Psych Videbeck Chapter 14: Anxiety and Anxiety Disorders
A client responds to bad news regarding test results by crying uncontrollably. What is the term for this response to a stressor?
Coping mechanism
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 Moderate Severe Panic
Mild
Which term describes feelings of being disconnected from oneself as seen in a panic attack? a) Depersonalization b) Automatisms c) Agoraphobia d) Derealization
a) Depersonalization
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 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." "With the development of more life skills and a demonstration of continued success in life, your anxiety will shrink and eventually disappear." "Every time you feel anxious, try to focus on how much easier your life would be if you didn't experience anxiety so often." "If you address the causes of your anxiety head-on, you will find that you can recover from it without medications or therapy."
"Anxiety is a feeling that is experienced by everyone at some point and it can never be completely removed from one's life."
nxiety. Which statement by the nurse is likely the most therapeutic intervention? "If you address the causes of your anxiety head-on, you will find that you can recover from it without medications or therapy." "Every time you feel anxious, try to focus on how much easier your life would be if you didn't experience anxiety so often." "Anxiety is a feeling that is experienced by everyone at some point and it can never be completely removed from one's life." "With the development of more life skills and a demonstration of continued success in life, your anxiety will shrink and eventually disappear."
"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 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? "Every time you feel anxious, try to focus on how much easier your life would be if you didn't experience anxiety so often." "If you address the causes of your anxiety head-on, you will find that you can recover from it without medications or therapy." "With the development of more life skills and a demonstration of continued success in life, your anxiety will shrink and eventually disappear." "Anxiety is a feeling that is experienced by everyone at some point and it can never be completely removed from one's life."
"Anxiety is a feeling that is experienced by everyone at some point and it can never be completely removed from one's life." It is therapeutic to foster in clients the understanding that the experience of anxiety is natural and inevitable. It would be inaccurate to promise recovery with increased success in life and self-discipline. Clients with anxiety are likely to be well aware of how much easier their lives would be without recurring anxiety.
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." "With the development of more life skills and a demonstration of continued success in life, your anxiety will shrink and eventually disappear." "If you address the causes of your anxiety head-on, you will find that you can recover from it without medications or therapy." "Every time you feel anxious, try to focus on how much easier your life would be if you didn't experience anxiety so often."
"Anxiety is a feeling that is experienced by everyone at some point and it can never be completely removed from one's life." It is therapeutic to foster in clients the understanding that the experience of anxiety is natural and inevitable. It would be inaccurate to promise recovery with increased success in life and self-discipline. Clients with anxiety are likely to be well aware of how much easier their lives would be without recurring anxiety.
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."
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 would be most appropriate for the nurse to provide about the nature of anxiety? "Anxiety is an abnormal response to everyday stress." "Anxiety is a sense of psychological distress." "Anxiety is a physiologic response to stress." "Anxiety is a normal response to everyday stress."
"Anxiety is a sense of psychological distress."
The nurse is assessing a client who recently experienced the client's first panic attack while at the grocery store. To identify complications of the disorder, the nurse should ask: "Do you have any problems going out alone to public places?" "What do you think is the origin of the panic you felt?" "Can you describe how you felt physically during the attack?" "Are you concerned there will be more panic attacks?"
"Do you have any problems going out alone to public places?"
The nurse is assessing a client who recently experienced their first panic attack while at the grocery store. What question should the nurse ask to identify complications of the disorder? "What do you think is the origin of the panic you felt?" "Are you concerned there will be more panic attacks?" "Can you describe how you felt physically during the attack?" "Do you have any problems going out alone to public places?"
"Do you have any problems going out alone to public places?" Rationale:To identify complications of the disorder when assessing a client who recently experienced the client's first panic attack while at a grocery store, the psychiatric nurse asks, "Do you have any problems going out alone to public places?"
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?"
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? "It sounds to me like you're doing a good job." "Your worries are a feature of your anxiety disorder. Tell yourself that you have nothing to worry about." "Has something changed at work that is causing you to worry?" "Why do you think you'll be fired?"
"Has something changed at work that is causing you to worry?"
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?" "Why do you think you'll be fired?" "Your worries are a feature of your anxiety disorder. Tell yourself that you have nothing to worry about." "It sounds to me like you're doing a good job."
"Has something changed at work that is causing you to worry?" The nurse begins an assessment by simply asking the client if he or she is currently feeling anxious or worried or has experienced these feelings recently. The nurse also asks the client about obsessive thinking patterns, worrying, compulsions and repetitive activity, specific phobias, and exposure to traumatic events. Once the nurse has determined that signs and symptoms of anxiety do exist, the nurse assesses the possible underlying causes and inquires about family history, recent life events, current stress level, personal history of anxiety, medical and medication history, history of substance abuse, and other possible causes of the anxiety.
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? "Why do you think you'll be fired?" "It sounds to me like you're doing a good job." "Has something changed at work that is causing you to worry?" "Your worries are a feature of your anxiety disorder. Tell yourself that you have nothing to worry about."
"Has something changed at work that is causing you to worry?" The nurse begins an assessment by simply asking the client if he or she is currently feeling anxious or worried or has experienced these feelings recently. The nurse also asks the client about obsessive thinking patterns, worrying, compulsions and repetitive activity, specific phobias, and exposure to traumatic events. Once the nurse has determined that signs and symptoms of anxiety do exist, the nurse assesses the possible underlying causes and inquires about family history, recent life events, current stress level, personal history of anxiety, medical and medication history, history of substance abuse, and other possible causes of the anxiety.
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?"
Which question in the assessment of a client with anxiety is most clinically appropriate? "What can I give you to make you feel less anxious right now?" "Does your anxiety make you feel less valuable and competent as a person?" "Do you think that you're justified in feeling anxious right now?" "How do you feel about everything that is happening in your life right now?"
"How do you feel about everything that is happening in your life right now?"
Which question in the assessment of a client with anxiety is most clinically appropriate? "Does your anxiety make you feel less valuable and competent as a person?" "What can I give you to make you feel less anxious right now?" "Do you think that you're justified in feeling anxious right now?" "How do you feel about everything that is happening in your life right now?"
"How do you feel about everything that is happening in your life right now?" An open-ended question that prompts the client to describe his or her current feelings is a useful assessment technique.
Which question in the assessment of a client with anxiety is most clinically appropriate? "Do you think that you're justified in feeling anxious right now?" "Does your anxiety make you feel less valuable and competent as a person?" "What can I give you to make you feel less anxious right now?" "How do you feel about everything that is happening in your life right now?"
"How do you feel about everything that is happening in your life right now?" An open-ended question that prompts the client to describe his or her current feelings is a useful assessment technique. Offering medications or other solutions, asking if the client feels justified in his or her feelings, and questioning the client's self-worth are not normally appropriate, or effective, assessment techniques.
A client asks the nurse, "How can I tell if what I am experiencing is just regular worrying and not an anxiety disorder?" What is the nurse's best response? "If you feel nervous before a big event, you likely have an anxiety disorder." "You have an anxiety disorder if you need medication to help you function." "Trouble falling asleep due to worrying indicates an anxiety disorder." "If you are unable to function occupationally and socially because of the anxiety"
"If you are unable to function occupationally and socially because of the 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."
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 experience a fight-or-flight response when threatened." "People with anxiety disorders generally find that the anxiety interferes with daily activities." "Normal anxiety does not result in feelings of dread or restlessness." "Normal anxiety occurs in response to everyday stressors."
"People with anxiety disorders generally find that the anxiety interferes with daily activities."
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? "Normal anxiety occurs in response to everyday stressors." "People with anxiety disorders experience a fight-or-flight response when threatened." "Normal anxiety does not result in feelings of dread or restlessness." "People with anxiety disorders generally find that the anxiety interferes with daily activities."
"People with anxiety disorders generally find that the anxiety interferes with daily activities."
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? "Normal anxiety does not result in feelings of dread or restlessness." "People with anxiety disorders experience a fight-or-flight response when threatened." "Normal anxiety occurs in response to everyday stressors." "People with anxiety disorders generally find that the anxiety interferes with daily activities."
"People with anxiety disorders generally find that the anxiety interferes with daily activities." Pathologic anxiety is suspected if a person feels anxious when no real threat exists, when a threat has passed long ago but continues to impair the person's functioning, or when a person substitutes adaptive coping mechanisms with maladaptive ones.
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? "Normal anxiety occurs in response to everyday stressors." "People with anxiety disorders experience a fight-or-flight response when threatened." "People with anxiety disorders generally find that the anxiety interferes with daily activities." "Normal anxiety does not result in feelings of dread or restlessness."
"People with anxiety disorders generally find that the anxiety interferes with daily activities." Pathologic anxiety is suspected if a person feels anxious when no real threat exists, when a threat has passed long ago but continues to impair the person's functioning, or when a person substitutes adaptive coping mechanisms with maladaptive ones.
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."
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." "I discourage her finger tapping since it serves to increase her anxiety level." "She knows that if she taps her fingers she will be able to lessen her anxiety." "I can tell that the more she taps, the less anxiety she is actually feeling."
"The client taps her fingers very rapidly when she is feeling anxious."
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." "She knows that if she taps her fingers she will be able to lessen her anxiety." "I can tell that the more she taps, the less anxiety she is actually feeling." "I discourage her finger tapping since it serves to increase her anxiety level."
"The client taps her fingers very rapidly when she is feeling anxious."
Which statement by the nurse demonstrates an understanding of the role automatisms have in a panic attack? "I discourage her finger tapping since it serves to increase her anxiety level." "I can tell that the more she taps, the less anxiety she is actually feeling." "She knows that if she taps her fingers she will be able to lessen her anxiety." "The client taps her fingers very rapidly when she is feeling anxious."
"The client taps her fingers very rapidly when she is feeling anxious." Automatisms are automatic, unconscious mannerisms associated with anxiety. Examples include tapping fingers, jingling keys, or twisting hair. Automatisms are geared toward anxiety relief and increase in frequency and intensity with the client's anxiety level. None of the remaining options accurately state the fact that the tapping identifies the level of anxiety a client is experiencing but does not manage or less the emotion.
Which statement by the nurse demonstrates an understanding of the role automatisms have in a panic attack? "I can tell that the more she taps, the less anxiety she is actually feeling." "I discourage her finger tapping since it serves to increase her anxiety level." "She knows that if she taps her fingers she will be able to lessen her anxiety." "The client taps her fingers very rapidly when she is feeling anxious."
"The client taps her fingers very rapidly when she is feeling anxious." Automatisms are automatic, unconscious mannerisms associated with anxiety. Examples include tapping fingers, jingling keys, or twisting hair. Automatisms are geared toward anxiety relief and increase in frequency and intensity with the client's anxiety level. None of the remaining options accurately state the fact that the tapping identifies the level of anxiety a client is experiencing but does not manage or less the emotion.
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." "She knows that if she taps her fingers she will be able to lessen her anxiety." "I discourage her finger tapping since it serves to increase her anxiety level." "I can tell that the more she taps, the less anxiety she is actually feeling."
"The client taps her fingers very rapidly when she is feeling anxious." Rationale:Automatisms are automatic, unconscious mannerisms associated with anxiety. Examples include tapping fingers, jingling keys, or twisting hair. Automatisms are geared toward anxiety relief and increase in frequency and intensity with the client's anxiety level. None of the remaining options accurately state the fact that the tapping identifies the level of anxiety a client is experiencing but does not manage or less the emotion.
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?"
A client comes to the emergency due to symptoms of a potential 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 ask? "What did you experience just before and during the attack?" "What do you think caused you to feel this way?" "Are you feeling much better now that you are lying down?" "Do you think you will be able to drive home?"
"What did you experience just before and during the attack?"
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 ask? "What did you experience just before and during the attack?" "What do you think caused you to feel this way?" "Do you think you will be able to drive home?" "Are you feeling much better now that you are lying down?"
"What did you experience just before and during the attack?" After it has been determined that the client does not have other medical problems, the nurse should assess for the characteristic symptoms of panic attack, focusing the questions on what the client was experiencing just before and during the attack. Asking the client if the client feels better provides no information for the nurse, and lying down may or may not be effective. Asking the client if the client thinks the client can drive home is a question that can be asked much later in the interview, after the attack subsides and the client is stable. Asking the client about what caused the attack is inappropriate because numerous stimuli, both external and internal, can provoke an attack. Most clients will not be able to identify a specific cause. The focus of care is on the characteristics of the attack.
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? "I'm not sure when I'm actually using a defense mechanism." "Defense mechanisms provide a sense of control over the uncontrollable." "I'm thankful that I have a way to manage my problems." "When I have a problem, I just deny it until it goes away."
"When I have a problem, I just deny it until it goes away." Rationale: The dependence on one or two defense mechanisms also can inhibit emotional growth, lead to poor problem-solving skills, and create difficulty with relationships. Denial should not be used to deal with all of one's problems. None of the remaining options present untrue or troubling statements regarding defense mechanisms
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 ask? "What did you experience just before and during the attack?" "Are you feeling much better now that you are lying down?" "What do you think caused you to feel this way?" "Do you think you will be able to drive home?"
"What did you experience just before and during the attack?" After it has been determined that the client does not have other medical problems, the nurse should assess for the characteristic symptoms of panic attack, focusing the questions on what the client was experiencing just before and during the attack. Asking the client if the client feels better provides no information for the nurse, and lying down may or may not be effective. Asking the client if the client thinks the client can drive home is a question that can be asked much later in the interview, after the attack subsides and the client is stable. Asking the client about what caused the attack is inappropriate because numerous stimuli, both external and internal, can provoke an attack. Most clients will not be able to identify a specific cause. The focus of care is on the characteristics of the attack.
The client reports that the client feels anxious when interacting socially with others and "never seems to know what to say." Which question indicates the nurse has a sound understanding of interpersonal theory as it relates to anxiety? "What kind of relationship do you have with your parents?" "Do other members of your family have similar problems?" "How long have you experienced these problems?" "What have you tried to help manage your feelings and discomfort?"
"What kind of relationship do you have with your parents?"
The client reports that the client feels anxious when interacting socially with others and "never seems to know what to say." Which question indicates the nurse has a sound understanding of interpersonal theory as it relates to anxiety? "Do other members of your family have similar problems?" "What kind of relationship do you have with your parents?" "What have you tried to help manage your feelings and discomfort?" "How long have you experienced these problems?"
"What kind of relationship do you have with your parents?" According to interpersonal theory, caregivers can communicate anxiety to infants or children through inadequate nurturing. Individuals who are exposed to poor parental nurturing may develop poor self-esteem or poor communication skills
The client reports that the client feels anxious when interacting socially with others and "never seems to know what to say." Which question indicates the nurse has a sound understanding of interpersonal theory as it relates to anxiety? "Do other members of your family have similar problems?" "What kind of relationship do you have with your parents?" "What have you tried to help manage your feelings and discomfort?" "How long have you experienced these problems?"
"What kind of relationship do you have with your parents?" According to interpersonal theory, caregivers can communicate anxiety to infants or children through inadequate nurturing. Individuals who are exposed to poor parental nurturing may develop poor self-esteem or poor communication skills. The other options, although assessment-oriented questions, do not necessarily relate directly to this client's specific problem.
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."
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? "I'm thankful that I have a way to manage my problems." "Defense mechanisms provide a sense of control over the uncontrollable." "I'm not sure when I'm actually using a defense mechanism." "When I have a problem, I just deny it until it goes away."
"When I have a problem, I just deny it until it goes away."
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? "I'm not sure when I'm actually using a defense mechanism." "I'm thankful that I have a way to manage my problems." "When I have a problem, I just deny it until it goes away." "Defense mechanisms provide a sense of control over the uncontrollable."
"When I have a problem, I just deny it until it goes away." The dependence on one or two defense mechanisms also can inhibit emotional growth, lead to poor problem-solving skills, and create difficulty with relationships. Denial should not be used to deal with all of one's problems. None of the remaining options present untrue or troubling statements regarding defense mechanisms.
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? "I'm thankful that I have a way to manage my problems." "Defense mechanisms provide a sense of control over the uncontrollable." "When I have a problem, I just deny it until it goes away." "I'm not sure when I'm actually using a defense mechanism."
"When I have a problem, I just deny it until it goes away." The dependence on one or two defense mechanisms also can inhibit emotional growth, lead to poor problem-solving skills, and create difficulty with relationships. Denial should not be used to deal with all of one's problems. None of the remaining options present untrue or troubling statements regarding defense mechanisms.
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." "With the development of more life skills and a demonstration of continued success in life, your anxiety will shrink and eventually disappear." "Every time you feel anxious, try to focus on how much easier your life would be if you didn't experience anxiety so often." "If you address the causes of your anxiety head-on, you will find that you can recover from it without medications or therapy."
"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? "It sounds to me like you're doing a good job." "Your worries are a feature of your anxiety disorder. Tell yourself that you have nothing to worry about." "Has something changed at work that is causing you to worry?" "Why do you think you'll be fired?"
"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? "What can I give you to make you feel less anxious right now?" "Does your anxiety make you feel less valuable and competent as a person?" "Do you think that you're justified in feeling anxious right now?" "How do you feel about everything that is happening in your life right now?"
"how do you feel about everything that is going on in your life right now?"
A client asks the nurse, "How can I tell if what I am experiencing is just regular worrying and not an anxiety disorder?" What is the nurse's best response? "You have an anxiety disorder if you need medication to help you function." "If you are unable to function occupationally and socially because of the anxiety" "Trouble falling asleep due to worrying indicates an anxiety disorder." "If you feel nervous before a big event, you likely have an anxiety disorder."
"if you are unable to function occupationally and socially because of the 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 experience a fight-or-flight response when threatened." "People with anxiety disorders generally find that the anxiety interferes with daily activities." "Normal anxiety does not result in feelings of dread or restlessness." "Normal anxiety occurs in response to everyday stressors."
"people with anxiety disorders generally find that anxiety interferes with daily activities."
A client comes to the emergency due to symptoms of a potential 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 ask? "Are you feeling much better now that you are lying down?" "What did you experience just before and during the attack?" "Do you think you will be able to drive home?" "What do you think caused you to feel this way?"
"what did you experience just before and during the attack?"
A client responds to bad news regarding test results by crying uncontrollably. What is the term for this response to a stressor? Adaptation Homeostasis Coping mechanism Defense mechanism
Coping mechanism
Nearly what percentage of adults are affected by anxiety disorders? 0.1 0.4 0.25 0.5
0.25 Rationale:Nearly 25% of adults are affected by anxiety disorders.
Nearly what percentage of adults are affected by anxiety disorders?
25%
Nearly what percentage of adults are affected by anxiety disorders? 10% 25% 40% 55%
25%
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
The nurse recognizes that who is the client 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 22-year-old soldier who served in the Middle East who "cannot sleep" and is facing criminal charges for hurting someone in a barroom brawl 70-year-old whose spouse died 1 year ago who has "no desire to leave my house" and reports severe fatigue 30-year-old business executive who reports being anxious about attending the meetings and social events that are the executive's job responsibilities
40-year-old who has reported numerous absences from work, muscle aches, and difficulty falling asleep for the last 8 months
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 22-year-old soldier who served in the Middle East who "cannot sleep" and is facing criminal charges for hurting someone in a barroom brawl 70-year-old whose spouse died 1 year ago who has "no desire to leave my house" and reports severe fatigue 30-year-old business executive who reports being anxious about attending the meetings and social events that are the executive's job responsibilities
40-year-old who has reported numerous absences from work, muscle aches, and difficulty falling asleep for the last 8 months NOTE: GAD is characterized by excessive worry and feelings of anxiety at least 50% of the time for 6 months or more. The client with GAD has three or more of the following symptoms: uneasiness, irritability, muscle tension, fatigue, difficulty thinking, and sleep alterations.
A patient with anxiety disorder has excessive anxiety and worries about multiple life circumstances. For how long would this patient experience these feelings before the anxiety disorder would be considered chronic and generalized? 4 months 6 months 12 months 2 months
6 months
Anxiety disorder is considered chronic and generalized when excessive anxiety and worry about two or more life circumstances exist for at least ... 6 months 2 months 12 months 4 months
6 months
A patient with anxiety disorder has excessive anxiety and worries about multiple life circumstances. For how long would this patient experience these feelings before the anxiety disorder would be considered chronic and generalized? 2 months 12 months 4 months 6 months
6 months For generalized anxiety disorder, the diagnostic criteria listed include unrealistic or excessive anxiety and worry about two or more life circumstances for 6 months or more, during which time these concerns exist for a majority of days
A patient with anxiety disorder has excessive anxiety and worries about multiple life circumstances. For how long would this patient experience these feelings before the anxiety disorder would be considered chronic and generalized? 2 months 6 months 4 months 12 months
6 months For generalized anxiety disorder, the diagnostic criteria listed include unrealistic or excessive anxiety and worry about two or more life circumstances for 6 months or more, during which time these concerns exist for a majority of days.
A patient with anxiety disorder has excessive anxiety and worries about multiple life circumstances. For how long would this patient experience these feelings before the anxiety disorder would be considered chronic and generalized? 6 months 12 months 2 months 4 months
6 months Rationale:For generalized anxiety disorder, the diagnostic criteria listed include unrealistic or excessive anxiety and worry about two or more life circumstances for 6 months or more, during which time these concerns exist for a majority of days.
A nurse assesses a client and determines that the client is experiencing mild anxiety based on what? The client is selectively inattentive The client is aware and alert The client has focused attention on a small area The client voices feelings of unreality
A client who is mildly anxious is aware, alert, sees, hears, and grasps more than before. Selective inattention reflects moderate anxiety. Focusing attention on a small area reflects severe anxiety. Feelings of unreality are associated with panic.
The nurse is assessing a client with anxiety. Which behavior might indicate that the client has moderate anxiety? The client is focused in an activity. The client is nervous and agitated. The client has impaired cognitive skills. The client is unable to communicate verbally.
A client who is moderately anxious has a disturbing feeling that something is wrong. This causes nervousness and agitation. Increased concentration and attention is seen in clients having mild anxiety. Cognitive skills are impaired in clients who have severe anxiety. Inability to communicate verbally indicates that the client is panicking.
What does desensitization refer to?
A systematic way to replace a panic response with a relaxation response
What does desensitization refer to? A systematic way to replace a panic response with a relaxation response A cognitive technique for replacing a worry with a positive statement Exposing the client to an anxiety-producing stimulus for 1 to 2 hours (flooding) Teaching the client to ignore or become immune to anxiety-producing situations
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
Which client is most likely to be at risk for drug dependence and difficulties with withdrawal? A man whose obsessive-compulsive disorder is being treated long term with paroxetine A client who has recently begun treatment with propranolol for the treatment of social phobia A woman who has been taking lorazepam for several months after witnessing a traumatic motor vehicle accident A client with generalized anxiety disorder who has responded well since beginning treatment with fluoxetine earlier in the year
A woman who has been taking lorazepam for several months after witnessing a traumatic motor vehicle accident
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 A man whose obsessive-compulsive disorder is being treated long term with paroxetine A client who has recently begun treatment with propranolol for the treatment of social phobia A client with generalized anxiety disorder who has responded well since beginning treatment with fluoxetine earlier in the year
A woman who has been taking lorazepam for several months after witnessing a traumatic motor vehicle accident The potential for dependence and difficulties with withdrawal is much higher with benzodiazepines than with beta-blockers or SSRIs
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 A client with generalized anxiety disorder who has responded well since beginning treatment with fluoxetine earlier in the year A man whose obsessive-compulsive disorder is being treated long term with paroxetine A client who has recently begun treatment with propranolol for the treatment of social phobia
A woman who has been taking lorazepam for several months after witnessing a traumatic motor vehicle accident The potential for dependence and difficulties with withdrawal is much higher with benzodiazepines than with beta-blockers or SSRIs.
Which client is most likely to be at risk for drug dependence and difficulties with withdrawal? A client who has recently begun treatment with propranolol for the treatment of social phobia A man whose obsessive-compulsive disorder is being treated long term with paroxetine A woman who has been taking lorazepam for several months after witnessing a traumatic motor vehicle accident A client with generalized anxiety disorder who has responded well since beginning treatment with fluoxetine earlier in the year
A woman who has been taking lorazepam for several months after witnessing a traumatic motor vehicle accident The potential for dependence and difficulties with withdrawal is much higher with benzodiazepines than with beta-blockers or SSRIs.
Which medication classification has been found to be effective in reducing or eliminating panic attacks? Antidepressants Anticholinergics Antipsychotics Antimanics
Antidepressants
What is the term for the change that takes place in response to a stressor? Rehabilitation Adaptation Positive movement Negative movement
Adaptation
The most important factor in the person's stress response is what?
Adaptive coping strategies
The most important factor in the person's stress response is what? Strength of the immune system Supportive friends Relaxation techniques Adaptive coping strategies
Adaptive coping strategies
the most important factor in the person's stress response is what? Adaptive coping strategies Supportive friends Relaxation techniques Strength of the immune system
Adaptive coping strategies The most important factor in a person's stress response is the ability of engage in adaptive coping behaviors. This ability can assist a person in developing resilience, or the ability to "bounce back" when faced with stress and stressful situations
The most important factor in the person's stress response is what? Supportive friends Relaxation techniques Strength of the immune system Adaptive coping strategies
Adaptive coping strategies The most important factor in a person's stress response is the ability of engage in adaptive coping behaviors. This ability can assist a person in developing resilience, or the ability to "bounce back" when faced with stress and stressful situations. The immune system, having a supportive network of friends, and understanding of relaxation techniques are also influencing factors when considering how an individual responds to stress; however, the correct option relates to an internal, sustainable strength that comes from adaptive coping.
A client approaches the nurse on an inpatient psychiatric hospital unit crying, trembling, and feeling nauseous. The client states, "I've tried everything, I still feel so anxious." Which action by the nurse would be most appropriate? Direct the client to continue deep breathing. Take the client on a walk around the unit. Take the client to the dayroom as a distraction. Administer the prescribed PRN anxiolytic medication.
Administer the prescribed PRN anxiolytic medication.
A client approaches the nurse on an inpatient psychiatric hospital unit crying, trembling, and feeling nauseous. The client states, "I've tried everything, I still feel so anxious." Which action by the nurse would be most appropriate? Take the client on a walk around the unit. Direct the client to continue deep breathing. Take the client to the dayroom as a distraction. Administer the prescribed PRN anxiolytic medication.
Administer the prescribed PRN anxiolytic medication.
A client approaches the nurse on an inpatient psychiatric hospital unit crying, trembling, and feeling nauseous. The client states, "I've tried everything, I still feel so anxious." Which action by the nurse would be most appropriate? Take the client to the dayroom as a distraction. Take the client on a walk around the unit. Administer the prescribed PRN anxiolytic medication. Direct the client to continue deep breathing.
Administer the prescribed PRN anxiolytic medication. The client is experiencing severe anxiety. The client tells the nurse the client has tried other strategies but they have not been effective. Given the client's report of symptoms, it would be appropriate to administer a dose of the prescribed PRN anxiolytic medication. Once the client is experiencing a decrease in the uncomfortable physiologic symptoms associated with the severe anxiety, it will be easier to engage the client in nonpharmacological interventions, such as deep breathing, to manage any residual signs and symptoms of the anxiety.
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 ask? "Are you feeling much better now that you are lying down?" "What did you experience just before and during the attack?" "Do you think you will be able to drive home?" "What do you think caused you to feel this way?"
After it has been determined that the client does not have other medical problems, the nurse should assess for the characteristic symptoms of panic attack, focusing the questions on what the client was experiencing just before and during the attack. Asking the client if the client feels better provides no information for the nurse, and lying down may or may not be effective. Asking the client if the client thinks the client can drive home is a question that can be asked much later in the interview, after the attack subsides and the client is stable. Asking the client about what caused the attack is inappropriate because numerous stimuli, both external and internal, can provoke an attack. Most clients will not be able to identify a specific cause. The focus of care is on the characteristics of the attack.
A client is currently experiencing panic. Which acation would be most appropriate for the nurse to do? Allow the client to pace Ask the client repeated questions about feelings Employ the use of negative self-talk Urge the client to engage in vigorous exercise
Allow the client to pace
A client is currently experiencing panic. Which action would be most appropriate for the nurse to do? Employ the use of negative self-talk Ask the client repeated questions about feelings Allow the client to pace Urge the client to engage in vigorous exercise
Allow the client to pace
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? Defense mechanism Coping mechanism Caregiver burden Crisis
Coping mechanism
A client is currently experiencing panic. Which action would be most appropriate for the nurse to do? Allow the client to pace Ask the client repeated questions about feelings Employ the use of negative self-talk Urge the client to engage in vigorous exercise
Allow the client to pace With panic, the nurse should stay with the client. Allow pacing and walk with the client. No content inputs to the client's thinking should be made by the nurse. Asking repeated questions and teaching would be inappropriate because the client is already over-stressed. The client should use positive self-talk.
A client is currently experiencing panic. Which action would be most appropriate for the nurse to do? Urge the client to engage in vigorous exercise Employ the use of negative self-talk Ask the client repeated questions about feelings Allow the client to pace
Allow the client to pace With panic, the nurse should stay with the client. Allow pacing and walk with the client. No content inputs to the client's thinking should be made by the nurse. Asking repeated questions and teaching would be inappropriate because the client is already over-stressed. The client should use positive self-talk. Encouraging vigorous exercise would increase the physiological arousal associated with panic and should be avoided until the client is calm. Exercise should be encouraged for prevention and to promote mental wellness.
A client is currently experiencing panic. Which action would be most appropriate for the nurse to do? Ask the client repeated questions about feelings Urge the client to engage in vigorous exercise Employ the use of negative self-talk Allow the client to pace
Allow the client to pace With panic, the nurse should stay with the client. Allow pacing and walk with the client. No content inputs to the client's thinking should be made by the nurse. Asking repeated questions and teaching would be inappropriate because the client is already over-stressed. The client should use positive self-talk. Encouraging vigorous exercise would increase the physiological arousal associated with panic and should be avoided until the client is calm. Exercise should be encouraged for prevention and to promote mental wellness.
What part of the brain is thought to be involved in the production of anxiety as a result of the identification of incoming sensory information as threatening? Amygdala Cerebellum Brainstem Cerebral cortex
Amygdala
During which type of anxiety does a person's perceptual field actually increase? Panic Severe Mild Moderate
Mild During mild anxiety, a person's perceptual field widens slightly, and the person is able to observe more than before and to see relationships.
A client has sought treatment because of the overwhelming anxiety the client experiences regarding the safety of the client's young children. The client admits that the client will not normally let the client's children leave the client's sight for fear that they will be abducted, abused, or injured. The client is unable to function at work as a result of this anxiety. The nurse would recognize that this client experiences which condition? Signal anxiety Fear Derealization Anticipatory anxiety
Anticipatory anxiety
A client has sought treatment because of the overwhelming anxiety the client experiences regarding the safety of the client's young children. The client admits that the client will not normally let the client's children leave the client's sight for fear that they will be abducted, abused, or injured. The client is unable to function at work as a result of this anxiety. The nurse would recognize that this client experiences which condition? Fear Derealization Anticipatory anxiety Signal anxiety
Anticipatory anxiety Anticipatory anxiety exists in the context of phobia. People with phobias develop anticipatory anxiety even when thinking about possibly encountering the dreaded phobic situation (i.e., danger to the client's children). The anticipatory anxiety in this case is so severe that the client is unable to function in certain situations leading to hardship. Signal anxiety refers to the natural anxiety mechanism that communicates danger or motivation for needed change. Fear refers to feeling afraid or threatened by a clearly identifiable external stimulus that presents a danger to a person. Derealization refers to a stage in the experience of anxiety when a person senses that things are not real.
A client has sought treatment because of the overwhelming anxiety the client experiences regarding the safety of the client's young children. The client admits that the client will not normally let the client's children leave the client's sight for fear that they will be abducted, abused, or injured. The client is unable to function at work as a result of this anxiety. The nurse would recognize that this client experiences which condition? Derealization Fear Signal anxiety Anticipatory anxiety
Anticipatory anxiety Anticipatory anxiety exists in the context of phobia. People with phobias develop anticipatory anxiety even when thinking about possibly encountering the dreaded phobic situation (i.e., danger to the client's children). The anticipatory anxiety in this case is so severe that the client is unable to function in certain situations leading to hardship. Signal anxiety refers to the natural anxiety mechanism that communicates danger or motivation for needed change. Fear refers to feeling afraid or threatened by a clearly identifiable external stimulus that presents a danger to a person. Derealization refers to a stage in the experience of anxiety when a person senses that things are not real.
A client has sought treatment because of the overwhelming anxiety the client experiences regarding the safety of the client's young children. The client admits that the client will not normally let the client's children leave the client's sight for fear that they will be abducted, abused, or injured. The client is unable to function at work as a result of this anxiety. The nurse would recognize that this client experiences which condition? Fear Anticipatory anxiety Derealization Signal anxiety
Anticipatory anxiety anticipatory anxiety exists in the context of phobia. People with phobias develop anticipatory anxiety even when thinking about possibly encountering the dreaded phobic situation (i.e., danger to the client's children). The anticipatory anxiety in this case is so severe that the client is unable to function in certain situations leading to hardship
Panic disorder is treated with cognitive-behavioral techniques, deep breathing, and relaxation, in addition to what?
Antidepressants
Panic disorder is treated with cognitive-behavioral techniques, deep breathing, and relaxation, in addition to what? Antidepressants Anticonvulsants Antipsychotics Central nervous system depressants
Antidepressants
Panic disorder is treated with cognitive-behavioral techniques, deep breathing, and relaxation, in addition to what? Antidepressants Anticonvulsants Antipsychotics Central nervous system depressants
Antidepressants
The mental health nurse knows that which medication classification has been found to be effective in reducing or eliminating panic attacks? Antimanics Antidepressants Anticholinergics Antipsychotics
Antidepressants
Which medication classification has been found to be effective in reducing or eliminating panic attacks?
Antidepressants
Panic disorder is treated with cognitive-behavioral techniques, deep breathing, and relaxation, in addition to what? Central nervous system depressants Antidepressants Antipsychotics Anticonvulsants
Antidepressants Panic disorder is treated with cognitive-behavioral techniques, deep breathing and relaxation, and medication such as benzodiazepines, selective serotonin reuptake inhibitors, tricyclics, and antihypertensives, such as clonidine and propranolol.
Which medication classification has been found to be effective in reducing or eliminating panic attacks? Antimanics Antipsychotics Anticholinergics Antidepressants
Antidepressants Rationale:Tricyclic and monoamine oxidase inhibitor antidepressants have been found to be effective in treating clients with panic attacks. Why these drugs help control panic attacks is not clearly understood. Anticholinergic agents, which are smooth-muscle relaxants, relieve physical symptoms of anxiety but do not relieve the anxiety itself. Antipsychotic drugs are inappropriate because clients who experience panic attacks are not psychotic. Mood stabilizers are not indicated because panic attacks are rarely associated with mood changes.
Which medication classification has been found to be effective in reducing or eliminating panic attacks? Antipsychotics Antimanics Antidepressants Anticholinergics
Antidepressants Tricyclic and monoamine oxidase inhibitor antidepressants have been found to be effective in treating clients with panic attacks. Why these drugs help control panic attacks is not clearly understood. Anticholinergic agents, which are smooth-muscle relaxants, relieve physical symptoms of anxiety but do not relieve the anxiety itself. Antipsychotic drugs are inappropriate because clients who experience panic attacks are not psychotic. Mood stabilizers are not indicated because panic attacks are rarely associated with mood changes.
When explaining the difference between anxiety and fear, the mental health nurse shares what? Select all that apply. Fear results in objective, physical responses caused by real danger Obsessive-compulsive behavior is often the result of abandonment Anxiety involves experiencing subjective, uncomfortable feelings resulting from unknown causes People who experience anxiety tend to use maladaptive coping mechanisms Anxiety is likely to result from an attempt to overcome stress
Anxiety involves experiencing subjective, uncomfortable feelings resulting from unknown causes Fear results in objective, physical responses caused by real danger Anxiety is likely to result from an attempt to overcome stress When explaining the difference between anxiety and fear, the mental health nurse shares that anxiety involves experiencing subjective, uncomfortable feelings resulting from unknown causes. At some point in time, all people experience anxiety, as this is a normal human response to a threat or stress. It is inaccurate to say that people who experience anxiety tend to use maladaptive coping mechanisms. Obsessive compulsive disorder is a complex anxiety disorder that not only has its roots in abandonment, but there are multiple factors contributing to why this anxiety disorder may be present in individuals.
When explaining the difference between anxiety and fear, the mental health nurse shares what? Select all that apply. Anxiety involves experiencing subjective, uncomfortable feelings resulting from unknown causes Fear results in objective, physical responses caused by real danger Anxiety is likely to result from an attempt to overcome stress People who experience anxiety tend to use maladaptive coping mechanisms Obsessive-compulsive behavior is often the result of abandonment
Anxiety involves experiencing subjective, uncomfortable feelings resulting from unknown causes Fear results in objective, physical responses caused by real danger Anxiety is likely to result from an attempt to overcome stress
A hospitalized client states that the client is having difficulty resting. Which intervention would help promote rest?
Assisting the client with deep-breathing exercises
A hospitalized client states that the client is having difficulty resting. Which intervention would help promote rest? Leaving the client's door open so the client can see into the hallway Assisting the client with deep-breathing exercises Offering the client a cup of tea Encouraging the client to take prescribed sedatives daily
Assisting the client with deep-breathing exercises
A hospitalized client states that the client is having difficulty resting. Which intervention would help promote rest? Assisting the client with deep-breathing exercises Encouraging the client to take prescribed sedatives daily Offering the client a cup of tea Leaving the client's door open so the client can see into the hallway
Assisting the client with deep-breathing exercises Deep-breathing exercises are beneficial to promoting rest as they help the client to relax. The client's door should be closed to reduce noise and distractions. Tea contains caffeine, which acts as a stimulant. While sedatives may be used occasionally for assistance with rest, regular use isn't advised because dependence may develop.
Which of the following is a behavioral symptom of anxiety? Tremors Apprehension Avoidance Impatience
Avoidance
A biologic theory explains anxiety disorders in which way?
Based in genetics with clinical symptoms being a result of chromosomal influence
A biologic theory explains anxiety disorders in which way? Based in genetics with clinical symptoms being a result of chromosomal influence Rooted in episodes of physical or psychological abuse that occurred at times of developmental growth Originated from disappointments resulting from an exaggerated sense of self-worth Caused by substance abuse, particularly narcotics, resulting in damage to the brain's receptors
Based in genetics with clinical symptoms being a result of chromosomal influence
A biologic theory explains anxiety disorders in which way? Caused by substance abuse, particularly narcotics, resulting in damage to the brain's receptors Rooted in episodes of physical or psychological abuse that occurred at times of developmental growth Based in genetics with clinical symptoms being a result of chromosomal influence Originated from disappointments resulting from an exaggerated sense of self-worth
Based in genetics with clinical symptoms being a result of chromosomal influence Research has provided solid evidence that anxiety disorders have a basis in genetics, with clinical symptoms a result of chromosomal influence.
Which medication classifications used in the treatment of panic disorder can cause physical dependence?
Benzodiazepines
Which medication classifications used in the treatment of panic disorder can cause physical dependence? Benzodiazepines Selective serotonin reuptake inhibitors (SSRIs) Tricyclic antidepressants (TCAs) Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Benzodiazepines
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? Crisis Caregiver burden Coping mechanism Defense mechanism
Coping mechanism Mild anxiety is often managed without conscious thought by coping mechanisms, which are behaviors used to decrease stress and anxiety.
Clients taking benzodiazepines need education about what? Avoiding cheeses and smoked meats Interactions with monoamine oxidase inhibitors (MAOIs) Avoiding spending too much time in the sun Concomitant use of alcohol
Benzodiazepines have long been the drugs of choice for treatment of anxiety disorders. They can induce a physical dependence and can induce severe withdrawal symptoms and intense rebound anxiety when discontinued abruptly. They potentiate the effects of alcohol and other sedative hypnotics, are commonly abused, and have several significant side effects. The most common adverse effects are sedation, ataxia, loss of coordination, slurred speech, memory impairment, paradoxical agitation, and dizziness. They also cause psychomotor impairment.
When discussing various types of anxiolytic medications with a client, the nurse recognizes that which medication has the lowest potential for abuse?
Buspirone
When discussing various types of anxiolytic medications with a client, the nurse recognizes that which medication has the lowest potential for abuse? Alprazolam Lorazepam Buspirone Diazepam
Buspirone Buspirone is a nonbenzodiazepine medication that does not have abuse potential. Benzodiazepines such as alprazolam, lorazepam, and diazepam have abuse potential and may become addictive.
Buspirone has been prescribed for a client with anxiety. When providing health education, the nurse should describe what benefit of this medication over other anxiolytics? decreased risk of hepatic injury less central nervous system depression rapid onset and short duration sublingual administration
Buspirone is a newer anxiolytic drug that does not cause sedation or muscle relaxation. It is preferred when the client needs to be alert such as when driving or working. Buspirone does not have a reduced risk of hepatic injury relative to other anxiolytics, nor does it have a faster onset and shorter duration. It is administered orally, not sublingually.
When discussing various types of anxiolytic medications with a client, the nurse recognizes that which medication has the lowest potential for abuse? Alprazolam Diazepam Buspirone Lorazepam
Buspirone is a nonbenzodiazepine medication that does not have abuse potential. Benzodiazepines such as alprazolam, lorazepam, and diazepam have abuse potential and may become addictive.
All of the following pharmacological agents are useful in treating anxiety disorders except which ones? Tricyclic antidepressants Selective serotonin reuptake inhibitors (SSRIs) Benzodiazepines Calcium channel blockers
Calcium channel blockers Tricyclic antidepressants and SSRIs are known to be useful in reducing anxiety and are sometimes useful in treating the anxiety disorders. Benzodiazepines are an excellent choice for the treatment of symptoms of anxiety; however, they are extremely addictive and should only be given in the case of true anxiety disorders. Calcium channel blockers are not used in treating anxiety disorders.
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.
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. Client will be stress free. Client will avoid stressful situations. Client will start antianxiety agent.
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
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 Phobia Obsession Derealization
Compulsion
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 Phobia Obsession Derealization
Compulsion
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 Derealization Obsession Phobia
Compulsion Compulsions are ritualistic or repetitive behaviors or mental acts that a person carries out continuously in an attempt to neutralize anxiety. A phobia is an illogical, intense, persistent fear of a specific object or a social situation that causes extreme distress and interferes with normal functioning. An obsession is a recurrent, persistent, intrusive, and unwanted thought, image, or impulse that causes marked anxiety and interference with interpersonal, social, or occupational function. Derealization is sensing that things are not real.
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? Obsession Phobia Compulsion Derealization
Compulsion Compulsions are ritualistic or repetitive behaviors or mental acts that a person carries out continuously in an attempt to neutralize anxiety. A phobia is an illogical, intense, persistent fear of a specific object or a social situation that causes extreme distress and interferes with normal functioning. An obsession is a recurrent, persistent, intrusive, and unwanted thought, image, or impulse that causes marked anxiety and interference with interpersonal, social, or occupational function. Derealization is sensing that things are not real.
Clients taking benzodiazepines need education about what?
Concomitant use of alcohol
Clients taking benzodiazepines need education about what? Avoiding cheeses and smoked meats Interactions with monoamine oxidase inhibitors (MAOIs) Avoiding spending too much time in the sun Concomitant use of alcohol
Concomitant use of alcohol
Clients taking benzodiazepines need education about what? Avoiding cheeses and smoked meats Interactions with monoamine oxidase inhibitors (MAOIs) Avoiding spending too much time in the sun Concomitant use of alcohol
Concomitant use of alcohol
Clients taking benzodiazepines need education about what? Interactions with monoamine oxidase inhibitors (MAOIs) Avoiding cheeses and smoked meats Concomitant use of alcohol Avoiding spending too much time in the sun
Concomitant use of alcohol
Clients taking benzodiazepines need education about what? Interactions with monoamine oxidase inhibitors (MAOIs) Avoiding cheeses and smoked meats Concomitant use of alcohol Avoiding spending too much time in the sun
Concomitant use of alcohol Benzodiazepines have long been the drugs of choice for treatment of anxiety disorders. They can induce a physical dependence and can induce severe withdrawal symptoms and intense rebound anxiety when discontinued abruptly. They potentiate the effects of alcohol and other sedative hypnotics, are commonly abused, and have several significant side effects. The most common adverse effects are sedation, ataxia, loss of coordination, slurred speech, memory impairment, paradoxical agitation, and dizziness. They also cause psychomotor impairment.
Clients taking benzodiazepines need education about what? Interactions with monoamine oxidase inhibitors (MAOIs) Avoiding cheeses and smoked meats Avoiding spending too much time in the sun Concomitant use of alcohol
Concomitant use of alcohol Benzodiazepines have long been the drugs of choice for treatment of anxiety disorders. They can induce a physical dependence and can induce severe withdrawal symptoms and intense rebound anxiety when discontinued abruptly. They potentiate the effects of alcohol and other sedative hypnotics, are commonly abused, and have several significant side effects. The most common adverse effects are sedation, ataxia, loss of coordination, slurred speech, memory impairment, paradoxical agitation, and dizziness. They also cause psychomotor impairment.
The nurse is educating a client and family about managing panic attacks after discharge from treatment. The nurse includes which in the discharge teaching? Select all that apply. Weaning off of medications as necessary Development of a regular exercise program Lessening the amount of daily responsibilities Continued development of positive coping skills Continued practice of relaxation techniques
Continued development of positive coping skills Continued practice of relaxation techniques Development of a regular exercise program
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 Caregiver burden Defense mechanism Crisis
Coping mechanism Mild anxiety is often managed without conscious thought by coping mechanisms, which are behaviors used to decrease stress and anxiety. There are many typical behaviors used as coping mechanisms, including smoking.
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? Crisis Defense mechanism Coping mechanism Caregiver burden
Coping mechanism Mild anxiety is often managed without conscious thought by coping mechanisms, which are behaviors used to decrease stress and anxiety. There are many typical behaviors used as coping mechanisms, including smoking.
Humans are able to adapt to physiological and psychological threats. Which is key to a person's adaptation to these situations?
Coping mechanisms
Humans are able to adapt to physiological and psychological threats. Which is key to a person's adaptation to these situations? Coping mechanisms Ability to ignore symptoms Previous experience Communication skills
Coping mechanisms
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? Parasympathetic nervous system Sympathetic nervous system Motherly response system Central nervous system
Correct response: Sympathetic nervous system Explanation: The sympathetic nervous system activates the fight or flight response quickly as a survival response that results in an increased heart and respiratory rate, moist hands and feet, and dilated pupils. The parasympathetic system is most active in nonstressful events. The motherly instinct is not a proven physiological system.
A nurse in a psychiatric inpatient unit is caring for a client with generalized anxiety disorder. As part of the client's treatment, the psychiatrist orders lorazepam, 1 mg by mouth three times per day. During lorazepam therapy, the nurse should remind the client to: avoid caffeine. avoid aged cheeses. stay out of the sun. maintain an adequate salt intake.
Correct response: avoid caffeine. Explanation: Ingesting 500 mg or more of caffeine can significantly alter the anxiolytic effects of lorazepam. Other dietary restrictions are unnecessary. Staying out of the sun or using sunscreens is required when taking phenothiazines. An adequate salt intake is necessary for clients receiving lithium.
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? "It sounds to me like you're doing a good job." "Your worries are a feature of your anxiety disorder. Tell yourself that you have nothing to worry about." "Has something changed at work that is causing you to worry?" "Why do you think you'll be fired?"
Correct response: "Has something changed at work that is causing you to worry?" Explanation: The nurse begins an assessment by simply asking the client if he or she is currently feeling anxious or worried or has experienced these feelings recently. The nurse also asks the client about obsessive thinking patterns, worrying, compulsions and repetitive activity, specific phobias, and exposure to traumatic events. Once the nurse has determined that signs and symptoms of anxiety do exist, the nurse assesses the possible underlying causes and inquires about family history, recent life events, current stress level, personal history of anxiety, medical and medication history, history of substance abuse, and other possible causes of the anxiety.
Which question in the assessment of a client with anxiety is mostclinically appropriate? "What can I give you to make you feel less anxious right now?" "Does your anxiety make you feel less valuable and competent as a person?" "Do you think that you're justified in feeling anxious right now?" "How do you feel about everything that is happening in your life right now?"
Correct response: "How do you feel about everything that is happening in your life right now?" Explanation: An open-ended question that prompts the client to describe his or her current feelings is a useful assessment technique. Offering medications or other solutions, asking if the client feels justified in his or her feelings, and questioning the client's self-worth are not normally appropriate, or effective, assessment techniques.
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."
Correct response: "I saw you change clothes several times today. Do you find this tiring?" Explanation: Mentioning to the client that changing clothes so often may be tiring focuses on the client's feelings rather than making an assumption. This helps reduce the intensity of the client's ritualistic behavior, thereby promoting trust and rapport. Suggesting to the client to dress only once per day and implying that the client's behavior is bothersome or foolish would convey disapproval, impede trust and rapport, promote dysfunctional behavior, and worsen anxiety. Saying to the client that "you are a perfectionist about the clothes you wear" is sarcastic and does not promote trust and rapport. The client has been dressing and undressing repetitively in response to anxiety not perfectionism. The client already knows the need for repetitive dressing and undressing is frustrating and wants to be understood instead of misunderstood. Perfectionism is more reflective of obsessive-compulsive personality disorder instead of obsessive-compulsive disorder.
A 40-year-old client is admitted for a surgical biopsy of a suspicious lump in the left breast. The client is tearfully writing a letter to the client's two children and 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?" "I can understand that you're nervous, but this really is a minor procedure. You'll be back in your room before you know it." "Try to take a few deep breaths and relax. I have some medication that will help." "I'm sure your children know how much you love them. You'll be able to talk to them on the phone in a few hours."
Correct response: "In case anything goes wrong? What are your thoughts and feelings right now?" Explanation: By acknowledging how the client feels, this response encourages discussion about what the client is thinking and feeling. Minimizing the client's feelings or offering empty reassurances isn't therapeutic or helpful. Deep breathing and preoperative medication would be appropriate only after the client has expressed the fears and dealt with them.
The nurse in the emergency department (ED) is caring for a client who suffers recurrent panic attacks. The client states, "I want to know what causes these panic attacks so I can do something to keep it from happening again." Which responses by the nurse is correct? Select all that apply. "Panic attacks are not your fault. They are thought to be caused by high levels of epinephrine." "No one really knows what causes panic attacks." "There are no treatments for panic attacks outside of behavioral modification therapy." "Psychological factors and social triggers can contribute to panic attacks." "Some people believe that panic attacks are caused by an abnormal pathway in the brain."
Correct response: "Panic attacks are not your fault. They are thought to be caused by high levels of epinephrine." "Psychological factors and social triggers can contribute to panic attacks." Explanation: An excess of epinephrine (NE) is thought to be a causative factor. There are specific neurotransmitters and areas of the brain that are responsible for the perceptions and symptoms of a panic attack. Medications act on these specific areas of the brain to lessen the occurrence of panic attacks. Psychological factors and social conditions may contribute but are not causative of panic attacks. The answer, "Some people believe that panic attacks are caused by an abnormal pathway in the brain" is incorrect. Neurological deficits may be present in other anxiety disorders, such as obsessive compulsive disorder, but are not associated with panic attacks.
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." "I discourage her finger tapping since it serves to increase her anxiety level." "She knows that if she taps her fingers she will be able to lessen her anxiety." "I can tell that the more she taps, the less anxiety she is actually feeling."
Correct response: "The client taps her fingers very rapidly when she is feeling anxious." Explanation: Automatisms are automatic, unconscious mannerisms associated with anxiety. Examples include tapping fingers, jingling keys, or twisting hair. Automatisms are geared toward anxiety relief and increase in frequency and intensity with the client's anxiety level. None of the remaining options accurately state the fact that the tapping identifies the level of anxiety a client is experiencing but does not manage or less the emotion.
A client approaches the nurse on an inpatient psychiatric hospital unit crying, trembling, and feeling nauseous. The client states, "I've tried everything, I still feel so anxious." Which action by the nurse would be most appropriate? Direct the client to continue deep breathing. Take the client on a walk around the unit. Take the client to the dayroom as a distraction. Administer the prescribed PRN anxiolytic medication.
Correct response: Administer the prescribed PRN anxiolytic medication. Explanation: The client is experiencing severe anxiety. The client tells the nurse the client has tried other strategies but they have not been effective. Given the client's report of symptoms, it would be appropriate to administer a dose of the prescribed PRN anxiolytic medication. Once the client is experiencing a decrease in the uncomfortable physiologic symptoms associated with the severe anxiety, it will be easier to engage the client in nonpharmacological interventions, such as deep breathing, to manage any residual signs and symptoms of the anxiety.
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 has sought treatment because of the overwhelming anxiety the client experiences regarding the safety of the client's young children. The client admits that the client will not normally let the client's children leave the client's sight for fear that they will be abducted, abused, or injured. The client is unable to function at work as a result of this anxiety. The nurse would recognize that this client experiences which condition? Signal anxiety Fear Derealization Anticipatory anxiety
Correct response: Anticipatory anxiety Explanation: Anticipatory anxiety exists in the context of phobia. People with phobias develop anticipatory anxiety even when thinking about possibly encountering the dreaded phobic situation (i.e., danger to the client's children). The anticipatory anxiety in this case is so severe that the client is unable to function in certain situations leading to hardship. Signal anxiety refers to the natural anxiety mechanism that communicates danger or motivation for needed change. Fear refers to feeling afraid or threatened by a clearly identifiable external stimulus that presents a danger to a person. Derealization refers to a stage in the experience of anxiety when a person senses that things are not real.
The nurse is teaching a client prescribed the antianxiety agent chlordiazepoxide. The nurse should incorporate which instruction into the teaching plan? Avoid taking antianxiety drugs with alcohol. Take the medication at the same time each day, avoiding taking at bedtime. Take antianxiety drugs in the morning with breakfast or a snack. Avoid consuming items with tyramine when taking antianxiety agents.
Correct response: Avoid taking antianxiety drugs with alcohol. Explanation: The client should be instructed to avoid alcohol while taking chlordiazepoxide because alcohol potentiates the drug's CNS depressant effect. Taken at bedtime, this drug will induce sleep and can potentiate the effects of other drugs. Chlordiazepoxide comes in capsule form and can usually be taken with water any time of day. Tyramine is restricted with monoamine oxidase inhibitors, not antianxiety agents.
A client who experiences panic anxiety around dogs is sitting in a room with a dog and the client's nurse therapist. The nurse therapist is using which behavioral intervention for this type of anxiety? Systematic desensitization Implosion therapy Relaxation exercise Biofeedback
Correct response: Systematic desensitization Explanation: Systematic desensitization refers to the exposure of a person to a fear-producing situation in a systematized manner to decrease a phobic disorder. Implosion therapy, while similar, is not the technique described in this option. This scenario lacks the physical control techniques implemented by relaxation exercise, and it lacks the auditory and/or visual techniques implemented by biofeedback.
The nurse is teaching a client diagnosed with a generalized anxiety disorder how to effectively cope with severe distress. Which interventions would the nurse use to promote effective coping with anxiety? Select all that apply. Discuss previous methods that were effective in handling stress. Encourage the client to limit to a mutually decided amount of time spent on worrying. Help the client to establish a goal and develop a plan to meet the goal. Teach the client how to label feelings and how to express them. Discuss ways to examine the reality of fears. Assist the client to acknowledge the major consequences of blaming others.
Correct response: Discuss previous methods that were effective in handling stress. Encourage the client to limit to a mutually decided amount of time spent on worrying. Help the client to establish a goal and develop a plan to meet the goal. Teach the client how to label feelings and how to express them. Explanation: To promote effective skills, the nurse would focus on having the client identify successful coping skills used in the past and on building on the client's knowledge of the disorder. Setting a mutually agreed upon limit on the amount of time spent worrying gives the client boundaries and acknowledges the concerns. Establishing a goal and planning to meet the goal allows the client to engage in solving the problem and exercise control over the stressful situation. Labeling and expressing feelings is a healthy way to acknowledge feelings. Clients with schizophrenia, not generalized anxiety disorder, require help with focusing on reality-based behaviors. Clients who demonstrate oppositional behavior tend to blame others instead of taking responsibility for their inappropriate behavior.
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? Reviewing the client's previous medication administration record and the client's current list of medications Questioning the client about the clinician who first diagnosed the medical problem Asking the client to provide a detailed explanation of his or her medical problem to determine if the presentation is typical of the problem Establishing whether the client's anxiety preceded the medical problem or whether the medical problem appeared first
Correct response: Establishing whether the client's anxiety preceded the medical problem or whether the medical problem appeared first Explanation: Considering the relationship of anxiety with the onset, exacerbation, or remission of the general medical condition can help determine whether a medical condition contributes to anxiety or vice versa. The client's medication list, the identity of the clinician who diagnosed the disease, and the client's symptoms are all aspects of the assessment process, but these are less likely to establish the primary cause.
When a client is experiencing panic, which is the priorityintervention? Give the client medication immediately. Move the client to a quiet environment. Offer the client therapy to calm down. Physically restrain the client.
Correct response: Move the client to a quiet environment. Explanation: Decreasing external stimuli will help lower the client's anxiety level. The client's safety is priority. Anxious behavior can be escalated by external stimuli. In a large area, the client can feel lost and panicked, but a smaller room can enhance a sense of security. Medicating the client would be inappropriate. Restraint should only be used as a last resort. Therapy can be appropriate once the client's anxiety level decreases.
Relaxation techniques help clients with anxiety disorders because they can promote what? Reduction of autonomic arousal Increase in sympathetic stimulation Release of cortisol Increase in the metabolic rate
Correct response: Reduction of autonomic arousal Explanation: Regularly inducing the relaxation response reduces the general level of autonomic arousal in anxious clients. It lowers blood pressure, heart rate, metabolic rate, and oxygen demands. This physiologic effect may result from effects on the production of cortisol, a hormone the body releases in response to stress. Cortisol is helpful during the fight-or-flight response, but its prolonged presence in chronically anxious or stressed clients can inhibit the immune system and have other deleterious effects on the body.
A client is worried and states, "I just know I won't be able to sleep before my surgery." What sleeping pattern would the nurse anticipate? The client will likely not be able to sleep. The worry will make the client fall asleep quickly. The client will probably not be able to stay asleep. The client will likely sleep all night.
Correct response: The client will likely not be able to sleep. The expectation that the onset of sleep will be difficult increases the person's anxiety. The anxiety floods the brain with stimulating chemicals that interfere with relaxation, which is a prerequisite for natural sleep. Given the client's anxiety about the surgery, as well as the expectation that they will not sleep, it is likely that the client will not be able to sleep. Worry may cause exhaustion, but it will not cause the client to fall asleep quickly. Since the client will likely not sleep, the nurse does not anticipate patterns of wakening for the client.
A client periodically has acute panic attacks. These attacks are unpredictable and have no apparent association with a specific object or situation. During an acute panic attack, the client may experience: a decreased perceptual field. a decreased heart rate. a decreased respiratory rate. heightened concentration.
Correct response: a decreased perceptual field. Explanation: Panic is the most severe level of anxiety. During a panic attack, a client's perceptual field, narrows. The client becomes more self-focused, less aware of surroundings, and unable to process information from the environment. The client's decreased perceptual field impairs attention and ability to concentrate. During an acute panic attack, the client may experience an increase, not a decrease, in heart and respiratory rates, resulting from stimulation of the sympathetic nervous system.
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 helping the client identify ways to eliminate all sources of stress in his or her daily life educating the client concerning the use of medications to manage anxiety disorders assessing the client for possible symptoms of panic disorder
Correct response: assessing the client's ability to implement stress management techniques effectively Explanation: For people with anxiety disorders, it is important to emphasize that the goal is effective management of stress and anxiety, not the total elimination of anxiety. Learning anxiety management techniques and effective methods for coping with life and its stresses is essential for overall improvement in life quality. Although medication is important to relieve excessive anxiety, it does not solve or eliminate the problem entirely. While assessment is appropriate, it is not directly associated with the management and treatment of the original disorder.
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? Cognitive therapy Deep breathing Desensitization Problem-solving
Deep breathing
A nurse notices that a client with obsessive-compulsive disorder washes the hands for long periods each day. How should the nurse respond to this compulsive behavior? by setting aside times during which the client can focus on the behavior by urging the client to reduce the frequency of the behavior as rapidly as possible by calling attention to or trying to prevent the behavior by discouraging the client from verbalizing his anxieties
Correct response: by setting aside times during which the client can focus on the behavior Explanation: The nurse should set aside times during which the client is free to focus on the compulsive behavior or obsessive thoughts. The nurse should urge the client to reduce the frequency of the compulsive behavior gradually, not rapidly. The nurse shouldn't call attention to the behavior or try to prevent it. Trying to prevent the behavior may frighten and hurt the client. The nurse should encourage the client to verbalize anxieties to help distract attention from the compulsive behavior.
A client admitted to the unit is visibly anxious. The nurse documents what assessment finding as an expected finding in a client experiencing mild to moderate anxiety? dyspnea chest pain increased heart rate drop in blood pressure
Correct response: increased heart rate Explanation: During anxiety, the sympathetic nervous system is activated. This can result in increased heart rate and cardiac contractility, leading to an increase in cardiac output and blood pressure (BP = CO x HR). The client's respiratory rate may increase, but unless the client is experiencing a panic attack, neither dyspnea nor chest pain should be present. If these present with mild anxiety, the nurse would not document these as an expected finding.
A client who is a painter recently fractured a tibia and can't work. The client worries about finances. To treat the client's anxiety, the physician orders buspirone, 5 mg by mouth three times per day. Which drugs interact with buspirone? beta-adrenergic blockers antineoplastic drugs antiparkinsonian drugs monoamine oxidase (MAO) inhibitors
Correct response: monoamine oxidase (MAO) inhibitors Explanation: Buspirone interacts only with MAO inhibitors, producing a hypertensive reaction. Administration of beta-adrenergic blockers, antineoplastic drugs, or antiparkinsonian drugs wouldn't cause an interaction, so they can be administered simultaneously with buspirone.
A client arrives on the psychiatric unit exhibiting extreme excitement, disorientation, incoherent speech, agitation, frantic and aimless physical activity, and grandiose delusion. Which nursing diagnosis takes highest priority for this client at this time? ineffective coping hopelessness risk for injury disturbed personal identity
Correct response: risk for injury Explanation: This client is at increased risk for injury because of severe hyperactivity, disorientation, and agitation. Although ineffective coping, hopelessness, and disturbed personal identity also are appropriate diagnoses, the client's safety takes highest priority. The nurse should take immediate action to protect the client from injury.
A nurse is reviewing the medical record of a client diagnosed with anxiety disorder. Which information would the nurse interpret as suggestive of a common comorbidity associated with anxiety? Daily consumption of large amounts of alcohol A history of obsessive-compulsive disorder A history of severe trauma in childhood Difficulty with maintaining boundaries
Daily consumption of large amounts of alcohol
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 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 Cognitive therapy Problem-solving Desensitization
Deep breathing Helping the client focus on deep breathing can decrease the hyperarousal involved in panic attacks. It is also an opportunity for the therapist to teach the client self-help and adaptive coping mechanisms for panic attacks.
Which term describes feelings of being disconnected from oneself as seen in a panic attack? Derealization Automatisms Agoraphobia Depersonalization
Depersonalization Rationale: Depersonalization describes feelings of being disconnected from oneself as seen in a panic attack. Derealization is sensing that things are not real. Automatisms are automatic, unconscious mannerisms. Agoraphobia is a fear of being outside.
Which term describes feelings of being disconnected from oneself as seen in a panic attack? Automatisms Derealization Agoraphobia Depersonalization
Depersonalization describes feelings of being disconnected from oneself as seen in a panic attack. Derealization is sensing that things are not real.
When assessing an elderly client who has newly been diagnosed with an anxiety disorder, the mental health nurse's priority is to carry out which task? Determine the client's risk for self-harm or harm to others Obtain a thorough history, focusing on the client's physiologic functioning Assess for physical conditions that may affect anxiety Determine the effects that culture has had on the client's anxiety issues
Determine the client's risk for self-harm or harm to others
When assessing an elderly client who has newly been diagnosed with an anxiety disorder, the mental health nurse's priority is to carry out which task? Determine the client's risk for self-harm or harm to others Determine the effects that culture has had on the client's anxiety issues Obtain a thorough history, focusing on the client's physiologic functioning Assess for physical conditions that may affect anxiety
Determine the client's risk for self-harm or harm to others
When assessing an elderly client who has newly been diagnosed with an anxiety disorder, the mental health nurse's priority is to carry out which task? Obtain a thorough history, focusing on the client's physiologic functioning Determine the client's risk for self-harm or harm to others Determine the effects that culture has had on the client's anxiety issues Assess for physical conditions that may affect anxiety
Determine the client's risk for self-harm or harm to others The first step in the assessment process is to identify the client's level of anxiety and to determine whether a threat of self-harm or harm to others exists. In any situation where the client history is not known, the nursing priority is safety.
A nurse is assessing a client suffering from stress and anxiety. The most common physiologic response to stress and anxiety is: sedation. diarrhea. vertigo. urticaria.
Diarrhea is the most common physiologic response to stress and anxiety. Sedation, vertigo, and urticaria could also be related to stress and anxiety but they don't occur as commonly as diarrhea.
A nurse is assessing a client and determines that the client is experiencing severe anxiety based on which finding? Eagerness for more information A heightened sense of awareness Distorted sensory awareness Goal directed behavior
Distorted sensory awareness In severe anxiety, perception becomes increasingly distorted, sensory input diminishes, and processing of sensory stimuli becomes scattered and disorganized.
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
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. Agitation Dry mouth Blurred vision Constipation Vomiting
Dry mouth Blurred vision Constipation
An individual experiencing panic attacks can also experience depersonalization, which is the sense of being disconnected from one-self. True False
True Rationale: keyword is panic
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
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? Endorphins Dopamine Epinephrine Testosterone
Epinephrine
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? Testosterone Endorphins Dopamine Epinephrine
Epinephrine In the sympathetic-adrenal-medullary response to stress, the sympathetic nervous system stimulates the adrenal gland to release epinephrine and norepinephrine. Corticotropin-releasing factor, adrenocorticotropic hormone (ACTH), and glucocorticoids are released in the hypothalamic-pituitary response to stress.
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? Testosterone Endorphins Epinephrine Dopamine
Epinephrine In the sympathetic-adrenal-medullary response to stress, the sympathetic nervous system stimulates the adrenal gland to release epinephrine and norepinephrine. Corticotropin-releasing factor, adrenocorticotropic hormone (ACTH), and glucocorticoids are released in the hypothalamic-pituitary response to stress.
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? Testosterone Epinephrine Dopamine Endorphins
Epinephrine n the sympathetic-adrenal-medullary response to stress, the sympathetic nervous system stimulates the adrenal gland to release epinephrine and norepinephrine.
Nursing interventions for physical stress related illness should include what? Assessing the need for increased dose of benzodiazepines Attending group therapy Establishing daily routines of meals and sleeping Fostering use of a social support system
Establishing daily routines of meals and sleeping
Nursing interventions for physical stress related illness should include what? Attending group therapy Fostering use of a social support system Assessing the need for increased dose of benzodiazepines Establishing daily routines of meals and sleeping
Establishing daily routines of meals and sleeping Individuals experiencing or at risk for untoward stress responses may benefit from a number of biologic interventions. The importance of (re-)establishing regular routines for activities of daily living (e.g., eating, sleeping, self-care, and leisure time) cannot be overstated. As well as ensuring adequate nutrition, sleep and rest, and hygiene, a routine may help to structure an individual's time and give them a sense of personal control or mastery.
Nursing interventions for physical stress related illness should include what? Assessing the need for increased dose of benzodiazepines Attending group therapy Establishing daily routines of meals and sleeping Fostering use of a social support system
Establishing daily routines of meals and sleeping The importance of (re-)establishing regular routines for activities of daily living (e.g., eating, sleeping, self-care, and leisure time) cannot be overstated. As well as ensuring adequate nutrition, sleep and rest, and hygiene, a routine may help to structure an individual's time and give them a sense of personal control or mastery.
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 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? Reviewing the client's previous medication administration record and the client's current list of medications Questioning the client about the clinician who first diagnosed the medical problem Asking the client to provide a detailed explanation of his or her medical problem to determine if the presentation is typical of the problem Establishing whether the client's anxiety preceded the medical problem or whether the medical problem appeared first
Establishing whether the client's anxiety preceded the medical problem or whether the medical problem appeared first
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 Asking the client to provide a detailed explanation of his or her medical problem to determine if the presentation is typical of the problem Questioning the client about the clinician who first diagnosed the medical problem Reviewing the client's previous medication administration record and the client's current list of medications
Establishing whether the client's anxiety preceded the medical problem or whether the medical problem appeared first Considering the relationship of anxiety with the onset, exacerbation, or remission of the general medical condition can help determine whether a medical condition contributes to anxiety or vice versa. The client's medication list, the identity of the clinician who diagnosed the disease, and the client's symptoms are all aspects of the assessment process, but these are less likely to establish the primary cause.
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? Reviewing the client's previous medication administration record and the client's current list of medications Asking the client to provide a detailed explanation of his or her medical problem to determine if the presentation is typical of the problem Questioning the client about the clinician who first diagnosed the medical problem Establishing whether the client's anxiety preceded the medical problem or whether the medical problem appeared first
Establishing whether the client's anxiety preceded the medical problem or whether the medical problem appeared first Considering the relationship of anxiety with the onset, exacerbation, or remission of the general medical condition can help determine whether a medical condition contributes to anxiety or vice versa. The client's medication list, the identity of the clinician who diagnosed the disease, and the client's symptoms are all aspects of the assessment process, but these are less likely to establish the primary cause.
Generalized anxiety disorder (GAD) is characterized by what criteria? Excessive worry or anxiety lasting more than 6 months Flashbacks and feelings of unreality Fear of going outdoors Behavioral changes in response to panic attacks
Excessive worry or anxiety lasting more than 6 months
Anxiety and fear both refer to the same feeling or being afraid or threatened by an external stimulus. True False
False
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, "I'm always so nervous when I come to the clinic." The nurse interprets the client's statement and vital signs as reflecting which situation? Exhaustion Fight-or-flight response Severe anxiety Defense mechanism
Fight-or-flight response
A patient with anxiety disorder has excessive anxiety and worries about multiple life circumstances. For how long would this patient experience these feelings before the anxiety disorder would be considered chronic and generalized? 6 months 2 months 12 months 4 months
For generalized anxiety disorder, the diagnostic criteria listed include unrealistic or excessive anxiety and worry about two or more life circumstances for 6 months or more, during which time these concerns exist for a majority of days.
A 21-year-old client has been recently diagnosed with agoraphobia. Which situation is most likely to cause the client anxiety? Having a blood sample drawn and experiencing mild pain Going to a crowded, outdoor market independently Having the client's work performance closely scrutinized by a supervisor Gaining 5 pounds and being unable to exercise vigorously
Going to a crowded, outdoor market independently
A 21-year-old client has been recently diagnosed with agoraphobia. Which situation is most likely to cause the client anxiety? Going to a crowded, outdoor market independently Having the client's work performance closely scrutinized by a supervisor Having a blood sample drawn and experiencing mild pain Gaining 5 pounds and being unable to exercise vigorously
Going to a crowded, outdoor market independently Agoraphobia is the fear of being alone in public places from which the person thinks escape would be difficult or help would be unavailable if he or she were incapacitated
A client comes in for a therapy session and begins to have a panic attack. The therapist asks the client to sit 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? Decatastrophizing Progressive relaxation Guided imagery Desensitization
Guided imagery Guided imagery involves imagining a safe, enjoyable place to relax. In desensitization, the therapist progressively exposes the client to the threatening object in a safe setting until the client's anxiety decreases
The nurse is assessing a client with anxiety. What symptom indicates that the the client has adopted a maladaptive behavior in response to stress? Tachycardia Dyspnea Headache Pedal edema
Headache
While conducting a class on anxiety and stress reduction, a nurse describes the symptoms of anxiety (including panic), informing the class that the physical symptoms of a panic attack can mimic what? Stroke Gastrointestinal flu Heart attack Appendicitis
Heart attack
A nurse is assessing a client with anxiety. Which signs and symptoms would the nurse attribute to sympathetic nervous stimulation? Select all that apply. Pressure to urinate Fainting Heart racing Hypertension Bradycardia
Heart racing Hypertension
A nurse is assessing a client with anxiety. Which signs and symptoms would the nurse attribute to sympathetic nervous stimulation? Select all that apply. Hypertension Heart racing Fainting Pressure to urinate Bradycardia
Hypertension Heart racing Rationale:Heart racing and hypertension are anxiety signs and symptoms related to sympathetic nervous stimulation. Pressure to urinate, fainting, and bradycardia are related to parasympathetic nervous stimulation.
Concomitant use of antidepressants with monoamine oxidase inhibitors (MAOIs) can cause which life-threatening drug interaction? Risk of seizures Sedation Hypotensive crisis Hypertensive crisis
Hypertensive crisis
Which is considered a tricyclic antidepressant (TCA) used in the treatment of clients with panic disorder? Imipramine Fluoxetine Sertraline Lorazepam
Imipramine
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.
Which is one characteristic that differentiates generalized anxiety disorder (GAD) and panic disorder? In panic disorder, the person suffers from a chronic state of elevated anxiety. Panic disorders are more easily treated than GAD. In GAD, the person usually does not experience eruptions of acute anxiety. GAD is characterized by occasional, unexpected panic attacks.
In GAD, the person usually does not experience eruptions of acute anxiety.
Which is one characteristic that differentiates generalized anxiety disorder (GAD) and panic disorder? In panic disorder, the person suffers from a chronic state of elevated anxiety. GAD is characterized by occasional, unexpected panic attacks. Panic disorders are more easily treated than GAD. In GAD, the person usually does not experience eruptions of acute anxiety.
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 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? Vasodilation of peripheral blood vessels Increased blood pressure Decrease in blood glucose levels Pupil constriction
Increased blood pressure
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? Vasodilation of peripheral blood vessels Decrease in blood glucose levels Pupil constriction Increased blood pressure
Increased blood pressure An initial response to stress, as seen by the fight-or-flight response, is an increase in the client's heart rate and blood pressure. Vasoconstriction leads to the increase in blood pressure
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 Pupil constriction Vasodilation of peripheral blood vessels Decrease in blood glucose levels
Increased blood pressure An initial response to stress, as seen by the fight-or-flight response, is an increase in the client's heart rate and blood pressure. Vasoconstriction leads to the increase in blood pressure. Blood glucose levels increase, supplying more readily available energy, and pupils dilate.
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? Vasodilation of peripheral blood vessels Pupil constriction Decrease in blood glucose levels Increased blood pressure
Increased blood pressure An initial response to stress, as seen by the fight-or-flight response, is an increase in the client's heart rate and blood pressure. Vasoconstriction leads to the increase in blood pressure. Blood glucose levels increase, supplying more readily available energy, and pupils dilate.
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.
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. People with panic attacks often have fewer attacks if they also have agoraphobia. Typically, individuals experience this disorder after the age of 30 years. Persons rarely have an underlying comorbid condition of depression.
Individuals may believe they are having a heart attack when a panic attack occurs.
During the admission assessment of a 27-year-old client who has been diagnosed with an anxiety disorder, the nurse observes that the client is becoming increasingly restless and agitated. How should the nurse respond to this development? Inform the client that the assessment can be postponed if the client is finding it overwhelming. Increase the speed of the assessment in order to ensure that it is completed sooner and inform the client that the nurse is doing so. Provide education regarding the level of anxiety that the client may be experiencing. Explain to the client that the client's current feelings of anxiety have the potential to foster better coping skills in the future.
Inform the client that the assessment can be postponed if the client is finding it overwhelming.
A group of students is reviewing information about the etiology of generalized anxiety disorder (GAD). The students demonstrate understanding of this information when they identify which as representing the bases for this disorder? Inaccurate environmental danger assessment Exposure to multiple stressful life events Kindling caused by overstimulation Intense worry and stress about work or simple family life
Intense worry and stress about work or simple family life
A group of students is reviewing information about the etiology of generalized anxiety disorder (GAD). The students demonstrate understanding of this information when they identify which as representing the bases for this disorder? Kindling caused by overstimulation Exposure to multiple stressful life events Inaccurate environmental danger assessment Intense worry and stress about work or simple family life
Intense worry and stress about work or simple family life Adults with GAD often worry about matters such as their job, household finances, health of family members, or simple matters (e.g., household chores or being late for appointments). The intensity of the worry fluctuates, and stress tends to intensify the worry and anxiety symptoms. Cognitive behavioral theory regarding the etiology of GAD proposes that the disorder results from inaccurate assessment of perceived environmental dangers. Although there are no specific sociocultural theories related to the development of GAD, a high-stress lifestyle and multiple stressful life events may be contributors. Kindling results from overstimulation or repeated stimulation of nerve cells by environmental stressors.
A nursing role in providing client education regarding panic disorder includes which of the following? (Select all that apply.) Introduction of appropriate coping skills Identification of alternate treatment modalities Involving family and support persons when appropriate Providing feedback to support the client Adjustment of treatment plan when indicated
Introduction of appropriate coping skills Identification of alternate treatment modalities Involving family and support persons when appropriate Providing feedback to support the client
A client receiving benzodiazepine therapy as treatment for panic disorder comes to the emergency department for evaluation. The nurse suspects the client is experiencing benzodiazepine withdrawal based on which of the following findings? Select all that apply. Hypersomnia Irritability Apprehension Agitation Sour taste
Irritability Apprehension Agitation
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
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? Will interfere with her cognitive abilities Is conducive to concentration and problem solving May be transferred to her tutor and result in test anxiety Is pathologic and warrants postponing the test
Is conducive to concentration and problem solving
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? Will interfere with her cognitive abilities Is conducive to concentration and problem solving May be transferred to her tutor and result in test anxiety Is pathologic and warrants postponing the test
Is conducive to concentration and problem solving Mild anxiety is often helpful to individuals and can assist in maintaining concentration and problem-solving abilities. Moderate to severe anxiety can begin to inhibit an individual's coping because these levels create physiologic responses (such as tachycardia and sweating) and psychological responses (such as loss of concentration and inability to focus) that may prevent the person from functioning adequately, interfere with cognitive abilities, and become pathologic if not treated adequately.
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." "With the development of more life skills and a demonstration of continued success in life, your anxiety will shrink and eventually disappear." "Every time you feel anxious, try to focus on how much easier your life would be if you didn't experience anxiety so often." "If you address the causes of your anxiety head-on, you will find that you can recover from it without medications or therapy."
It is therapeutic to foster in clients the understanding that the experience of anxiety is natural and inevitable. It would be inaccurate to promise recovery with increased success in life and self-discipline. Clients with anxiety are likely to be well aware of how much easier their lives would be without recurring anxiety.
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 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 Duloxetine Escitalopram Fluvoxamine
Lorazepam
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 Duloxetine Escitalopram Fluvoxamine
Lorazepam
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
Lorazepam is commonly given along with a neuroleptic agent. What is the purpose of administering the drugs together? to reduce anxiety and potentiate the neuroleptic's sedative action to counteract the neuroleptic's extrapyramidal effects to manage depressed clients to increase a client's level of awareness and concentration
Lorazepam, when taken with a neuroleptic such as haloperidol, potentiates the neuroleptic's sedating effect and is used to treat severely agitated clients. Lorazepam wouldn't be given to counteract extrapyramidal effects. Both drugs can cause depression, so they aren't used to treat depression. The drugs' depressant effect would decrease concentration, not increase it.
Lorazepam is commonly given along with a neuroleptic agent. What is the purpose of administering the drugs together? to reduce anxiety and potentiate the neuroleptic's sedative action to counteract the neuroleptic's extrapyramidal effects to manage depressed clients to increase a client's level of awareness and concentration
Lorazepam, when taken with a neuroleptic such as haloperidol, potentiates the neuroleptic's sedating effect and is used to treat severely agitated clients. Lorazepam wouldn't be given to counteract extrapyramidal effects. Both drugs can cause depression, so they aren't used to treat depression. The drugs' depressant effect would decrease concentration, not increase it.
When assessing a client with anxiety, the nurse should recognize that anxiety may often be a result of what? Cognitive deficits Organic brain changes Medications Fluid and electrolyte imbalances
Medications
A client reports the client is beginning a new job and is feeling anxious about the client's performance. The nurse can explain which type of anxiety can actually improve functioning? Mild Moderate Severe All anxiety decreases functioning
Mild
During which type of anxiety does a person's perceptual field actually increase? Mild Moderate Severe Panic
Mild
During which type of anxiety does a person's perceptual field actually increase? Panic Moderate Severe Mild
Mild During mild anxiety, a person's perceptual field widens slightly, and the person is able to observe more than before and to see relationships. During moderate anxiety, the perceptual field narrows slightly. The person does not notice what goes on peripheral to the immediate focus but can do so if attention is directed there by another observer. The perceptual field is greatly reduced in severe anxiety. During panic anxiety, the perceptual field is reduced to a detail, which is usually "blown up."
During which type of anxiety does a person's perceptual field actually increase? Panic Moderate Mild Severe
Mild During mild anxiety, a person's perceptual field widens slightly, and the person is able to observe more than before and to see relationships. During moderate anxiety, the perceptual field narrows slightly. The person does not notice what goes on peripheral to the immediate focus but can do so if attention is directed there by another observer. The perceptual field is greatly reduced in severe anxiety. During panic anxiety, the perceptual field is reduced to a detail, which is usually "blown up."
Which level of anxiety helps the client focus the client's attention to learn, problem solve, think, act, feel, and protect himself or herself? Moderate Severe Mild Panic
Mild Rationale:In mild anxiety, sensory stimulation increases and helps the client focus the client's attention to learn, solve problems, and think. Moderate anxiety causes the client to have difficulty concentrating independently, but he or she can be redirected to the topic. Severe anxiety causes the client to have a reduced perceptual field and he or she cannot complete tasks. Panic anxiety reduces the perceptual field to focus on the self, and the client cannot process any environmental stimuli.
The mental health nurse is gathering a health history on a new client. The client is constantly pacing the floor and is concerned only with stating that the client is about to die. The nurse would classify this level of anxiety as what? Moderate Euphoria Mild Severe
Moderate
The mental health nurse is gathering a health history on a new client. The client is constantly pacing the floor and is concerned only with stating that the client is about to die. The nurse would classify this level of anxiety as what? Euphoria Severe Mild Moderate
Moderate In moderate anxiety, the client experiences a narrowing of the ability to concentrate. The client paces, has voice tremors, and has an increased rate of speech. During euphoria, the client experiences an exaggerated feeling of well-being that is not directly proportional to a specific circumstance or situation. Mild anxiety causes the client to have an increased alertness to inner feelings or the environment. During severe anxiety, the client is able to focus on only small or scattered details.
The mental health nurse is gathering a health history on a new client. The client is constantly pacing the floor and is concerned only with stating that the client is about to die. The nurse would classify this level of anxiety as what? Mild Euphoria Moderate Severe
Moderate Rationale:In moderate anxiety, the client experiences a narrowing of the ability to concentrate. The client paces, has voice tremors, and has an increased rate of speech. During euphoria, the client experiences an exaggerated feeling of well-being that is not directly proportional to a specific circumstance or situation. Mild anxiety causes the client to have an increased alertness to inner feelings or the environment. During severe anxiety, the client is able to focus on only small or scattered details.
When a client is experiencing panic, which is the priority intervention?
Move the client to a quiet environment.
When a client is experiencing panic, which is the priority intervention? Give the client medication immediately. Move the client to a quiet environment. Offer the client therapy to calm down. Physically restrain the client.
Move the client to a quiet environment.
When a client is experiencing panic, which is the priority intervention? Physically restrain the client. Move the client to a quiet environment. Offer the client therapy to calm down. Give the client medication immediately.
Move the client to a quiet environment. Decreasing external stimuli will help lower the client's anxiety level. The client's safety is priority. Anxious behavior can be escalated by external stimuli. In a large area, the client can feel lost and panicked, but a smaller room can enhance a sense of security. Medicating the client would be inappropriate. Restraint should only be used as a last resort. Therapy can be appropriate once the client's anxiety level decreases.
The causes of anxiety disorders can be best explained by what?
Neurobiologic vulnerabilities and perception of psychosocial stress
The nurse is teaching a class to a group of individuals diagnosed with anxiety disorders. When describing the underlying cause of these disorders, which information would the nurse most likely include? Inactivation of stress hormones A heritable predisposition unrelated to brain abnormalities Distorted thinking patterns Neurotransmitter involvement
Neurotransmitter involvement
The nurse can document correctly that a client diagnosed with an anxiety disorder is experiencing moderate anxiety when the nurse observes the client doing what? Pacing and repeatedly asking staff what time the "doctor will be here." Reporting, "I just can't relax; I've got things to do." Telling another client that "there is nothing they can do for me; I just know it's really bad." Demonstrating difficulty actually verbalizing anxious feelings
Pacing and repeatedly asking staff what time the "doctor will be here."
The nurse can document correctly that a client diagnosed with an anxiety disorder is experiencing moderate anxiety when the nurse observes the client doing what? Reporting, "I just can't relax; I've got things to do." Telling another client that "there is nothing they can do for me; I just know it's really bad." Demonstrating difficulty actually verbalizing anxious feelings Pacing and repeatedly asking staff what time the "doctor will be here."
Pacing and repeatedly asking staff what time the "doctor will be here." The nurse documents that a client diagnosed with an anxiety disorder is experiencing moderate anxiety when the nurse observes the client pacing and repeatedly asking staff members when the doctor will arrive. Moderate anxiety is characterized by wandering attention. The client may require repeated redirection, such as in this scenario.
The nurse has read in a client's admission record that the client has been taking propranolol for psychiatric, rather than medical, reasons. The nurse should recognize that the client likely has a history of which mental health condition? Obsessive-compulsive disorder (OCD) Panic disorder Acute stress disorder Nightmares
Panic disorder
The nurse has read in a client's admission record that the client has been taking propranolol for psychiatric, rather than medical, reasons. The nurse should recognize that the client likely has a history of which mental health condition? Obsessive-compulsive disorder (OCD) Panic disorder Nightmares Acute stress disorder
Panic disorder Propranolol is used in the treatment of panic disorder, but it is not a common pharmacological intervention for OCD, acute stress disorder, or nightmares.
The nurse has read in a client's admission record that the client has been taking propranolol for psychiatric, rather than medical, reasons. The nurse should recognize that the client likely has a history of which mental health condition? Obsessive-compulsive disorder (OCD) Panic disorder Acute stress disorder Nightmares
Panic disorder Propranolol is used in the treatment of panic disorder, but it is not a common pharmacological intervention for OCD, acute stress disorder, or nightmares.
The nurse has read in a client's admission record that the client has been taking propranolol for psychiatric, rather than medical, reasons. The nurse should recognize that the client likely has a history of which mental health condition? Obsessive-compulsive disorder (OCD) Nightmares Panic disorder Acute stress disorder
Panic disorder Propranolol is used in the treatment of panic disorder, but it is not a common pharmacological intervention for OCD, acute stress disorder, or nightmares.
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 experience a fight-or-flight response when threatened." "People with anxiety disorders generally find that the anxiety interferes with daily activities." "Normal anxiety does not result in feelings of dread or restlessness." "Normal anxiety occurs in response to everyday stressors."
Pathologic anxiety is suspected if a person feels anxious when no real threat exists, when a threat has passed long ago but continues to impair the person's functioning, or when a person substitutes adaptive coping mechanisms with maladaptive ones.
A client has become increasingly afraid to ride in elevators. While in an elevator one morning, the client experiences shortness of breath, palpitations, dizziness, and trembling. A physician can find no physiological basis for these symptoms and refers the client to a psychiatric clinical nurse specialist for outpatient counseling sessions. Which type of therapy is most likely to reduce the client's anxiety level? psychoanalytically oriented psychotherapy group psychotherapy systematic desensitization referral for evaluation for electroconvulsive therapy
Phobias are commonly viewed as learned responses to anxiety that can be unlearned through certain techniques such as behavior modification. Systematic desensitization, a form of behavior modification, attempts to reduce anxiety, and thereby eradicate the phobia, through gradual exposure to anxiety-producing stimuli. Psychoanalytically oriented therapy also may be effective in this situation, but years of treatment are required to achieve results. Group psychotherapy could be used as an adjunct treatment to increase the client's self-esteem and reduce generalized anxiety. Electroconvulsive therapy is reserved primarily for clients with severe depression or psychosis who respond poorly to other treatments; it's rarely indicated for phobic disorders.
Which condition involves a persistent, irrational fear attached to an object or situation that objectively does not pose a significant danger? Phobic disorders Posttraumatic stress disorder Obsessive-compulsive disorder Stress disorders
Phobic disorders
The nurse is teaching a client with an anxiety disorder ways to manage anxiety. The nurse suggests which schedule for practicing relaxation techniques? Use the techniques as needed when experiencing severe anxiety. Practice the techniques when relatively calm. Reserve these techniques for episodes of panic. Expect to practice the techniques when meeting with a therapist.
Practice the techniques when relatively calm.
A nurse is preparing a plan of care for a client with anxiety. Which elements would the nurse likely include? Select all that apply. Providing supportive feedback Identifying treatment modalities Using appropriate coping skills Involving family for support, if appropriate Using restraint when panic develops
Providing supportive feedback Identifying treatment modalities Using appropriate coping skills Involving family for support, if appropriate
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
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 Providing the client with a safe, quiet, and private place Encouraging the client to verbalize feelings and concerns Approaching the client in a calm, confident manner
Providing the client with a comforting touch
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? Approaching the client in a calm, confident manner Encouraging the client to verbalize feelings and concerns Providing the client with a comforting touch Providing the client with a safe, quiet, and private place
Providing the client with a comforting touch It is important to establish rapport and trust with the anxious client before using therapeutic touch. Touching an anxious client may actually increase anxiety. Trust can be established by approaching the client in a calm and confident manner; providing a place that is quiet, safe, and private; and encouraging the client to verbalize feelings and concerns
Relaxation techniques help clients with anxiety disorders because they can promote what?
Reduction of autonomic arousal
Relaxation techniques help clients with anxiety disorders because they can promote what? Increase in sympathetic stimulation Reduction of autonomic arousal Release of cortisol Increase in the metabolic rate
Reduction of autonomic arousal Regularly inducing the relaxation response reduces the general level of autonomic arousal in anxious clients. It lowers blood pressure, heart rate, metabolic rate, and oxygen demands. This physiologic effect may result from effects on the production of cortisol, a hormone the body releases in response to stress. Cortisol is helpful during the fight-or-flight response, but its prolonged presence in chronically anxious or stressed clients can inhibit the immune system and have other deleterious effects on the body.
Relaxation techniques help clients with anxiety disorders because they can promote what? Increase in the metabolic rate Release of cortisol Reduction of autonomic arousal Increase in sympathetic stimulation
Reduction of autonomic arousal Regularly inducing the relaxation response reduces the general level of autonomic arousal in anxious clients. It lowers blood pressure, heart rate, metabolic rate, and oxygen demands. This physiologic effect may result from effects on the production of cortisol, a hormone the body releases in response to stress. Cortisol is helpful during the fight-or-flight response, but its prolonged presence in chronically anxious or stressed clients can inhibit the immune system and have other deleterious effects on the body.
The nurse is teaching about postoperative wound care. As the wound is uncovered, the client begins mumbling, breathing rapidly, and trying to get out of bed, and the client does not respond when the nurse calls his name. The nurse determines that the client is experiencing anxiety. Which of the following should be the nurse's first action? Proceed with wound care quickly Replace the dressing on the wound Get the assistance of another nurse Ask the client to describe his feelings
Replace the dressing on the wound
A client experiencing stress has tachycardia and tachypnea. On the basis of the physiological model of the general adaptation syndrome, in which stage is this client? Stress Alarm reaction Resistance Exhaustion
Resistance
Which should be included in a teaching plan for a client prescribed a benzodiazepine? Stop taking drug if sedation develops Consume caffeine in moderation Maintain a fluid restriction Rise slowly from a lying or sitting position
Rise slowly from a lying or sitting position Clients taking a benzodiazepine should rise slowly from a lying or sitting position. The client should drink adequate fluids, avoid caffeine, and not stop taking the drug abruptly.
Which should be included in a teaching plan for a client prescribed a benzodiazepine? Maintain a fluid restriction Rise slowly from a lying or sitting position Consume caffeine in moderation Stop taking drug if sedation develops
Rise slowly from a lying or sitting position Clients taking a benzodiazepine should rise slowly from a lying or sitting position. The client should drink adequate fluids, avoid caffeine, and not stop taking the drug abruptly.
Which should be included in a teaching plan for a client prescribed a benzodiazepine? Rise slowly from a lying or sitting position Stop taking drug if sedation develops Consume caffeine in moderation Maintain a fluid restriction
Rise slowly from a lying or sitting position Rationale:Clients taking a benzodiazepine should rise slowly from a lying or sitting position. The client should drink adequate fluids, avoid caffeine, and not stop taking the drug abruptly.
Which medication classification has been used to treat social phobia? Selective serotonin reuptake inhibitors (SSRIs) Monoamine oxidase inhibitors (MAOIs) Tricyclic antidepressants (TCAs) Nonbenzodiazepines
SSRIs are used to treat clients with social phobia because they significantly reduce social anxiety and phobic avoidance. Benzodiazepines are also used to reduce anxiety caused by phobias.
Which medication classifications used in the treatment of panic disorder can cause physical dependence? Benzodiazepines Selective serotonin reuptake inhibitors (SSRIs) Tricyclic antidepressants (TCAs) Serotonin-norepinephrine reuptake inhibitors (SNRIs)
SSRIs, SNRIs, TCAs, monoamine oxidase inhibitors (MAOIs), and antianxiety medication (benzodiazepines) have been shown to be effective in panic disorders. Benzodiazepines are well tolerated but physical dependence is a potential side effect, and they carry the risk of withdrawal symptoms upon discontinuation of use.
Which is the primary concern for a client with panic-level anxiety? Safety Emotional needs Physiologic needs Social support
Safety
Which is the primary concern for a client with panic-level anxiety? Emotional needs Social support Safety Physiologic needs
Safety Rationale:During panic-level anxiety, the person's safety is the primary concern. He or she cannot perceive potential harm and may have no capacity for rational thought. Emotional needs, physiologic needs, and social support are important but not the primary concern.
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 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? Benzodiazepine Selective serotonin reuptake inhibitor (SSRI) Monoamine oxidase inhibitor (MAOI) Tricyclic antidepressant (TCA)
Selective serotonin reuptake inhibitor (SSRI)
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? Benzodiazepines Tricyclic antidepressants Selective serotonin reuptake inhibitors Antihypertensives
Selective serotonin reuptake inhibitors
Which medication classification has been used to treat social phobia? Selective serotonin reuptake inhibitors (SSRIs) Monoamine oxidase inhibitors (MAOIs) Tricyclic antidepressants (TCAs) Nonbenzodiazepines
Selective serotonin reuptake inhibitors (SSRIs)
Which medication classification has been used to treat social phobia? Selective serotonin reuptake inhibitors (SSRIs) Monoamine oxidase inhibitors (MAOIs) Tricyclic antidepressants (TCAs) Nonbenzodiazepines
Selective serotonin reuptake inhibitors (SSRIs) SSRIs are used to treat clients with social phobia because they significantly reduce social anxiety and phobic avoidance. Benzodiazepines are also used to reduce anxiety caused by phobias.
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
According to psychodynamic theorists, anxiety develops from which of the following? Separation and loss Learned response Exposure to panicogenic substances Interoceptive conditioning
Separation and loss
After reviewing various etiologic theories associated with panic disorder, the nurse demonstrates understanding of the psychodynamic theory, identifying which as the underlying cause? Conditioning Separation or loss Heritability Activation of stress hormone
Separation or loss
A nurse determines that a client who is experiencing anxiety is using relief or primitive survival behaviors. The nurse determines that the client is experiencing which degree of anxiety? Mild Moderate Severe Panic
Severe
A nurse determines that a client who is experiencing anxiety is using relief or primitive survival behaviors. The nurse determines that the client is experiencing which degree of anxiety? Panic Severe Mild Moderate
Severe Rationale:A client experiencing severe anxiety typically uses relief behaviors. With mild anxiety, the client is easily able to recognize and name anxiety. With moderate anxiety, the client is usually able to state that he or she is anxious. With panic, the client is perplexed and self-absorbed.
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 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 Agoraphobia Obsessive-compulsive disorder Panic disorder
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
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? Obsessive-compulsive disorder Panic disorder Agoraphobia Social phobia
Social phobia Social phobia represents a persistent, irrational fear of and compelling desire to avoid situations in which the person may be exposed to unfamiliar people or to the scrutiny of others. Additionally, the person harbors the fear of behaving in a way that may prove humiliating or embarrassing. The person will experience marked anticipatory anxiety if confronted with such a situation and will attempt to avoid it.
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? Panic disorder Social phobia Obsessive-compulsive disorder Agoraphobia
Social phobia Social phobia represents a persistent, irrational fear of and compelling desire to avoid situations in which the person may be exposed to unfamiliar people or to the scrutiny of others. Additionally, the person harbors the fear of behaving in a way that may prove humiliating or embarrassing. The person will experience marked anticipatory anxiety if confronted with such a situation and will attempt to avoid it.
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 should remain with the client until the anxiety is reduced. The nurse should speak in a soft and calm voice. The nurse should take the client to a nonstimulating environment.
Speaking in short, simple, and easy-to-understand sentences has been shown to be effective with clients with moderate anxiety whose attention wanders. Not leaving the client alone unless the anxiety is reduced and speaking in a soft voice are interventions used with a client with severe anxiety. If the client has panic-level anxiety, the nurse should give primary attention to the safety of the client and move the client to a nonstimulating environment.
Which condition involves a persistent, irrational fear attached to an object or situation that objectively does not pose a significant danger?
Specific phobia
Which condition involves a persistent, irrational fear attached to an object or situation that objectively does not pose a significant danger? Specific phobia Posttraumatic stress disorder Obsessive-compulsive disorder Generalized anxiety disorder
Specific phobia
Which condition involves a persistent, irrational fear attached to an object or situation that objectively does not pose a significant danger? Posttraumatic stress disorder Generalized anxiety disorder Specific phobia Obsessive-compulsive disorder
Specific phobia Specific phobia is a disorder marked by persistent fear of clearly discernible, circumscribed objects or situations, which often leads to avoidance behaviors. Posttraumatic stress disorder can occur following exposure to an actual or threatened traumatic event such as death, serious injury, or sexual violence. In obsessive-compulsive disorder, affected clients have both obsessions and compulsions and believe that they have no control over them, which results in devastating consequences for the individuals. Generally speaking, clients with generalized anxiety disorder feel frustrated, disgusted with life, demoralized, and hopeless. They may state that they cannot remember a time that they did not feel anxious. They experience a sense of ill-being and uneasiness and a fear of imminent disaster.
Which condition involves a persistent, irrational fear attached to an object or situation that objectively does not pose a significant danger? Specific phobia Posttraumatic stress disorder Obsessive-compulsive disorder Generalized anxiety disorder
Specific phobia Specific phobia is a disorder marked by persistent fear of clearly discernible, circumscribed objects or situations, which often leads to avoidance behaviors. Posttraumatic stress disorder can occur following exposure to an actual or threatened traumatic event such as death, serious injury, or sexual violence. In obsessive-compulsive disorder, affected clients have both obsessions and compulsions and believe that they have no control over them, which results in devastating consequences for the individuals. Generally speaking, clients with generalized anxiety disorder feel frustrated, disgusted with life, demoralized, and hopeless. They may state that they cannot remember a time that they did not feel anxious. They experience a sense of ill-being and uneasiness and a fear of imminent disaster.
A client who has been diagnosed with panic disorder visits the clinic and experiences a panic attack. The client tells the nurse, "I'm so nervous. My hands are shaking, and I'm sweating. I feel as if I'm having a stroke right now." What would be the priority intervention at this time? Stay with the client while remaining calm. Move the client to a safe environment. Tell the client that the attack will soon pass. Teach the client deep breathing techniques to calm the client.
Stay with the client while remaining calm.
The nurse is caring for a client who is being treated in the emergency department for a panic attack. Which nursing intervention would be most appropriate? Demonstrate empathy for the client by trying to mimic the client's state of anxiety. Tell the client that the nurse must leave to go report the client's symptoms to the psychiatrist on duty. Tell the client this is an acute exacerbation with a positive prognosis and low morbidity. Stay with the client, emphasizing that the client is safe and that the nurse will remain with the client.
Stay with the client, emphasizing that the client is safe and that the nurse will remain with the client.
A client presents to the nurses' station with symptoms of a panic attack, including shortness of breath, dizziness, trembling, and nausea. Which is the nurse's first intervention? Teach the client relaxation techniques. Administer PRN antianxiety medication. Stay with the client, and offer support. Help the client identify triggers for anxiety.
Staying with the client and offering support will provide a sense of security. Never leave a client alone during a panic attack. Teaching relaxation techniques and helping the client identify triggers are not appropriate during an acute panic attack, but they are important interventions when the client is calmer and able to receive information. Administering anxiety medication isn't the best initial action, because they don't take effect immediately.
Which would be an appropriate intervention for a client experiencing an anxiety attack? Staying with the client and speaking in short sentences Turning on the lights and opening the windows so that the client does not feel crowded Leaving the client alone Turning on stereo music
Staying with the client and speaking in short sentences
Which would be an appropriate intervention of a client experiencing a panic attack?
Staying with the client and speaking in short sentences
Which would be an appropriate intervention of a client experiencing a panic attack? Staying with the client and speaking in short sentences Turning on the lights and opening the windows so that the client does not feel crowded Leaving the client alone Turning on stereo music loudly
Staying with the client and speaking in short sentences
Which would be an appropriate intervention for a client experiencing an anxiety attack? Turning on the lights and opening the windows so that the client does not feel crowded Leaving the client alone Staying with the client and speaking in short sentences Turning on stereo music
Staying with the client and speaking in short sentences Appropriate nursing interventions for an anxiety attack include using short sentences, staying with the client, decreasing stimuli, remaining calm, and medicating as needed. Leaving the client alone, turning on a stereo or lights, and opening windows may increase the client's anxiety.
Which would be an appropriate intervention for a client experiencing an anxiety attack? Turning on stereo music Staying with the client and speaking in short sentences Turning on the lights and opening the windows so that the client does not feel crowded Leaving the client alone
Staying with the client and speaking in short sentences Rationale:Appropriate nursing interventions for an anxiety attack include using short sentences, staying with the client, decreasing stimuli, remaining calm, and medicating as needed. Leaving the client alone, turning on a stereo or lights, and opening windows may increase the client's anxiety.
The nurse knows that which statement is true about stress and anxiety? All people handle stress in the same way. Stress is a person's reaction to anxiety. Anxiety occurs when a person has trouble dealing with life situations, problems, and goals. Stress is the wear and tear that life causes on the body.
Stress is the wear and tear that life causes on the body.
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
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? Parasympathetic nervous system Sympathetic nervous system Motherly response system Central nervous system
Sympathetic nervous system
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? Central nervous system Parasympathetic nervous system Motherly response system Sympathetic nervous system
Sympathetic nervous system
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? Parasympathetic nervous system Motherly response system Sympathetic nervous system Central nervous system
Sympathetic nervous system The sympathetic nervous system activates the fight or flight response quickly as a survival response that results in an increased heart and respiratory rate, moist hands and feet, and dilated pupils. The parasympathetic system is most active in nonstressful events. The motherly instinct is not a proven physiological system.
A client who experiences panic anxiety around dogs is sitting in a room with a dog and the client's nurse therapist. The nurse therapist is using which behavioral intervention for this type of anxiety? Systematic desensitization Implosion therapy Relaxation exercise Biofeedback
Systematic desensitization
A client who experiences panic anxiety around dogs is sitting in a room with a dog and the client's nurse therapist. The nurse therapist is using which behavioral intervention for this type of anxiety? Relaxation exercise Biofeedback Implosion therapy Systematic desensitization
Systematic desensitization Systematic desensitization refers to the exposure of a person to a fear-producing situation in a systematized manner to decrease a phobic disorder. Implosion therapy, while similar, is not the technique described in this option. This scenario lacks the physical control techniques implemented by relaxation exercise, and it lacks the auditory and/or visual techniques implemented by biofeedback.
Which is a cardiovascular response of the sympathetic nervous system?
Tachycardia
Which is a cardiovascular response of the sympathetic nervous system? Tachycardia Bradypnea Hypotension Bradycardia
Tachycardia
Which is a cardiovascular response of the sympathetic nervous system? Bradypnea Bradycardia Hypotension Tachycardia
Tachycardia Rationale:Tachycardia is a cardiovascular response of the sympathetic nervous system. Bradypnea, hypotension, and bradycardia are responses of the parasympathetic system. Sympathetic cardiovascular responses to stress include increased heart rate, cardiac contractility, and cardiac output; increased blood pressure; and peripheral vasoconstriction.
A client at an outpatient psychiatric clinic has been experiencing anxiety. The nurse would like to suggest activities for the client to do in their spare time. What would be an appropriate activity for the nurse to suggest to the client? Select all that apply. taking up a hobby board games daily walks bingo stretching exercises
Taking daily walks and stretching exercises allow the client to expend energy and establish a trusting, neutral relationship with the nurse. Taking up a hobby will help the client change their attention and focus from negative anxiety to more positive and relaxed thoughts. The other suggestions are higher stimulation activities that insert competition and added anxiety to the situation.
A nurse is seeing a client prior to discharge after being admitted to hospital for suicidal ideation. As the nurse begins the discharge process, the client closes the eyes and begins rapid, shallow breathing. The client also begins to shake and perspire profusely. Which actions should the nurse take? Select all that apply. Assess the client for suicidal ideation. Talk to the client in a comforting manner. Ask the client to spend some time alone. Reassure the client of being safe. Take the client to a quiet space.
Talk to the client in a comforting manner. Reassure the client of being safe. Take the client to a quiet space.
A nurse is seeing a client prior to discharge after being admitted to hospital for suicidal ideation. As the nurse begins the discharge process, the client closes the eyes and begins rapid, shallow breathing. The client also begins to shake and perspire profusely. Which actions should the nurse take? Select all that apply. Talk to the client in a comforting manner. Take the client to a quiet space. Reassure the client of being safe. Ask the client to spend some time alone. Assess the client for suicidal ideation.
Talk to the client in a comforting manner. Take the client to a quiet space. Reassure the client of being safe.
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
A group of nursing students are reviewing signs and symptoms of anxiety. The students demonstrate a need for additional review when they identify what? Palpitations Extreme restlessness Motor excitement Tearfulness
Tearfulness
A group of nursing students are reviewing signs and symptoms of anxiety. The students demonstrate a need for additional review when they identify what? Motor excitement Tearfulness Extreme restlessness Palpitations
Tearfulness Rationale:The clinical symptoms of anxiety are numerous. They are generally classified as physiologic, psychological or emotional, behavioral, and intellectual or cognitive responses to stress. The clinical symptoms may vary according to the level of anxiety exhibited by the client. Tearfulness and sadness are symptoms of depression, not of anxiety.
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 Motor excitement Palpitations Extreme restlessness
Tearfulness The clinical symptoms of anxiety are numerous. They are generally classified as physiologic, psychological or emotional, behavioral, and intellectual or cognitive responses to stress. The clinical symptoms may vary according to the level of anxiety exhibited by the client. Tearfulness and sadness are symptoms of depression, not of anxiety.
All except which are considered clinical symptoms of anxiety?
Tearfulness and sadness
All except which are considered clinical symptoms of anxiety? Palpitations Extreme restlessness Motor excitement Tearfulness and sadness
Tearfulness and sadness
All except which are considered clinical symptoms of anxiety? Tearfulness and sadness Motor excitement Palpitations Extreme restlessness
Tearfulness and sadness The clinical symptoms of anxiety are numerous. They are generally classified as physiologic, psychological or emotional, behavioral, and intellectual or cognitive responses to stress. The clinical symptoms may vary according to the level of anxiety exhibited by the client. Tearfulness and sadness are symptoms of depression, not of anxiety.
All except which are considered clinical symptoms of anxiety? Tearfulness and sadness Motor excitement Extreme restlessness Palpitations
Tearfulness and sadness The clinical symptoms of anxiety are numerous. They are generally classified as physiologic, psychological or emotional, behavioral, and intellectual or cognitive responses to stress. The clinical symptoms may vary according to the level of anxiety exhibited by the client. Tearfulness and sadness are symptoms of depression, not of anxiety.
A client is experiencing moderate anxiety. Which manifestation would the nurse most likely observe? Select all that apply. The client can sustain attention on a particular focus. The client verbally states, "For some reason, I am feeling anxious now." The client has flights of ideas and confusion. The client makes distorted inferences because of inadequacy of observed data. The client may pace, run, or fight violently if asked to perform a task the client does not want to perform.
The client can sustain attention on a particular focus. The client verbally states, "For some reason, I am feeling anxious now."
The nurse understands that a certain level of anxiety is required in a client for effective learning. Which anxiety-related symptom indicates the client may be able to learn effectively? The client is trembling. The client is speaking in a high-pitch voice. The client has heightened awareness. The client has increased muscle tension.
The client has heightened awareness.
The nurse understands that a certain level of anxiety is required in a client for effective learning. Which anxiety-related symptom indicates the client may be able to learn effectively? The client has increased muscle tension. The client is speaking in a high-pitch voice. The client has heightened awareness. The client is trembling.
The client has heightened awareness.
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 is probably physically dependent on alcohol. Drinking alcohol is more socially acceptable than taking medications. A few glasses of wine each night is not necessarily a problem. The client has insufficient adaptive coping mechanisms.
The client has insufficient adaptive coping mechanisms.
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 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 is probably physically dependent on alcohol. Drinking alcohol is more socially acceptable than taking medications. The client has no adaptive coping mechanisms. A few glasses of wine each night is not necessarily a problem.
The client has no adaptive coping mechanisms.
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? A few glasses of wine each night is not necessarily a problem. Drinking alcohol is more socially acceptable than taking medications. The client is probably physically dependent on alcohol. The client has no adaptive coping mechanisms.
The client has no adaptive coping mechanisms. Clients learn to reduce the anxiety they feel in either functional or dysfunctional ways. The nurse first explores with the client what techniques the client has used in the past and helps the client identify and enhance those strategies that are most beneficial. The nurse and client identify maladaptive coping strategies, such as social withdrawal or alcohol use, and replace them with adaptive strategies that suit the client's personal, cultural, and spiritual values. The nurse should not ask the client to give up coping mechanisms, even maladaptive ones, without offering other adaptive mechanisms.
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 is probably physically dependent on alcohol. Drinking alcohol is more socially acceptable than taking medications. The client has no adaptive coping mechanisms. A few glasses of wine each night is not necessarily a problem.
The client has no adaptive coping mechanisms. Clients learn to reduce the anxiety they feel in either functional or dysfunctional ways. The nurse first explores with the client what techniques the client has used in the past and helps the client identify and enhance those strategies that are most beneficial. The nurse and client identify maladaptive coping strategies, such as social withdrawal or alcohol use, and replace them with adaptive strategies that suit the client's personal, cultural, and spiritual values. The nurse should not ask the client to give up coping mechanisms, even maladaptive ones, without offering other adaptive mechanisms.
A nurse assesses a client and determines that the client is experiencing mild anxiety based on what?
The client is aware and alert
A nurse assesses a client and determines that the client is experiencing mild anxiety based on what? The client is selectively inattentive The client is aware and alert The client has focused attention on a small area The client voices feelings of unreality
The client is aware and alert
A nurse assesses a client and determines that the client is experiencing mild anxiety based on what? The client has focused attention on a small area The client is selectively inattentive The client voices feelings of unreality The client is aware and alert
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 is assessing a client with anxiety. Which behavior might indicate that the client has moderate anxiety? The client is focused in an activity. The client is nervous and agitated. The client has impaired cognitive skills. The client is unable to communicate verbally.
The client is nervous and agitated.
The nurse is assessing a client with anxiety. Which behavior might indicate that the client has moderate anxiety? The client is unable to communicate verbally. The client has impaired cognitive skills. The client is nervous and agitated. The client is focused in an activity.
The client is nervous and agitated. A client who is moderately anxious has a disturbing feeling that something is wrong. This causes nervousness and agitation. Increased concentration and attention is seen in clients having mild anxiety. Cognitive skills are impaired in clients who have severe anxiety. Inability to communicate verbally indicates that the client is panicking.
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 client is unable to communicate verbally. The client is focused in an activity. The client has impaired cognitive skills.
The client is nervous and agitated. A client who is moderately anxious has a disturbing feeling that something is wrong. This causes nervousness and agitation. Increased concentration and attention is seen in clients having mild anxiety. Cognitive skills are impaired in clients who have severe anxiety. Inability to communicate verbally indicates that the client is panicking.
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.
Which factor has the least influence on achieving mental health for the client who has anxiety disorder? The client's mother also suffered from an anxiety disorder. The client was raised in a household with high stress and frequent geographic moves. The client's mother often related to the client in ways that reflected the mother's high level of anxiety. The client is often late to school and makes poor grades in most of the client's subjects.
The client is often late to school and makes poor grades in most of the client's subjects.
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. The client's mother also suffered from an anxiety disorder. The client was raised in a household with high stress and frequent geographic moves. The client's mother often related to the client in ways that reflected the mother's high level of anxiety.
The client is often late to school and makes poor grades in most of the client's subjects. Being late to school and making poor grades are behaviors that indicate that the client is having difficulty; they are not factors influencing the development of the client's anxiety disorder.
A client diagnosed with anxiety disorder is prescribed buspirone. What priority teaching will the nurse provide? Buspirone can cause immediate bradycardia. Buspirone blood levels need to be checked 1 week after initiating the drug. Buspirone can cause neuroleptic malignant syndrome. Buspirone has a delayed therapeutic effect of between 14 to 30 days.
The client should be informed that the drug's therapeutic effect might not be achieved for 14 to 30 days. The client must be instructed to continue taking the drug as directed. Tachycardia, not bradycardia, is a reported effect of buspirone. Blood level checks are not necessary. Neuroleptic malignant syndrome has not been reported with this drug.
The nurse can be confident that the admitted client diagnosed with an anxiety disorder will respond well to treatment when the client which of the following conditions are present? The client states, "I understand what I need to do, and I'm ready to do it so I'm back to normal." The client has a family that is truly willing and capable of supporting him during the treatment The client readily agrees to immediately notify the mental health care team if symptoms reoccur after discharge The client has a no history of other psychiatric disorders
The client states, "I understand what I need to do, and I'm ready to do it so I'm back to normal."
The nurse can be confident that the admitted client diagnosed with an anxiety disorder will respond well to treatment when the client which of the following conditions are present? The client has a no history of other psychiatric disorders The client states, "I understand what I need to do, and I'm ready to do it so I'm back to normal." The client has a family that is truly willing and capable of supporting him during the treatment The client readily agrees to immediately notify the mental health care team if symptoms reoccur after discharge
The client states, "I understand what I need to do, and I'm ready to do it so I'm back to normal."
The nurse is caring for a client diagnosed with anxiety disorder. The client is demonstrating difficulty concentrating and is preoccupied with feelings of helplessness. When creating the plan of care, which goal would be most appropriate for this client? The client will avoid stimuli that induces anxiety. The client will identify the source of anxiety. The client will display ability to cope with anxiety. The client will show interest in activities.
The client will display ability to cope with anxiety. Coping is a process used by individuals to manage anxiety, and may be effective or ineffective. Anxiety disorders are diagnosed when anxiety no longer functions as a signal of danger, or a motivation for needed change but becomes chronic and permeates major portions of the person's life, resulting in maladaptive behaviors and emotional disability. Nurses encounter anxious clients and families in a variety of situations. The nurse must first assess the person's anxiety level because this determines what interventions are likely to be effective. When working with an anxious person, the nurse must remain calm and in control. The goal for the client with anxiety is ultimately to be able to cope with anxiety. During the treatment the client will have to identify the source of anxiety, be able to adapt to stimuli that produces anxiety, and show interest in activities that previously caused anxiety.
The nurse is caring for a client diagnosed with anxiety disorder. The client is demonstrating difficulty concentrating and is preoccupied with feelings of helplessness. When creating the plan of care, which goal would be most appropriate for this client? The client will avoid stimuli that induces anxiety. The client will identify the source of anxiety. The client will show interest in activities. The client will display ability to cope with anxiety.
The client will display ability to cope with anxiety. Coping is a process used by individuals to manage anxiety, and may be effective or ineffective. Anxiety disorders are diagnosed when anxiety no longer functions as a signal of danger, or a motivation for needed change but becomes chronic and permeates major portions of the person's life, resulting in maladaptive behaviors and emotional disability. Nurses encounter anxious clients and families in a variety of situations. The nurse must first assess the person's anxiety level because this determines what interventions are likely to be effective. When working with an anxious person, the nurse must remain calm and in control. The goal for the client with anxiety is ultimately to be able to cope with anxiety. During the treatment the client will have to identify the source of anxiety, be able to adapt to stimuli that produces anxiety, and show interest in activities that previously caused anxiety.
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.
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 return to rational thought. The client would have an enhanced sense of security. The client would be able to demonstrate relaxation techniques. The client would be able to understand what the nurse is saying.
The client would have an enhanced sense of security.
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 client would be able to understand what the nurse is saying. The client would be able to demonstrate relaxation techniques. The client would return to rational thought.
The client would have an enhanced sense of security. A client with panic-level anxiety should be taken to a small, isolated room. This is to reduce any external stimuli that could escalate anxiety. Taking the client to a small room would make the client feel more protected and secured. A client experiencing a panic attack may lose rational thought; however, this intervention would not directly improve thought processes. The client would not be able to demonstrate relaxation techniques in a panic laden state. This intervention would not enhance the client's ability to understand what the nurse is saying.
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
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 use of progressive tensing and relaxing of muscles to release tension in each muscle group Using a positive self-image to increase and intensify physical workouts in the gym, which decreases stress The mindful use of a word, phrase, or visual image, which allows oneself to be distracted and temporarily escape from stressful situations The use of music and humor to create a calm and relaxed demeanor, which allows escape from stressful situations
The mindful use of a word, phrase, or visual image, which allows oneself to be distracted and temporarily escape from stressful situations
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 use of progressive tensing and relaxing of muscles to release tension in each muscle group Using a positive self-image to increase and intensify physical workouts in the gym, which decreases stress The mindful use of a word, phrase, or visual image, which allows oneself to be distracted and temporarily escape from stressful situations The use of music and humor to create a calm and relaxed demeanor, which allows escape from stressful situations
The mindful use of a word, phrase, or visual image, which allows oneself to be distracted and temporarily escape from stressful situations Guided imagery is the mindful use of a word, phrase, or visual image for the purpose of distracting oneself from distressing situations or consciously taking time to relax or reenergize. The use of progressive tensing and relaxing of muscles to release tension in each muscle group is incorrect; it describes progressive muscle relaxation. Using a positive self-image to increase and intensify physical workouts in the gym, which decreases stress is incorrect; it is not an identified technique and is an answer that "sounds good" and creates a distraction for the test taker. The use of music and humor to create a calm and relaxed demeanor, which allows escape from stressful situations is incorrect; relaxing with music is not guided imagery.
The most important factor in the person's stress response is what? Strength of the immune system Supportive friends Relaxation techniques Adaptive coping strategies
The most important factor in a person's stress response is the ability of engage in adaptive coping behaviors. This ability can assist a person in developing resilience, or the ability to "bounce back" when faced with stress and stressful situations. The immune system, having a supportive network of friends, and understanding of relaxation techniques are also influencing factors when considering how an individual responds to stress; however, the correct option relates to an internal, sustainable strength that comes from adaptive coping.
The nurse recognizes that who is the client 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 22-year-old soldier who served in the Middle East who "cannot sleep" and is facing criminal charges for hurting someone in a barroom brawl 70-year-old whose spouse died 1 year ago who has "no desire to leave my house" and reports severe fatigue 30-year-old business executive who reports being anxious about attending the meetings and social events that are the executive's job responsibilities
The nurse recognizes that the client most likely experiencing GAD is a 40-year-old who has reported numerous absences from work, muscle aches, and difficulty falling asleep for the last 8 months. The other options provided do not describe conditions of GAD.
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.
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 should remain with the client until the anxiety is reduced. The nurse should speak in a soft and calm voice. The nurse should take the client to a nonstimulating environment.
The nurse should speak in short and simple sentences.
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 a soft and calm voice. The nurse should remain with the client until the anxiety is reduced. The nurse should speak in short and simple sentences. The nurse should take the client to a nonstimulating environment.
The nurse should speak in short and simple sentences. Speaking in short, simple, and easy-to-understand sentences has been shown to be effective with clients with moderate anxiety whose attention wanders. Not leaving the client alone unless the anxiety is reduced and speaking in a soft voice are interventions used with a client with severe anxiety. If the client has panic-level anxiety, the nurse should give primary attention to the safety of the client and move the client to a nonstimulating environment.
A nurse is talking with a client who has experienced panic attacks. The client asks the nurse, "What causes these attacks?" Which information would the nurse most likely integrate into the response about the etiology of panic disorders? There is evidence of a substantial familial predisposition to panic disorder Neurologic abnormalities are a rare occurrence with panic disorder The link between panic disorders and neurotransmitters is lacking There is a strong evidence supporting a psychodynamic influence
There is evidence of a substantial familial predisposition to panic disorder
etiology of panic disorders? There is evidence of a substantial familial predisposition to panic disorder Neurologic abnormalities are a rare occurrence with panic disorder The link between panic disorders and neurotransmitters is lacking There is a strong evidence supporting a psychodynamic influence
There is evidence of a substantial familial predisposition to panic disorder
A client is admitted to the acute psychiatric care unit after 2 weeks of increasingly erratic behavior. The client is unkempt, has lost approximately 9 lb (4 kg), has been sleeping poorly, and exhibits hyperactivity. The client loudly denies the need for hospitalization. What priority intervention will the nurse apply? providing adequate hygiene asking the client to go eat a meal in the day room decreasing environmental stimulation orientating the client to the unit activities
This client is at increased risk for injuring self or others. Decreasing environmental stimulation, a measure the nurse may take independently, may reduce the client's hyperactivity. Providing adequate hygiene is an appropriate nursing intervention but isn't the highest priority. Because the overall goal is to reduce the client's hyperactivity, orientating him to unit activities is contraindicated. Asking the client to go eat a meal in the day room is contraindicated because there is risk for harm to self or others and it is likely there will be more stimulation in the day room.
Which of the following is inconsistent with panic-level anxiety? The nurse needs to maintain a non-stimulating environment. The goal is to lower the client's anxiety to mild or moderate before proceeding with anything else. The nurse should remain with the client until the panic recedes. This level of anxiety can be sustained indefinitely.
This level of anxiety can be sustained indefinitely.
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 To calm restlessness
To focus attention to learn To feel and think To motivate to make a change To engage in goal-directed activity
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 learning that a roommate is HIV-positive, a client asks a nurse about moving to another room on the psychiatric unit because the client no longer feels "safe." What should the nurse do first? Move the client to another room. Ask the client to describe the fears. Move the client's roommate to a private room. Explain that such a move wouldn't be therapeutic for the client or the roommate.
To intervene effectively, the nurse must first understand the client's fears. After exploring the fears, the nurse may move the client or roommate or explain why such a move wouldn't be therapeutic, as needed.
A client who recently developed paralysis of the arms is diagnosed with functional neurologic symptom disorder after tests fail to uncover a physical cause for the paralysis. Which intervention should the nurse include in the care plan for this client? exercising the client's arms regularly insisting that the client eat without assistance working with the client rather than with the family teaching the client how to use nonpharmacologic pain-control methods
To maintain the integrity of the affected areas and prevent muscle wasting and contractures, the nurse should help the client perform regular passive range-of-motion exercises with the arms. The nurse shouldn't insist that the client use the arms to perform such functions as eating without assistance, because the client can't consciously control the symptoms and move the arms; such insistence may anger the client and endanger the therapeutic relationship. The nurse should include family members in the client's care because they may be contributing to the client's stress or conflict and are essential to helping the client regain function of the arms. The client isn't experiencing pain and, therefore, doesn't need education regarding pain management.
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
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 Providing the client with a safe, quiet, and private place Encouraging the client to verbalize feelings and concerns Approaching the client in a calm, confident manner
Touching the client in an attempt to comfort the client
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? Encouraging the client to verbalize feelings and concerns Approaching the client in a calm, confident manner Touching the client in an attempt to comfort the client Providing the client with a safe, quiet, and private place
Touching the client in an attempt to comfort the client
Which would not be an initial intervention for the client with acute anxiety?
Touching the client in an attempt to comfort the client
Which would not be an initial intervention for the client with acute anxiety? Touching the client in an attempt to comfort the client Use of open-ended communication techniques Encouraging the client to verbalize feelings and concerns Maintaining a nonstimulating environment
Touching the client in an attempt to comfort the client
Which would not be included in the plan of care for a client diagnosed with acute anxiety? Encouraging the client to verbalize feelings and concerns Providing the client with a safe, quiet, and private place Approaching the client in a calm, confident manner Touching the client in an attempt to comfort the client
Touching the client in an attempt to comfort the client Rationale:The emergency nurse must establish rapport and trust with the anxious client before using therapeutic touch. Touching an anxious client may actually increase anxiety. Trust can be established by approaching the client in a calm and confident manner; providing a place that is quiet, safe, and private; and encouraging the client to verbalize feelings and concerns.
Which would not be an initial intervention for the client with acute anxiety? Touching the client in an attempt to comfort the client Maintaining a nonstimulating environment Encouraging the client to verbalize feelings and concerns Use of open-ended communication techniques
Touching the client in an attempt to comfort the client The nurse should evaluate carefully the use of touch because clients with high anxiety may interpret touch by a stranger as a threat and pull away abruptly. Use open-ended questions, encouraging the client to verbalize feelings and concerns, and maintain a nonstimulating environment.
Which would not be an initial intervention for the client with acute anxiety? Touching the client in an attempt to comfort the client Use of open-ended communication techniques Maintaining a nonstimulating environment Encouraging the client to verbalize feelings and concerns
Touching the client in an attempt to comfort the client The nurse should evaluate carefully the use of touch because clients with high anxiety may interpret touch by a stranger as a threat and pull away abruptly. Use open-ended questions, encouraging the client to verbalize feelings and concerns, and maintain a nonstimulating environment.
All of the following pharmacological agents are useful in treating anxiety disorders except which ones? Tricyclic antidepressants Selective serotonin reuptake inhibitors (SSRIs) Benzodiazepines Calcium channel blockers
Tricyclic antidepressants and SSRIs are known to be useful in reducing anxiety and are sometimes useful in treating the anxiety disorders. Benzodiazepines are an excellent choice for the treatment of symptoms of anxiety; however, they are extremely addictive and should only be given in the case of true anxiety disorders. Calcium channel blockers are not used in treating anxiety disorders.
A client with Anxiety and sleeplessness should avoid caffeine. True False
True
Clients with anxiety often need to be taught relaxation techniques, such as listening to music, medication etc. to attend work, school and meet their goals. True False
True
In anxiety due to medical conditions, the individual's symptoms of anxiety are a direct physiological medical condition, such as hyperthyroidism, pulmonary embolism, or cardiac dysrhythmias. True False
True
Mild anxiety can be productive and does not require direct intervention. True False
True
When an anxious client depersonalizes they often need to be asked "what is happening." True False
True
A nurse is preparing a plan of care for a client with anxiety. Which would the nurse likely include? Select all that apply. Using restraint when panic develops Providing supportive feedback Identifying treatment modalities Using appropriate coping skill Involving family for support, if appropriate
Using appropriate coping skill Identifying treatment modalities Involving family for support, if appropriate Providing supportive feedback Appropriate measures to include in the plan of care for a client with anxiety include: introducing appropriate coping skills, identifying alternate treatment modalities, involving family and support persons when appropriate, and providing feedback that is supportive to the client. Restraint is always a last resort.
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 Using restraint when panic develops
Using appropriate coping skill Identifying treatment modalities Involving family for support, if appropriate Providing supportive feedback
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
A nurse is preparing a plan of care for a client with anxiety. Which elements would the nurse likely include? Select all that apply. Involving family for support, if appropriate Using appropriate coping skills Identifying treatment modalities Providing supportive feedback Using restraint when panic develops
Using appropriate coping skills Identifying treatment modalities Involving family for support, if appropriate Providing supportive feedback
A nurse is preparing a plan of care for a client with anxiety. Which elements would the nurse likely include? Select all that apply. Providing supportive feedback Using appropriate coping skills Identifying treatment modalities Using restraint when panic develops Involving family for support, if appropriate
Using appropriate coping skills Identifying treatment modalities Involving family for support, if appropriate Providing supportive feedback Appropriate measures to include in the plan of care for a client with anxiety include: introducing appropriate coping skills, identifying alternate treatment modalities, involving family and support persons when appropriate, and providing feedback that is supportive to the client. Restraint is always a last resort.
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 Providing supportive feedback Using restraint when panic develops Identifying treatment modalities Involving family for support, if appropriate
Using appropriate coping skills Providing supportive feedback Identifying treatment modalities Involving family for support, if appropriate Rationale:Appropriate measures to include in the plan of care for a client with anxiety include: introducing appropriate coping skills, identifying alternate treatment modalities, involving family and support persons when appropriate, and providing feedback that is supportive to the client. Restraint is always a last resort.
A client is prescribed a serotonin-norepinephrine reuptake inhibitor. The nurse would identify that which of the following is most commonly prescribed? Venlafaxine Fluoxetine Paroxetine Duloxetine
Venlafaxine
A group of students is reviewing information about anxiety disorders in preparation for a class examination. The students demonstrate understanding of the material when they state what? Anxiety disorders rank second to depression in psychiatric illnesses being treated. Women experience anxiety disorders more often than do men. Most anxiety disorders tend to be short term with individuals achieving full recovery. Anxiety disorders are more common among children than among adolescents.
Women experience anxiety disorders more often than do men.
A group of students is reviewing information about anxiety disorders in preparation for a class examination. The students demonstrate understanding of the material when they state what? Women experience anxiety disorders more often than do men. Anxiety disorders rank second to depression in psychiatric illnesses being treated. Anxiety disorders are more common among children than among adolescents. Most anxiety disorders tend to be short term with individuals achieving full recovery.
Women experience anxiety disorders more often than do men. Women experience anxiety disorders more often than do men by a 2-to-1 ratio. Anxiety disorders are the most common of the psychiatric illnesses treated by health care providers. They tend to be chronic and persistent illnesses with full recovery more likely among those who do not have other mental or physical illnesses. Anxiety disorders are the most common condition of adolescents, with one in three having an anxiety disorder.
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. a) Blurred vision b) Constipation c) Vomiting d) Agitation e) Dry mouth
a) Blurred vision b) Constipation e) Dry mouth
The nurse is providing care for a psychiatric-mental health client who has a diagnosis of anxiety. Which of the nurse's following statements is likely the most therapeutic intervention? a) "Anxiety is a feeling that is experienced by everyone at some point and it can never be completely removed from one's life." b) "Every time you feel anxious, try to focus on how much easier your life would be if you didn't experience anxiety so often." c) "With the development of more life skills and a demonstration of continued success in life, your anxiety will shrink and eventually disappear." d) "If you address the causes of your anxiety head-on, you will find that you can recover from it without medications or therapy."
a) "Anxiety is a feeling that is experienced by everyone at some point and it can never be completely removed from one's life."
A 25-year-old woman tells the nurse that she has been worried and tearful lately because of pressures at work. She states, "My boyfriend tells me that it's 'stress' and 'anxiety,' but doesn't everyone have that? What is anxiety anyway?" Which of the following responses gives the best information about the nature of anxiety? a) "Anxiety is a sense of psychological distress." b) "Anxiety is a physiologic response to stress." c) "Anxiety is an abnormal response to everyday stress." d) "Anxiety is a normal response to everyday stress."
a) "Anxiety is a sense of psychological distress."
Nearly which percentage of adults is affected by anxiety disorders? a) 25% b) 55% c) 40% d) 10%
a) 25%
When explaining the difference between anxiety and fear, the mental health nurse shares that (Select all that apply.) a) Anxiety involves experiencing subjective, uncomfortable feelings resulting from unknown causes b) Depression is a risk factor for developing anxiety c) Fear results in objective, physical responses caused by real danger d) Anxiety is likely to result from an attempt to overcome stress e) Obsessive-compulsive behavior is often the result of abandonment
a) Anxiety involves experiencing subjective, uncomfortable feelings resulting from unknown causes c) Fear results in objective, physical responses caused by real danger d) Anxiety is likely to result from an attempt to overcome stress
The nurse is conducting an admission assessment of a client who has a history of generalized anxiety disorder. After gauging the client's level of anxiety, what other assessment should the nurse prioritize? a) Determining whether there is potential for the client to harm himself or herself or others b) Obtaining a set of vital signs including apical heart rate and oxygen saturation c) Assessing the client's insight into his or her condition and gauging orientation and judgment d) Determining the client's understanding of factors that contribute to his or her anxiety
a) Determining whether there is potential for the client to harm himself or herself or others
Generalized anxiety disorder (GAD) is characterized by what? a) Excessive worry or anxiety lasting more than 6 months b) Fear of going outdoors c) Behavioral changes in response to panic attacks d) Flashbacks and feelings of unreality
a) Excessive worry or anxiety lasting more than 6 months
The nurse is assessing a client with anxiety. What symptom indicates that the the client has adopted a maladaptive behavior in response to stress? a) Headache b) Tachycardia c) Pedal edema d) Dyspnea
a) Headache
Which level of anxiety helps the client focus attention to learn, problem solve, think, act, feel, and protect himself or herself? a) Mild b) Severe c) Moderate d) Panic
a) Mild
After reviewing various etiologic theories associated with panic disorder, the nurse demonstrates understanding of the psychodynamic theory, identifying which of the following as the underlying cause? a) Separation b) Conditioning c) Activation of stress hormone d) Decreased control over environment
a) Separation
In speaking with a client with moderate anxiety, the client goes off on unrelated tangents. To help the client's attention from wandering, which is an effective intervention? a) The nurse should speak in short and simple sentence. b) The nurse should take the client to a non-stimulating environment. c) The nurse should remain with the client until the anxiety is reduced. d) The nurse should speak in a soft and calm voice.
a) The nurse should speak in short and simple sentence.
Interventions for a client with panic disorder would include a) encouraging the client to verbalize feelings b) helping the client to avoid panic-producing situations c) reminding the client to practice relaxation when anxiety level is low d) teaching the client reframing techniques. e) teaching relaxation exercises to the client f) telling the client to ignore any anxious feelings
a) encouraging the client to verbalize feelings c) reminding the client to practice relaxation when anxiety level is low d) teaching the client reframing techniques. e) teaching relaxation exercises to the client
Which medication classification has been found to be effective in reducing or eliminating panic attacks? a. Antidepressants b. Antimanics c. Anticholinergics d. Antipsychotics
a. Antidepressants Rationale: Tricyclic and monoamine oxidase inhibitor antidepressants have been found to be effective in treating clients with panic attacks. Why these drugs help control panic attacks is not clearly understood. Anticholinergic agents, which are smooth-muscle relaxants, relieve physical symptoms of anxiety but do not relieve the anxiety itself. Antipsychotic drugs are inappropriate because clients who experience panic attacks are not psychotic. Mood stabilizers are not indicated because panic attacks are rarely associated with mood changes.
When explaining the difference between anxiety and fear, the mental health nurse shares that (Select all that apply.) a. Anxiety involves experiencing subjective, uncomfortable feelings resulting from unknown causes b. Fear results in objective, physical responses caused by real danger c. Anxiety is likely to result from an attempt to overcome stress d. Depression is a risk factor for developing anxiety e. Obsessive-compulsive behavior is often the result of abandonment
a. Anxiety involves experiencing subjective, uncomfortable feelings resulting from unknown causes b. Fear results in objective, physical responses caused by real danger c. Anxiety is likely to result from an attempt to overcome stress Rationale: When explaining the difference between anxiety and fear, the mental health nurse shares that anxiety involves experiencing subjective, uncomfortable feelings resulting from unknown causes.
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. a. Clouded sensorium b. Dry mouth c. Blurred vision d. Constipation e. Vomiting
a. Clouded sensorium b. Dry mouth c. Blurred vision d. Constipation Rationale: Dry mouth, blurred vision, clouded sensorium and constipation are known side effects of benzodiazepines. Vomiting is not known to occur with benzodiazepines. These side effects are associated with non benzodiazepine drugs that are used to treat anxiety like Buspirone (BuSpar).
The nurse is educating a client and family about managing panic attacks after discharge from treatment. The nurse includes which of the following in the discharge teaching? Select all that apply. a. Continued development of positive coping skills b. Maintaining prescribed medications c. Increasing the amount of daily responsibilities d. Continued practice of relaxation techniques e. Development of a regular exercise program
a. Continued development of positive coping skills b. Maintaining prescribed medications d. Continued practice of relaxation techniques e. Development of a regular exercise program Rationale: Client/family education for panic disorder includes reviewing breathing control and relaxation techniques, discussing positive coping strategies, encouraging regular exercise, emphasizing the importance of maintaining prescribed medication regimen and regular follow-up, describing time management techniques such as creating "to do" lists with realistic estimated deadlines for each activity, crossing off completed items for a sense of accomplishment, saying "no," and stressing the importance of maintaining contact with community and participating in supportive organizations. Medication should be adhered to as prescribed. Increasing the amount of daily responsibilities at this time may increase anxiety. cannot be avoided,
Which of the following statements about the use of defense mechanisms in persons with anxiety disorders is accurate? Select all that apply. a. Defense mechanisms are a human's attempt to reduce anxiety. b. Persons are usually aware when they are using defense mechanisms. c. Defense mechanisms can be harmful when overused. d. Defense mechanisms are cognitive distortions. e. Defense mechanisms can control the awareness of anxiety. f. The use of defense mechanisms should be avoided.
a. Defense mechanisms are a human's attempt to reduce anxiety. c. Defense mechanisms can be harmful when overused. d. Defense mechanisms are cognitive distortions. e. Defense mechanisms can control the awareness of anxiety. Rationale: Freud described defense mechanisms as the human's attempt to control awareness of and to reduce anxiety. Defense mechanisms are cognitive distortions that a person uses unconsciously to maintain a sense of being in control of a situation, to lessen discomfort, and to deal with stress. Because defense mechanisms arise from the unconscious, the person is unaware of using them. Some people overuse defense mechanisms, which stops them from learning a variety of appropriate methods to resolve anxiety-producing situations. The dependence on one or two defense mechanisms also can inhibit emotional growth, lead to poor problem-solving skills, and create difficulty with relationships.
A nurse has been told that a client's anxiety is at the panic level. The nurse would assess the client for manifestations at this level of anxiety. a. Dizziness, palpitations, and nausea b. Feelings of "butterflies" in the stomach c. Feelings of fatigue and inability to remain awake d. Obsessive thoughts and compulsive behavior
a. Dizziness, palpitations, and nausea
A nurse is assessing a client with anxiety. Which signs and symptoms would the nurse attribute to sympathetic nervous stimulation? Select all that apply. a. Heart racing b. Bradycardia c. Hypertension d. Fainting f. Pressure to urinate
a. Heart racing c. Hypertension Rartionale: Pressure to urinate, fainting, and bradycardia are related to parasympathetic nervous stimulation.
A nurse is preparing a plan of care for a client with anxiety. Which elements would the nurse likely include? Select all that apply. a. Identifying treatment modalities b. Providing supportive feedback c. Using appropriate coping skills d. Involving family for support, if appropriate e. Using restraint when panic develops
a. Identifying treatment modalities b. Providing supportive feedback c. Using appropriate coping skills d. Involving family for support, if appropriate
When a client is experiencing a panic attack while in the recreation room, what interventions are the nurse's first priorities? Select all that apply. a. Provide a safe environment. b. Request a prescription for an antianxiety agent c. Offer the client therapy to calm down d. Ensure the client's privacy. e. Engage the client in recreational activities.
a. Provide a safe environment. d. Ensure the client's privacy. Rationale: During a panic attack, the nurse's first concern is to provide a safe environment and to ensure the client's privacy. If the environment is overstimulating, the client should move to a less stimulating place. Decreasing external stimuli will help lower the client's anxiety level. The client's safety is priority. Anxious behavior can be escalated by external stimuli. In a large area, the client can feel lost and panicked, but a smaller room can enhance a sense of security. An antianxiety agent may be helpful, but it is not the priority. It would likely be stimulating to engage the client in recreational activities.
Which of the following are believed to help individuals mediate, or lessen, the effects of stress. Select all that apply: a. Spirituality b. Wealth c. Higher education level d. Social support e. Culture
a. Spirituality d. Social support
A group of nursing students are reviewing signs and symptoms of anxiety. The students demonstrate a need for additional review when they identify what? a. Tearfulness b. Motor excitement c. Extreme restlessness d. Palpitations
a. Tearfulness Rationale: The clinical symptoms of anxiety are numerous. They are generally classified as physiologic, psychological or emotional, behavioral, and intellectual or cognitive responses to stress. The clinical symptoms may vary according to the level of anxiety exhibited by the client. Tearfulness and sadness are symptoms of depression, not of anxiety.
Interventions for a client with panic disorder would include (select all): a. encouraging the client to verbalize feelings b. helping the client avoid panic-producing situations c. reminding the client to practice relaxation when anxiety level is low d. teaching the client reframing techniques e. teaching relaxation exercises to the client. f. telling the client to ignore any anxious feelings.
a. encouraging the client to verbalize feelings c. reminding the client to practice relaxation when anxiety level is low d. teaching the client reframing techniques e. teaching relaxation exercises to the client.
What is the term for the change that takes place in response to a stressor? Rehabilitation Adaptation Positive movement Negative movement
adaptation
The most important factor in the person's stress response is what? Strength of the immune system Supportive friends Relaxation techniques Adaptive coping strategies
adaptive coping strategies
A psychiatric nurse visits a client at home. The client tells the nurse that he or she experiences chest pain, shortness of breath, and sweating whenever leaving home. The client has been unable to go to work for six weeks. The nurse recognizes this problem as which behavior? claustrophobia agoraphobia acrophobia mysophobia
agoraphobia
A client is currently experiencing panic. Which action would be most appropriate for the nurse to do? Allow the client to pace Ask the client repeated questions about feelings Employ the use of negative self-talk Urge the client to engage in vigorous exercise
allow the client to pace
Which client, presenting with a report of vague physical symptoms, should be assessed for possible anxiety by the nurse? a Native American client a African American client an Asian American client an Arab American client
an Asian American client
severe anxiety
an increased level of anxiety when more primitive survival skills take over, defensive responses ensue, and cognitive skills decrease significantly; person with severe anxiety has trouble thinking and reasoning the perceptual field is greatly reduced in severe anxiet
A client has sought treatment because of the overwhelming anxiety the client experiences regarding the safety of the client's young children. The client admits that the client will not normally let the client's children leave the client's sight for fear that they will be abducted, abused, or injured. The client is unable to function at work as a result of this anxiety. The nurse would recognize that this client experiences which condition? Signal anxiety Fear Derealization Anticipatory anxiety
anticipatory anxiety
Panic disorder is treated with cognitive-behavioral techniques, deep breathing, and relaxation, in addition to what? Antidepressants Anticonvulsants Antipsychotics Central nervous system depressants
antidepressants
Which nursing assessment is most appropriate for an older client presenting with reports of generalized anxiety? assess for depression assess for panic attacks assess for elder abuse assess for dementia
assess for depression
Which nursing assessment is most appropriate for an older client presenting with reports of generalized anxiety? assess for depression assess for panic attacks assess for elder abuse assess for dementia
assess for depression
Which nursing assessment is most appropriate for an older client presenting with reports of generalized anxiety? assess for panic attacks assess for depression assess for dementia assess for elder abuse
assess for depression Rationale:Late-onset generalized anxiety disorder (GAD) is usually associated with depression. Although less common, panic attacks can occur in later life and are often related to depression or a physical illness such as cardiovascular, GI, or chronic pulmonary diseases. While the remaining options are appropriate, they are not associated with the possible comorbid conditions of GAD.
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
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 helping the client identify ways to eliminate all sources of stress in his or her daily life educating the client concerning the use of medications to manage anxiety disorders assessing the client for possible symptoms of panic disorder
assessing the client's ability to implement stress management techniques effectively
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 helping the client identify ways to eliminate all sources of stress in his or her daily life educating the client concerning the use of medications to manage anxiety disorders assessing the client for possible symptoms of panic disorder
assessing the client's ability to implement stress management techniques effectively
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 helping the client identify ways to eliminate all sources of stress in his or her daily life educating the client concerning the use of medications to manage anxiety disorders assessing the client for possible symptoms of panic disorder
assessing the client's ability to implement stress management techniques effectively
Which nursing intervention is focused on the primary goal of anxiety management and treatment? assessing the client for possible symptoms of panic disorder educating the client concerning the use of medications to manage anxiety disorders helping the client identify ways to eliminate all sources of stress in his or her daily life assessing the client's ability to implement stress management techniques effectively
assessing the client's ability to implement stress management techniques effectively For people with anxiety disorders, it is important to emphasize that the goal is effective management of stress and anxiety, not the total elimination of anxiety. Learning anxiety management techniques and effective methods for coping with life and its stresses is essential for overall improvement in life quality.
Which nursing intervention is focused on the primary goal of anxiety management and treatment? helping the client identify ways to eliminate all sources of stress in his or her daily life assessing the client's ability to implement stress management techniques effectively educating the client concerning the use of medications to manage anxiety disorders assessing the client for possible symptoms of panic disorder
assessing the client's ability to implement stress management techniques effectively For people with anxiety disorders, it is important to emphasize that the goal is effective management of stress and anxiety, not the total elimination of anxiety. Learning anxiety management techniques and effective methods for coping with life and its stresses is essential for overall improvement in life quality. Although medication is important to relieve excessive anxiety, it does not solve or eliminate the problem entirely. While assessment is appropriate, it is not directly associated with the management and treatment of the original disorder.
Which nursing intervention is focused on the primary goal of anxiety management and treatment? educating the client concerning the use of medications to manage anxiety disorders assessing the client's ability to implement stress management techniques effectively helping the client identify ways to eliminate all sources of stress in his or her daily life assessing the client for possible symptoms of panic disorder
assessing the client's ability to implement stress management techniques effectively For people with anxiety disorders, it is important to emphasize that the goal is effective management of stress and anxiety, not the total elimination of anxiety. Learning anxiety management techniques and effective methods for coping with life and its stresses is essential for overall improvement in life quality. Although medication is important to relieve excessive anxiety, it does not solve or eliminate the problem entirely. While assessment is appropriate, it is not directly associated with the management and treatment of the original disorder.
Which nursing intervention is focused on the primary goal of anxiety management and treatment? helping the client identify ways to eliminate all sources of stress in his or her daily life assessing the client's ability to implement stress management techniques effectively assessing the client for possible symptoms of panic disorder educating the client concerning the use of medications to manage anxiety disorders
assessing the client's ability to implement stress management techniques effectively Rationale:For people with anxiety disorders, it is important to emphasize that the goal is effective management of stress and anxiety, not the total elimination of anxiety. Learning anxiety management techniques and effective methods for coping with life and its stresses is essential for overall improvement in life quality. Although medication is important to relieve excessive anxiety, it does not solve or eliminate the problem entirely. While assessment is appropriate, it is not directly associated with the management and treatment of the original disorder.
Automatisms
automatic, unconscious mannerisms associated with anxiety. Examples include tapping fingers, jingling keys, or twisting hair. Automatisms are geared toward anxiety relief and increase in frequency and intensity with the client's anxiety level.
Which of the following is a cardiovascular response of the sympathetic nervous system? a) Hypotension b) Bradycardia c) Bradypnea d) Tachycardia
d) Tachycardia
Research has provided solid evidence that anxiety disorders have a) Originated from disappointments resulting from an exaggerated sense of self-worth b) A basis in genetics with clinical symptoms being a result of chromosomal influence c) Their roots in episodes of physical or psychological abuse that occurred at times of developmental growth d) Caused by substance abuse, particularly narcotics, resulting in damage to the brain's receptors
b) A basis in genetics with clinical symptoms being a result of chromosomal influence
What does desensitization refer to? a) A cognitive technique for replacing a worry with a positive statement b) A systematic way to replace a panic response with a relaxation response c) Teaching the client to ignore or become immune to anxiety-producing situations d) Exposing the client to an anxiety-producing stimulus for 1 to 2 hours (flooding)
b) A systematic way to replace a panic response with a relaxation response
Which medication classification has been found to be effective in reducing or eliminating panic attacks? a) Antipsychotics b) Antidepressants c) Anticholinergics d) Antimanics
b) Antidepressants
A nurse assesses a client and determines that the client is experiencing mild anxiety based on which of the following? a) Selectively inattentive b) Aware and alert c) Focused attention on a small area d) Feelings of unreality
b) Aware and alert
The nurse documents that the client is in an anxiety state when she is observed ... a) Wringing her hands and asking staff when they think she will have another heart attack b) Crying hysterically and complaining of a shortness of breath when told that she has been scheduled for a heart catheterization c) The client refuses to have her blood pressure taken in her left arm because she is sure something bad will happen d) Reporting that she "can't sleep a wink" if she is not in her own bed
b) Crying hysterically and complaining of a shortness of breath when told that she has been scheduled for a heart catheterization
When assessing an elderly Hispanic client who has newly been diagnosed with anxiety, the mental health nurse's priority is to ... a) Assess for physical conditions that may affect anxiety b) Determine the client's risk for self-harm or harm to others c) Determining the effects that culture has had on the client's anxiety issues d) Obtain a thorough history, focusing on the client's physiologic functioning
b) Determine the client's risk for self-harm or harm to others
A 21-year-old woman has been recently diagnosed with agoraphobia. Which of the following situations is most likely to cause the woman anxiety? a) Gaining five pounds and being unable to exercise vigorously b) Going to a crowded, outdoor market on her own c) Having a blood sample drawn and experiencing mild pain d) Having her work performance closely scrutinized by a supervisor
b) Going to a crowded, outdoor market on her own
Which of the following is a parasympathetic effect of anxiety? a) Constipation b) Hyperactive bowel sounds c) Muscle tension d) Decreased urine output
b) Hyperactive bowel sounds
The nurse documents that a client diagnosed with an anxiety disorder is experiencing moderate anxiety when ... a) Heard telling another client that, "There is nothing they can do for me; I just know it's really bad." b) Observed pacing and repeatedly asking staff what time the "doctor will be here." c) Reporting, "I just can't relax; I've got thing to do." d) Has difficulty actually verbalizing his anxious feelings
b) Observed pacing and repeatedly asking staff what time the "doctor will be here."
The nurse has read in a client's admission record that the client has been taking propranolol (Inderal) for psychiatric, rather than medical, reasons. The nurse should recognize that the client likely has a history of what? a) Obsessive-compulsive disorder (OCD) b) Panic disorder c) Nightmares d) Acute stress disorder
b) Panic disorder
Relaxation techniques help clients with anxiety disorders because they do what? a) Increase metabolic rate b) Reduce autonomic arousal c) Increase sympathetic stimulation d) Release cortisol
b) Reduce autonomic arousal
A client who experiences paralyzing anxiety at the sight of a dog is supported in the act of sitting in a room with the animal. This is an example of the alternative behavioral technique called ... a) Implosion therapy b) Systematic desensitization c) Relaxation exercise d) Biofeedback
b) Systematic desensitization
A client is prescribed a serotonin-norepinephrine reuptake inhibitor. The nurse would identify that which of the following is most commonly prescribed? a) Paroxetine b) Venlafaxine c) Duloxetine d) Fluoxetine
b) Venlafaxine
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: Select all that apply a) calm restlessness. b) engage in goal-directed activity. c) to feel and think. d) motivate to make a change. e) to focus attention to learn.
b) engage in goal-directed activity. c) to feel and think. d) motivate to make a change. e) to focus attention to learn.
The best goal for a client learning a relaxation techniques is that the client will a) confront the source of anxiety directly b) experience anxiety without feeling overwhelmed c) report no episodes of anxiety d) suppress anxious feelings
b) experience anxiety without feeling overwhelmed
When assessing a client with anxiety, the nurse should recognize that anxiety may often be a result of what? a) Fluid and electrolyte imbalance b) medications
b) medications
The nurse is assessing a client who recently experienced their first panic attack while at the grocery store. What question should the nurse ask to identify complications of the disorder? a. "Are you concerned there will be more panic attacks?" b. "Do you have any problems going out alone to public places?" c. "What do you think is the origin of the panic you felt?" d. "Can you describe how you felt physically during the attack?"
b. "Do you have any problems going out alone to public places?" Rationale: To identify complications of the disorder when assessing a client who recently experienced the client's first panic attack while at a grocery store, the psychiatric nurse asks, "Do you have any problems going out alone to public places?"
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? a. "Defense mechanisms provide a sense of control over the uncontrollable." b. "When I have a problem, I just deny it until it goes away." c. "I'm not sure when I'm actually using a defense mechanism." d. "I'm thankful that I have a way to manage my problems."
b. "When I have a problem, I just deny it until it goes away."
Which level of anxiety helps the client focus the client's attention to learn, problem solve, think, act, feel, and protect himself or herself? a. Moderate b. Mild c. Panic d. Severe
b. Mild
The mental health nurse is gathering a health history on a new client. The client is constantly pacing the floor and is concerned only with stating that the client is about to die. The nurse would classify this level of anxiety as what? a. Mild b. Moderate c. Euphoria d. Severe
b. Moderate Rationale: In moderate anxiety, the client experiences a narrowing of the ability to concentrate. The client paces, has voice tremors, and has an increased rate of speech. During euphoria, the client experiences an exaggerated feeling of well-being that is not directly proportional to a specific circumstance or situation. Mild anxiety causes the client to have an increased alertness to inner feelings or the environment. During severe anxiety, the client is able to focus on only small or scattered details.
A nurse determines that a client who is experiencing anxiety is using relief or primitive survival behaviors. The nurse determines that the client is experiencing which degree of anxiety? a. Mild b. Severe c. Moderate d. Panic
b. Severe Rationale: With mild anxiety, the client is easily able to recognize and name anxiety. With moderate anxiety, the client is usually able to state that he or she is anxious. A client experiencing severe anxiety typically uses relief behaviors. With panic, the client is perplexed and self-absorbed.
Which is a cardiovascular response of the sympathetic nervous system? a. Bradycardia b. Tachycardia c. Hypotension d. Bradypnea
b. Tachycardia
Which would not be included in the plan of care for a client diagnosed with acute anxiety? a. Encouraging the client to verbalize feelings and concerns b. Touching the client in an attempt to comfort the client c. Approaching the client in a calm, confident manner d. Providing the client with a safe, quiet, and private place
b. Touching the client in an attempt to comfort the client
Which nursing assessment is most appropriate for an older client presenting with reports of generalized anxiety? a. assess for dementia b. assess for depression c. assess for panic attacks d. assess for elder abuse
b. assess for depression Rationale: Late-onset generalized anxiety disorder (GAD) is usually associated with depression. Although less common, panic attacks can occur in later life and are often related to depression or a physical illness such as cardiovascular, GI, or chronic pulmonary diseases. While the remaining options are appropriate, they are not associated with the possible comorbid conditions of GAD.
The best goal for a client learning a relaxation technique is that the client will a. confront the source of anxiety directly. b. experience anxiety without feeling overwhelmed. c. report no episodes of anxiety. d. suppress anxious feelings.
b. experience anxiety without feeling overwhelmed.
The nurse is assessing a client who recently experienced her first panic attack while at the grocery store. To identify complications of the disorder, the nurse should ask: a) "Are you concerned there will be more panic attacks?" b) "Can you describe how you felt physically during the attack?" c) "Do you have any problems going out alone to public places?" d) "What do you think is the origin of the panic you felt?"
c) "Do you have any problems going out alone to public places?"
Which of the following questions in the assessment of a client with anxiety is most clinically appropriate? a) "Do you think that you're justified in feeling anxious right now?" b) "Does your anxiety make you feel less valuable and competent as a person?" c) "How do you feel about everything that is happening in your life right now?" d) "What can I give you to make you feel less anxious right now?"
c) "How do you feel about everything that is happening in your life right now?"
The client diagnosed with social phobia that is culturally induced is the a) 40-year-old unemployed factory worker who is enrolled in college classes b) 25-year-old farmer who recently moved to the city c) 30-year-old Japanese immigrant d) 19-year-old Hispanic who speaks very little English
c) 30-year-old Japanese immigrant
A client with GAD states, "I have learned that the best thing I can do is to forget my worries." How would the nurse evaluate this statement? a) the client is developing insight b) the client's coping skills have improved c) the client need encouragement to verbalize feelings d) the client's treatment has been successful
c) the client need encouragement to verbalize feelings
The nurse recognizes that the client most likely experiencing generalized anxiety disorder (GAD) is a ... a) 70-year-old whose spouse died 1 year ago who has "no desire to leave my house" and reports severe fatigue b) 22-year-old soldier who served in the Middle East who "cannot sleep" and is facing criminal charges for hurting someone in a barroom brawl. c) 40-year-old who has reported numerous absences from work, muscle aches, and difficulty falling asleep for the last 8 months d) 30-year-old business executive who reports being anxious about attending the meetings and social events that are his job responsibilities
c) 40-year-old who has reported numerous absences from work, muscle aches, and difficulty falling asleep for the last 8 months
Cheryl was physically assaulted 1 week ago. She has been having trouble remembering the event and feels as if she is walking around in a dreamlike state. From what condition is Cheryl suffering? a) Dissociative stress disorder b) Posttraumatic stress disorder c) Acute stress disorder d) Amnesic stress disorder
c) Acute stress disorder
Panic disorder is treated with cognitive-behavioral techniques, deep breathing, and relaxation, in addition to which of the following? a) CNS depressants b) Antipsychotics c) Antianxiety medications d) Anticonvulsants
c) Antianxiety medications
The nurse is assessing a client suffering from stress and anxiety. The most common physiologic response to stress and anxiety is a) Vertigo b) Skin rash c) Diarrhea d) Sedation
c) Diarrhea
Severe levels of anxiety result in what? a) Impaired ability to concentrate b) Mild forgetfulness c) Distorted sensory awareness d) A heightened sense of awareness
c) Distorted sensory awareness
In teaching a client who has been prescribed a benzodiazepine for panic disorder, the nurse must be certain to do what? a) Instruct the client to come in every other week to get blood drawn and monitor for agranulocytosis. b) Instruct the client that if he has palpitations, he should contact his physician immediately because of the risk for dysrhythmias with this medication. c) Educate the client that this medication has a high risk for withdrawal symptoms, and he should not discontinue without a doctor's supervision. d) Educate the client that this medication will interact with certain food groups.
c) Educate the client that this medication has a high risk for withdrawal symptoms, and he should not discontinue without a doctor's supervision.
Clients taking benzodiazepines need education about which of the following? a) Avoiding spending too much time in the sun b) Avoiding cheeses and smoked meats c) Potentiation of alcohol effects d) Interactions with monoamine oxidase inhibitors (MAOIs)
c) Potentiation of alcohol effects
Which of the following is the primary concern for a client with panic-level anxiety? a) Emotional needs b) Physiologic needs c) Safety d) Social support
c) Safety
Which medication classification has been used to treat social phobia? a) Monoamine oxidase inhibitors (MAOIs) b) Nonbenzodiazepines c) Selective serotonin reuptake inhibitors (SSRIs) d) Tricyclic antidepressants (TCAs)
c) Selective serotonin reuptake inhibitors (SSRIs)
Eight months ago, a client was in a hotel fire and was the last person to be rescued from the roof. She watched her husband burn to death from the helicopter. She continues to have nightmares and is fearful that she will die in a fire. An appropriate nursing diagnosis for the client is what? a) Ego disintegration related to severe anxiety b) Unrealistic fear of fire related to conversion reaction c) Sleep pattern disturbance related to recurrent nightmares d) Anxiety related to illusions
c) Sleep pattern disturbance related to recurrent nightmares
A 30-year-old woman who has been unemployed secondary to her anxiety disorder states that she would like to have a job where she is alone and no one needs to evaluate her work. The nurse interprets these comments as an indicator of which of the following? a) Panic disorder b) Agoraphobia c) Social phobia d) Obsessive-compulsive disorder
c) Social phobia
All except which of the following are considered clinical symptoms of anxiety? a) Palpitations b) Extreme restlessness c) Tearfulness and sadness d) Motor excitement
c) Tearfulness and sadness
The nurse is assessing a client with anxiety. Which behavior might indicate that the client has moderate anxiety? a) The client is unable to communicate verbally. b) The client is focused in an activity. c) The client is nervous and agitated. d) The client has impaired cognitive skills.
c) The client is nervous and agitated.
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. a) The client would be able to understand what the nurse is saying. b) The client would return to rational thought. c) The client would have an enhanced sense of security. d) The client would be able to demonstrate relaxation techniques.
c) The client would have an enhanced sense of security.
Which of the following would not be included in the plan of care for a client diagnosed with acute anxiety? a) Encouraging the client to verbalize feelings and concerns b) Approaching the client in a calm, confident manner c) Touching the client in an attempt to comfort him d) Providing the client with a safe, quiet, and private place
c) Touching the client in an attempt to comfort him
When working with a client with moderate anxiety, the nurse would expect to see a) inability to compete tasks b) failure to respond to redirection c) increased automatisms or gestures d) narrowed perceptual field e) selective attention f) inability to connect thoughts independently
c) increased automatisms or gestures d) narrowed perceptual field e) selective attention f) inability to connect thoughts independently
Which of the following would be the best intervention for a client having a panic attack? a) involve the client in a physical activity b) offer a distraction such a music c) remain with the client d) teach the client a relation technique
c) remain with the client
The nurse observes a client who is becoming increasing upset. He is rapidly pacing, hyperventilating, clenching his jaw, wringing his hands, and trembling. His speech is high pitched and random; he seems preoccupied with his thoughts. He is pounding his fist into his other hand. The nurse identifies his anxiety level as a) mild b) moderate c) severe d) panic
c) severe
Jonathan comes in for a therapy session and is having a mild panic attack. The therapist asks him to relax in his chair and then gently asks him to imagine himself in a very safe and calm place. This technique, often useful in anxiety disorders, is called: a) desensitization. b) cognitive therapy. c) visualization. d) problem-solving.
c) visualization.
Which statement by the nurse demonstrates an understanding of the role automatisms have in a panic attack? a. "I discourage her finger tapping since it serves to increase her anxiety level." b. "She knows that if she taps her fingers she will be able to lessen her anxiety." c. "The client taps her fingers very rapidly when she is feeling anxious." d. "I can tell that the more she taps, the less anxiety she is actually feeling."
c. "The client taps her fingers very rapidly when she is feeling anxious." Rationale: Automatisms are automatic, unconscious mannerisms associated with anxiety. Examples include tapping fingers, jingling keys, or twisting hair. Automatisms are geared toward anxiety relief and increase in frequency and intensity with the client's anxiety level. None of the remaining options accurately state the fact that the tapping identifies the level of anxiety a client is experiencing but does not manage or less the emotion.
Nearly what percentage of adults are affected by anxiety disorders? a. 0.55 b. 0.1 c. 0.25 d. 0.4
c. 0.25
A patient with anxiety disorder has excessive anxiety and worries about multiple life circumstances. For how long would this patient experience these feelings before the anxiety disorder would be considered chronic and generalized? a. 2 months b. 12 months c. 6 months d. 4 months
c. 6 months Rationale: For generalized anxiety disorder, the diagnostic criteria listed include unrealistic or excessive anxiety and worry about two or more life circumstances for 6 months or more, during which time these concerns exist for a majority of days.
Which would be the best intervention for a client having a panic attack? a. Involve the client in a physical activity b. Offer a distraction such as music c. Remain with the client d. Teach the client a relaxation technique.
c. Remain with the client
Which should be included in a teaching plan for a client prescribed a benzodiazepine? a. Stop taking drug if sedation develops b. Maintain a fluid restriction c. Rise slowly from a lying or sitting position d. Consume caffeine in moderation
c. Rise slowly from a lying or sitting position
Which is the primary concern for a client with panic-level anxiety? a. Emotional needs b. Social support c. Safety d. Physiologic needs
c. Safety
A client with GAD states, "I have learned that the best thing I can do is to forget my worries." How would the nurse evaluate this statement? a. The client is developing insight b. The client's coping skills have improved c. The client needs encouragement to verbalize feelings d. The client's treatment has been successful
c. The client needs encouragement to verbalize feelings
Which nursing intervention is focused on the primary goal of anxiety management and treatment? a. helping the client identify ways to eliminate all sources of stress in his or her daily life b. assessing the client for possible symptoms of panic disorder c. assessing the client's ability to implement stress management techniques effectively d. educating the client concerning the use of medications to manage anxiety disorders
c. assessing the client's ability to implement stress management techniques effectively
When working with a client with moderate anxiety, the nurse would expect to see (select all): a. inability to complete tasks b. failure to respond to redirection c. increased automatisms or gestures d. narrowed perceptual field e. selective attention. f. inability to connect thoughts independently.
c. increased automatisms or gestures d. narrowed perceptual field e. selective attention. f. inability to connect thoughts independently.
The nurse observes a client who is becoming increasingly upset. He is rapidly pacing, hyperventilating, clenching his jaw, wringing his hands, and trembling. His speech is high-pitched and random; he seems preoccupied with his thoughts. He is pounding his fist into his other hand. The nurse identifies his anxiety level as a. mild b. moderate c. severe d. panic
c. severe
When assessing a client with anxiety, the nurse's questions should be a) avoided until the anxiety is gone b) open ended c) postponed until the client volunteers information d) specific and direct
d) specific and direct
A client responds to bad news regarding test results by crying uncontrollably. What is the term for this response to a stressor? Adaptation Homeostasis Coping mechanism Defense mechanism
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? Defense mechanism Coping mechanism Caregiver burden Crisis
coping mechanism
A client with generalized anxiety disorder states that he is worried about his job. He never feels like he has control over his responsibilities, even though he puts in extra hours. He adds that he is afraid he will be fired. Which response by the nurse is most therapeutic? a) "Why do you think you'll be fired?" b) "Your worries are a feature of your anxiety disorder. Tell yourself that you have nothing to worry about." c) "It sounds to me like you're doing a good job." d) "Has something changed at work that is causing you to worry?"
d) "Has something changed at work that is causing you to worry?"
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 of the following responses is best? a) "Normal anxiety occurs in response to everyday stressors." b) "Normal anxiety does not result in feelings of dread or restlessness." c) "People with anxiety disorders experience a fight-or-flight response when threatened." d) "People with anxiety disorders generally find that the anxiety interferes with daily activities."
d) "People with anxiety disorders generally find that the anxiety interferes with daily activities."
Anxiety disorder is considered chronic and generalized when excessive anxiety and worry about two or more life circumstances exist for at least ... a) 4 months b) 2 months c) 12 months d) 6 months
d) 6 months
When discussing various types of anxiolytic medications with a client, the nurse recognizes that which of the following medications has the lowest potential for abuse? a) Lorazepam (Ativan) b) Diazepam (Valium) c) Alprazolam (Xanax) d) Buspirone (BuSpar)
d) Buspirone (BuSpar)
All of the following pharmacological agents are useful in treating anxiety disorders except which ones? a) SSRIs b) Tricyclic antidepressants c) Benzodiazepines d) Calcium channel blockers
d) Calcium channel blockers
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? a) Will interfere with her cognitive abilities b) Is pathologic and warrants postponing the test c) May be transferred to her tutor and result in test anxiety d) Is conducive to concentration and problem solving
d) Is conducive to concentration and problem solving
The mental health nurse is gathering a health history on a new client. The client is constantly pacing the floor and stating that he is about to die. The nurse would classify this level of anxiety as which of the following? a) Euphoria b) Severe c) Mild d) Moderate
d) Moderate
Which of the following conditions involves a persistent, irrational fear attached to an object or situation that objectively does not pose a significant danger? a) Obsessive-compulsive disorder b) Stress disorders c) Post-traumatic stress disorder d) Phobic disorders
d) Phobic disorders
Which of the following should be included in a teaching plan for a client prescribed a benzodiazepine? a) Maintain a fluid restriction b) Consume caffeine in moderation c) Stop taking drug if sedation develops d) Rise slowly from a lying or sitting position
d) Rise slowly from a lying or sitting position
Which of the four classes of medications used for panic disorder is considered the safest because of low incidence of side effects and lack of physiologic dependence? a) Benzodiazepines b) Tricyclics c) Monoamine oxidase inhibitors d) Selective serotonin reuptake inhibitors
d) Selective serotonin reuptake inhibitors
Which of the following would be an appropriate intervention of a client experiencing an anxiety attack? a) Leaving the client alone b) Turning on stereo music c) Turning on the lights and opening the windows so that the client does not feel crowded d) Staying with the client and speaking in short sentences
d) Staying with the client and speaking in short sentences
A client with anxiety is beginning treatment with lorazepam (Ativan). It is most important for the nurse to assess the client's a) motivation for treatment b) family and social support c) use of coping mechanisms d) use of alcohol
d) use of alcohol
Which term describes feelings of being disconnected from oneself as seen in a panic attack? a. Agoraphobia b. Automatisms c. Derealization d. Depersonalization
d. Depersonalization
Which of the four classes of medications used for panic disorder is considered the safest because of low incidence of side effects and lack of physiological dependence? a. Benzodiazepines b. Tricyclics c. Monoamine oxidase inhibitors d. SSRIs
d. SSRIs
Which would be an appropriate intervention for a client experiencing an anxiety attack? a. Turning on stereo music b. Leaving the client alone c. Turning on the lights and opening the windows so that the client does not feel crowded d. Staying with the client and speaking in short sentences
d. Staying with the client and speaking in short sentences
When assessing a client with anxiety, the nurse's questions should be: a. avoided until anxiety is gone b. Open-ended c. postponed until the client volunteers the information d. simple and calm
d. simple and calm Rationale: p235
When assessing a client with anxiety, the nurse's questions should be avoided until a. the anxiety is gone. b. open-ended. c. postponed until the client volunteers information. d. specific and direct.
d. specific and direct.
A client with anxiety is beginning treatment with lorazepam (Ativan). It is more important for the nurse to assess the client's a. motivation for treatment b. family and social support c. use of coping mechanisms d. use of alcohol
d. use of alcohol
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. derealization. decatastrophizing. demonstrating automatisms.
depersonalization NOTE: Depersonalization is a feeling that the client may describe as being disconnected from herself, such as watching oneself. This is common when individuals experience panic levels of anxiety. Derealization refers to the sensation that things are not real or surreal during panic levels of anxiety. Decatastrophizing refers to a treatment approach used by therapists in which the client is asked questions in order to urge the client to develop a more realistic appraisal of the situation causing the anxiety. Automatisms are automatic, unconscious mannerisms that are geared toward relief of anxiety and increase in intensity and frequency with a rise in the client's anxiety level.
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 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. derealization. decatastrophizing. demonstrating automatisms.
depersonalization.
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. demonstrating automatisms. decatastrophizing. derealization.
depersonalization.
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. decatastrophizing. demonstrating automatisms. derealization.
depersonalization.
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: decatastrophizing. depersonalization. derealization. demonstrating automatisms.
depersonalization. Depersonalization is a feeling that the client may describe as being disconnected from herself, such as watching oneself. This is common when individuals experience panic levels of anxiety. Derealization refers to the sensation that things are not real or surreal during panic levels of anxiety. Decatastrophizing refers to a treatment approach used by therapists in which the client is asked questions in order to urge the client to develop a more realistic appraisal of the situation causing the anxiety. Automatisms are automatic, unconscious mannerisms that are geared toward relief of anxiety and increase in intensity and frequency with a rise in the client's anxiety level.
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: decatastrophizing. derealization. demonstrating automatisms. depersonalization.
depersonalization. Depersonalization is a feeling that the client may describe as being disconnected from herself, such as watching oneself. This is common when individuals experience panic levels of anxiety. Derealization refers to the sensation that things are not real or surreal during panic levels of anxiety. Decatastrophizing refers to a treatment approach used by therapists in which the client is asked questions in order to urge the client to develop a more realistic appraisal of the situation causing the anxiety. Automatisms are automatic, unconscious mannerisms that are geared toward relief of anxiety and increase in intensity and frequency with a rise in the client's anxiety level.
When assessing an older adult client who has newly been diagnosed with an anxiety disorder, the mental health nurse's priority is to carry out which task? Determine the client's risk for self-harm or harm to others Obtain a thorough history, focusing on the client's physiologic functioning Assess for physical conditions that may affect anxiety Determine the effects that culture has had on the client's anxiety issues
determine the client's risk for self-harm or harms to other
A nurse is assessing a client and determines that the client is experiencing severe anxiety based on which finding? A heightened sense of awareness Distorted sensory awareness Goal directed behavior Eagerness for more information
distorted sensory awareness
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. Agitation Dry mouth Blurred vision Constipation Vomiting
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. Educate the client that this medication will interact with certain food groups. Instruct the client to come in every other week to get blood drawn and monitor for agranulocytosis. Instruct the client that if the client has palpitations, the client should contact the client's physician immediately because of the risk for dysrhythmias with this medication.
educate the client that this medication has a high risk for withdrawal symptoms, and the client should not discontinue with a doctor's supervision
In teaching a client who has been prescribed a benzodiazepine for panic disorder, the nurse must be certain to do what? Instruct the client to come in every other week to get blood drawn and monitor for agranulocytosis. Educate the client that this medication will interact with certain food groups. Instruct the client that if the client has palpitations, the client should contact the client's physician immediately because of the risk for dysrhythmias with this medication. Educate the client that this medication has a high risk for withdrawal symptoms, and the client should not discontinue without a doctor's supervision.
educate the client that this medication has a high risk for withdrawal symptoms, and the client should not discontinue without a doctor's supervision. The benzodiazepines have a high risk for withdrawal symptoms, and the client needs to be educated as to this fact. The benzodiazepines do not interact with certain food groups like monoamine oxidase inhibitors do.
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? Endorphins Dopamine Epinephrine Testosterone
epinephrine
Nursing interventions for physical stress related illness should include what? Assessing the need for increased dose of benzodiazepines Attending group therapy Establishing daily routines of meals and sleeping Fostering use of a social support system
establishing daily routines for meals and sleeping
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? Reviewing the client's previous medication administration record and the client's current list of medications Questioning the client about the clinician who first diagnosed the medical problem Asking the client to provide a detailed explanation of his or her medical problem to determine if the presentation is typical of the problem Establishing whether the client's anxiety preceded the medical problem or whether the medical problem appeared first
establishing whether the client's anxiety preceded the medical problem or whether the medical problem appeared first
agoraphobia
fear of being outside
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? systematic desensitization flooding decatastrophizing assertiveness training
flooding
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
The nurse is assessing a client suffering from stress and anxiety. The most common physiologic response to stress and anxiety is: gastrointestinal upset. sedation. vertigo. skin rash.
gastrointestinal upset.
A client comes in for a therapy session and begins to have a panic attack. The therapist asks the client to sit 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? Decatastrophizing Guided imagery Desensitization Progressive relaxation
guided imagery
Moderate anxiety
he perceptual field narrows slightly. The person does not notice what goes on peripheral to the immediate focus but can do so if attention is directed there by another observe
Decatastrophizing involves
he therapist's use of questions to more realistically appraise the situation.
A nurse is assessing a client with anxiety. Which signs and symptoms would the nurse attribute to sympathetic nervous stimulation? Select all that apply. Fainting Hypertension Pressure to urinate Bradycardia Heart racing
heart racing, htn
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? Vasodilation of peripheral blood vessels Increased blood pressure Decrease in blood glucose levels Pupil constriction
increased blood pressure
During the admission assessment of a 27-year-old client who has been diagnosed with an anxiety disorder, the nurse observes that the client is becoming increasingly restless and agitated. How should the nurse respond to this development? Inform the client that the assessment can be postponed if the client is finding it overwhelming. Increase the speed of the assessment in order to ensure that it is completed sooner and inform the client that the nurse is doing so. Provide education regarding the level of anxiety that the client may be experiencing. Explain to the client that the client's current feelings of anxiety have the potential to foster better coping skills in the future.
inform the client that the assessment can be postponed if the client is finding it overwhelming
Panic anxiety
intense anxiety, may be a response to a life-threatening situation the perceptual field is reduced to a detail, which is usually "blown up."
A group of students is reviewing information about the etiology of generalized anxiety disorder (GAD). The students demonstrate understanding of this information when they identify which as representing the bases for this disorder? Inaccurate environmental danger assessment Exposure to multiple stressful life events Kindling caused by overstimulation Intense worry and stress about work or simple family life
intense worry and stress about work or simple family life
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 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 behavioral neurochemical genetic
interpersonal
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? neurochemical behavioral interpersonal genetic
interpersonal The interpersonal theory views anxiety as being generated from problems in interpersonal relationships. The behavioral theory views anxiety as being learned through experiences, and thus purports that behaviors can be unlearned. The neurochemical theory offers an explanation of anxiety as a dysfunction of the neurotransmitter Gamma-aminobutyric acid (GABA). Because GABA reduces anxiety, researchers believe that a problem with the regulation of these neurotransmitters occurs in anxiety disorder. The genetic theory views anxiety as having an inherited component because first-degree relatives of clients with increased anxiety have higher rates of anxiety.
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 behavioral neurochemical genetic
interpersonal Note: The interpersonal theory views anxiety as being generated from problems in interpersonal relationships.
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? Will interfere with her cognitive abilities Is conducive to concentration and problem solving May be transferred to her tutor and result in test anxiety Is pathologic and warrants postponing the test
is conducive to concentration and problem solving
When assessing a client with anxiety, the nurse should recognize that anxiety may often be a result of what? Cognitive deficits Organic brain changes Medications Fluid and electrolyte imbalances
medications
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
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 moderate severe panic
mild
During which type of anxiety does a person's perceptual field actually increase? Mild Moderate Severe Panic
mild
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 Moderate Severe Panic
mild
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? severe mild panic moderate
mild Mild anxiety is characterized by an increase in sensory stimulation that is helping the adolescent focus attention to achieve a goal. The anxiety is positive because it motivates the adolescent but does not interfere with social, occupational, or emotional functioning. The adolescent is still able to concentrate independently without having to be redirected to the topic. Moderate anxiety is characterized by a disturbing feeling that something is wrong. With moderate anxiety, a person can still process information but may have some trouble with concentration and require redirecting to focus. Severe anxiety is characterized by a significant decrease in a person's cognitive skills. If severe anxiety was being experienced, the adolescent would likely have trouble thinking and reasoning. Panic level of anxiety is characterized by physiological responses to anxiety that take over the ability to reason leading to diminished cognitive skills. It would be nearly impossible for the adolescent to make any decisions about how to organize time to complete homework if panic level of anxiety was being experienced.
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 moderate severe panic
mild Mild anxiety is characterized by an increase in sensory stimulation that is helping the adolescent focus attention to achieve a goal. The anxiety is positive because it motivates the adolescent but does not interfere with social, occupational, or emotional functioning. The adolescent is still able to concentrate independently without having to be redirected to the topic. Moderate anxiety is characterized by a disturbing feeling that something is wrong. With moderate anxiety, a person can still process information but may have some trouble with concentration and require redirecting to focus. Severe anxiety is characterized by a significant decrease in a person's cognitive skills. If severe anxiety was being experienced, the adolescent would likely have trouble thinking and reasoning. Panic level of anxiety is characterized by physiological responses to anxiety that take over the ability to reason leading to diminished cognitive skills. It would be nearly impossible for the adolescent to make any decisions about how to organize time to complete homework if panic level of anxiety was being experienced.
When a client is experiencing panic, which is the priority intervention? Give the client medication immediately. Move the client to a quiet environment. Offer the client therapy to calm down. Physically restrain the client.
move the client to a quiet environment
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 Providing the client with a safe, quiet, and private place Encouraging the client to verbalize feelings and concerns Approaching the client in a calm, confident manner
providing the client with a comforting touch
The nurse has read in a client's admission record that the client has been taking propranolol for psychiatric, rather than medical, reasons. The nurse should recognize that the client likely has a history of which mental health condition? Obsessive-compulsive disorder (OCD) Panic disorder Acute stress disorder Nightmares
panic disorders
The overall goals of care for individuals experiencing a stress response are to focus on interventions to develop ...
positive coping skills.
Fear
refers to feeling afraid or threatened by a clearly identifiable external stimulus that presents a danger to a person. Derealization refers to a stage in the experience of anxiety when a person senses that things are not real.
Signal anxiety
refers to the natural anxiety mechanism that communicates danger or motivation for needed change.
Which is the primary concern for a client with panic-level anxiety? Safety Emotional needs Physiologic needs Social support
safety
A school health nurse is meeting with the parents of a 6-year-old child who has been selectively mute. The nurse is offering the parents education regarding this problem. The nurse can tell the parents that what is true about selective mutism? selective mutism is associated with social anxiety parenting does not play a role in selective mutism selective mutism arises from child abuse children with selective mutism should be home-schooled.
selective mutism is associated with social anxiety
A school health nurse is meeting with the parents of a 6-year-old child who has been selectively mute. The nurse is offering the parents education regarding this problem. The nurse can tell the parents that what is true about selective mutism? parenting does not play a role in selective mutism selective mutism arises from child abuse children with selective mutism should be home-schooled. selective mutism is associated with social anxiety
selective mutism is associated with social anxiety Selective mutism is diagnosed in children when they fail to speak in social situations even though they are able to speak. There is a high level of social anxiety in these situations. It would be most accurate for the nurse to explain to the parents that selective mutism is associated with social anxiety. Parenting plays a role in perpetuating selective mutism because there is a cycle of avoidance that can be enabled or encouraged when the child continuously wants to avoid social settings. Selctive mutism does not necessarily arise from child abuse. Factors such as a shy disposition or family history of anxiety are most likely to be associated with selective mutism. By home-schooling a child who displays selective mustism, opportunities to learn to manage anxiety through exposure to the anxiety provoking stimuli (social settings) are lost. The child learns that avoiding is a healthy way of managing anxiety.
Which medication classification has been used to treat social phobia? Selective serotonin reuptake inhibitors (SSRIs) Monoamine oxidase inhibitors (MAOIs) Tricyclic antidepressants (TCAs) Antihistamines
selective serotonin reuptake inhibitors (SSRIs)
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.
A client says to the nurse, "I just can't talk in front of the group. I'm trembling and I feel like I'm going to pass out." The nurse assesses the client's anxiety to be at which level? Severe Mild Panic Moderate
severe
The mental health nurse is gathering a health history on a new client. The nurse has difficulty getting the client's attention, and the client is pacing the floor and concerned only with stating that they are about to die. The nurse would classify this level of anxiety as what? Moderate Euphoria Mild Severe
severe
A nurse is seeing a client in the emergency department who repeatedly presents with gastrointestinal discomfort. Despite exhaustive medical investigations, there are no significant medical findings to explain the discomfort. The nurse should suspect: endocrine dysfunction. chronic obstructive pulmonary disease. heart disease. somatic symptoms.
somatic symptoms.
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. this medication can cause addiction, so the client will need to keep the doses constant. the client may experience dry mouth and drowsiness during the first 2 days of treatment. this medication takes up to 3 months to be effective, so the client should be told to be patient.
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.
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 Reviewing the client's previous medication administration record and the client's current list of medications Asking the client to provide a detailed explanation of his or her medical problem to determine if the presentation is typical of the problem Questioning the client about the clinician who first diagnosed the medical problem
stablishing whether the client's anxiety preceded the medical problem or whether the medical problem appeared first
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? Parasympathetic nervous system Sympathetic nervous system Motherly response system Central nervous system
sympathetic nervous system
All except which are considered clinical symptoms of anxiety? Palpitations Extreme restlessness Motor excitement Tearfulness and sadness
tearfulness and sadness
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 is probably physically dependent on alcohol. Drinking alcohol is more socially acceptable than taking medications. The client has insufficient adaptive coping mechanisms. A few glasses of wine each night is not necessarily a problem.
the client has insufficient adaptive coping mechanisms
Which factor has the least influence on achieving mental health for the client who has anxiety disorder? The client's mother also suffered from an anxiety disorder. The client was raised in a household with high stress and frequent geographic moves. The client's mother often related to the client in ways that reflected the mother's high level of anxiety. The client is often late to school and makes poor grades in most of the client's subjects.
the client if often late to school and makes poor grades in most of the client's subjects NOTE: Being late to school and making poor grades are behaviors that indicate that the client is having difficulty; they are not factors influencing the development of the client's anxiety disorder.
A nurse assesses a client and determines that the client is experiencing mild anxiety based on what? The client is selectively inattentive The client is aware and alert The client has focused attention on a small area The client voices feelings of unreality
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 focused in an activity. The client is nervous and agitated. The client has impaired cognitive skills. The client is unable to communicate verbally.
the client is nervous and agitated
progressive relaxation,
the client progressively tightens, holds, and then relaxes muscle groups while letting tension flow from the body through rhythmic breathing.
The nurse can be confident that the client diagnosed with an anxiety disorder will respond well to treatment when which of the following situations or conditions are present? The client has a no history of other psychiatric disorders The client states, "I understand my symptoms and what I need to do to help myself, and I'm ready to do it so I'm back to normal." The client readily agrees to immediately notify the mental health care team if symptoms reoccur after discharge The client has a family that is truly willing and capable of supporting him during the treatme
the client states, "I understand my symptoms and what I need to do to help myself, and I'm ready to do it so I'm back to normal. Clients who respond well to treatment generally self-disclose an understanding of their clinical symptoms, are able to identify causes, and exhibit coping skills to promote behavioral change.
The nurse can be confident that the client diagnosed with an anxiety disorder will respond well to treatment when which of the following situations or conditions are present? The client states, "I understand my symptoms and what I need to do to help myself, and I'm ready to do it so I'm back to normal." The client has a family that is truly willing and capable of supporting him during the treatment The client readily agrees to immediately notify the mental health care team if symptoms reoccur after discharge The client has a no history of other psychiatric disorders
the client states, "i understand my symptoms and what i need to do to help myself, and i'm ready to do it so i'm back to normal."
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." "I discourage her finger tapping since it serves to increase her anxiety level." "She knows that if she taps her fingers she will be able to lessen her anxiety." "I can tell that the more she taps, the less anxiety she is actually feeling."
the client taps her fingers very rapidly when she is feeling anxious NOTE: Automatisms are automatic, unconscious mannerisms associated with anxiety. Examples include tapping fingers, jingling keys, or twisting hair
The nurse is caring for a client diagnosed with anxiety disorder. The client is demonstrating difficulty concentrating and is preoccupied with feelings of helplessness. When creating the plan of care, which goal would be most appropriate for this client? The client will identify the source of anxiety. The client will avoid stimuli that induces anxiety. The client will display ability to cope with anxiety. The client will show interest in activities.
the client will display ability to cope with anxiety
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 return to rational thought. The client would have an enhanced sense of security. The client would be able to demonstrate relaxation techniques. The client would be able to understand what the nurse is saying.
the client would have an enhanced sense of security
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 should remain with the client until the anxiety is reduced. The nurse should speak in a soft and calm voice. The nurse should take the client to a nonstimulating environment.
the nurse should speak in short and simple sentences
A nurse is talking with a client who has experienced panic attacks. The client asks the nurse, "What causes these attacks?" Which information would the nurse most likely integrate into the response about the etiology of panic disorders? There is evidence of a substantial familial predisposition to panic disorder Neurologic abnormalities are a rare occurrence with panic disorder The link between panic disorders and neurotransmitters is lacking There is a strong evidence supporting a psychodynamic influence
there is evidence of substantial familial predisposition to panic disorder
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 To calm restlessness
to focus attention to learn to feel and think to motivate to make a change to engage in goal-directed activity
Which would not be an initial intervention for the client with acute anxiety? Touching the client in an attempt to comfort the client Use of open-ended communication techniques Encouraging the client to verbalize feelings and concerns Maintaining a nonstimulating environment
touching the client in an attempt to comfort the client
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 Using restraint when panic develops
using appropriate coping skills identifying treatment modalities involving family for support providing supportive feedback
A group of students is reviewing information about anxiety disorders in preparation for a class examination. The students demonstrate understanding of the material when they make which statement? Anxiety disorders rank second to depression in psychiatric illnesses being treated. Women experience anxiety disorders more often than do men. Most anxiety disorders tend to be short term with individuals achieving full recovery. Anxiety disorders are more common among children than among adolescents.
women experience anxiety disorders more often than men