observes the client's blood pressure and heart rate are higher than what is normally expected for this client. The client tells the nurse, "It makes me nervous to come into the clinic." What is the most likely explanation for the unexpected change in the client's vital signs.
Self-preservation
A 30-year-old client who has been unemployed secondary to the client's anxiety disorder states that the client would like to have a job where the client is alone and no one needs to evaluate the client's work. The nurse interprets these comments as an indicator of what?
Social anxiety disorder
A 30-year-old client who has been unemployed secondary to anxiety disorder states that the client would like to have a job where the client is alone and no one needs 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 significant danger?
Specific phobia
Which would be an appropriate intervention of a client experiencing a panic attack?
Staying with the client and speaking in short sentences
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 client's subjects.
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
Which is a cardiovascular response of the sympathetic nervous system?
Tachycardia
A group of nursing students are reviewing signs and symptoms of anxiety. The students demonstrate a need for additional review when they identify what?
Tearfulness
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 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 a client with anxiety. Which behavior might indicate that the client has moderate anxiety?
The client is nervous and agitated.
The nurse at the student health center is seeing a group of nursing students who are interested in reducing their stress level. The nurse identifies guided imagery as an appropriate intervention. What does guided imagery involve?
The mindful use of a word, phrase, or visual image, which allows oneself to be distracted and temporarily escape from stressful situations
Which would not be an initial intervention for the client with acute anxiety?
Touching the client in an attempt to comfort the client
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.
The nurse is teaching shoulder exercises to a client recovering from a mastectomy. The nurse might view the client's mild anxiety during the session positively, because mild anxiety helps what? Select all that apply.
To focus attention to learn To feel and think To motivate to make a change To engage in goal-directed activity
After teaching a group of mental health nursing students about the care of a client experiencing a panic attack, the instructor determines that additional education is required when the students identify which as an appropriate intervention?
Touching the client in an attempt to comfort the client
A nurse is preparing a plan of care for a client with anxiety. Which would the nurse likely include? Select all that apply.
Using appropriate coping skill Identifying treatment modalities Involving family for support, if appropriate Providing supportive feedback
Which nursing intervention is focused on the primary goal of anxiety management and treatment?
assessing the client's ability to implement stress management techniques effectively
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.
A nurse is seeing a client who is experiencing symptoms of moderate anxiety. She tells the nurse she and her parents disagree over her sexual orientation. Which theory would best explain the course of the client's anxiety?
interpersonal
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. Which strategy is being used to treat the client's specific phobia?
flooding
An adolescent who is seeing the school health nurse states, "I won't be able to hang out with my friends on Friday night because I have two essays due Monday." What level of anxiety is the adolescent experiencing?
mild
A school health nurse is seeing a 7-year-old child. The mother of the child describes the child holding on to her leg and crying loudly when she attempts to leave the child at school each morning. The nurse should explain that the child is experiencing:
separation anxiety disorder.
