Sem 3 - Unit 1 - Anxiety - NCO
A female client with obsessive-compulsive disorder has become immobilized by her elaborate handwashing and walking rituals. Which feelings does the nurse recall are often the basis of obsessive-compulsive disorder? 1 Anxiety and guilt 2 Anger and hostility 3 Embarrassment and shame 4 Hopelessness and powerlessness
1 Anxiety and guilt Ritualistic behavior seen in this disorder is aimed at controlling feelings of anxiety and guilt by maintaining an absolute set pattern of action. Although the person with an obsessive-compulsive disorder may be angry and hostile, the feelings of anger and hostility do not precipitate the rituals. Although the person with an obsessive-compulsive disorder may be embarrassed and ashamed by the ritual or feel hopeless and powerless to the ritual, the basic feelings precipitating the rituals are usually anxiety and guilt.
Which medications are used to treat generalized anxiety disorder (GAD)? Select all that apply.: 1 Duloxetine 2 Venlafaxine 3 Clonazepam 4 Escitalopram 5 Clomipramine
1 Duloxetine 2 Venlafaxine 4 Escitalopram Duloxetine, venlafaxine, and escitalopram are antidepressants approved for the treatment of generalized anxiety disorder (GAD). Clonazepam and clomipramine are used to treat panic disorders.
A client is experiencing a panic attack. In light of the information shown, select the appropriate nursing intervention. 1 Remaining with the client until crisis is over 2 Reinforcing for the client the fact that a panic attack is rarely fatal 3 Communicating with the client with the use of short, concise sentences 4 Introducing soft, soothing music into the environment to distract the client
1 Remaining with the client until crisis is over It is appropriate to remain with the client during a panic attack while being mindful of the need for a low-stimulus environment. The client experiencing a panic attack is not capable of analyzing complicated communication. The client will not benefit from hearing that a panic attack is rarely fatal because the ability to think rationally may be greatly impaired. Additional environmental stimuli are not advisable and are likely to increase the client's anxiety level.
A client reports to the primary healthcare provider with a complaint of becoming panicked and having irrational fear of public talking. Which drug does the nurse anticipate to be prescribed by the primary healthcare provider? 1 Buspirone 2 Alprazolam 3 Diazepam 4 Lorazepam
2 Alprazolam Alprazolam (a benzodiazepine) is a short-acting anxiolytic drug used to treat those clients with panic disorders and the irrational fear of talking openly in public (agoraphobia). Buspirone, an anxiolytic drug that is different both chemically and pharmacologically from the benzodiazepines, is always administered on a scheduled basis (not "as-needed") for the treatment of anxiety. Diazepam is an anxiolytic drug commonly prescribed for the treatment of anxiety but has generally been replaced by short-acting benzodiazepines. Lorazepam is an intermediate-acting anxiolytic drug used in the treatment of acutely agitated clients.
Alprazolam is prescribed for a client with the diagnosis of panic disorder. The client refuses to take the medication because of fears of addiction. What should the nurse do initially? 1 Provide the client information about alprazolam. 2 Assess the client's feelings about alprazolam further. 3 Ask the practitioner about changing the client's medication. 4 Have the practitioner speak with the client about the safety of this medication.
2 Assess the client's feelings about alprazolam further. Before deciding how to ease the client's fears of addiction, the nurse must explore the full extent of the client's knowledge and feelings about taking this medication. Information may or may not be helpful; the client's feelings are what must be addressed. Although the nurse may eventually ask the practitioner to consider changing the medication or to speak with the client about its safety, neither is the priority at this time.
Which sedative-hypnotics are used to treat insomnia effects associated with a panic disorder? Select all that apply. 1 Phenelzine 2 Paroxetine 3 Alprazolam 4 Imipramine 5 Clonazepam
3 Alprazolam 5 Clonazepam Alprazolam and clonazepam are examples of benzodiazepines, a class of sedative-hypnotics used to treat clients with insomnia effects associated with panic disorders. Phenelzine is a monoamine oxidase inhibitor used to treat panic disorders and promote sleep. Paroxetine is a selective serotonin reuptake inhibitor used to treat panic disorders and promote sleep. Imipramine is a tricyclic antidepressant used to treat panic disorders and promote sleep.
Which drug is used to treat both generalized anxiety disorder and depression? 1 Fluoxetine 2 Bupropion 3 Duloxetine 4Mirtazapine
3 Duloxetine Duloxetine is an antidepressant drug used to treat both generalized anxiety disorder and depression. Fluoxetine is used to treat depression. Bupropion is used to treat depression and also aid in smoking cessation. Mirtazapine is used in the treatment of depression and also helpful in reducing the adverse sexual side effects in the male client receiving selective serotonin reuptake inhibitors therapy.
A nurse is teaching a group of recently hired staff members about conscious and unconscious defense mechanisms that are used to defend the self against anxiety. What is an example of a conscious defense mechanism that the nurse should include? 1 Undoing 2 Projection 3 Suppression 4 Intellectualization
3 Suppression Suppression is a conscious measure used as a defense against anxiety; the affected person intentionally avoids thinking about disturbing problems, wishes, feelings, or experiences. Undoing is an unconscious defense mechanism; it is the use of words or behavior to make amends symbolically for unacceptable thoughts, feelings, or actions. Projection is an unconscious defense mechanism; it is the false attribution to others of one's own unacceptable impulses, feelings, attitudes, or thoughts. Intellectualization is an unconscious defense mechanism; it is the use of thinking, ideas, or intellect to avoid emotionally charged feelings.
A client with an obsessive-compulsive disorder continually walks up and down the hall, touching every other chair. When unable to do this, the client becomes upset. What should the nurse do? 1 Distract the client, which will help the client forget about touching the chairs 2 Encourage the client to continue touching the chairs as long as the client wants until fatigue sets in 3 Remove chairs from the hall, thereby relieving the client of the necessity of touching every other one 4 Allow the behavior to continue for a specified time, letting the client help set the time limits to be imposed
4 Allow the behavior to continue for a specified time, letting the client help set the time limits to be imposed It is important to set limits on the behavior, but it is also important to involve the client in the decision-making. Distracting the client, which will help the client forget about touching the chairs, is nontherapeutic; rarely can a client be distracted from a ritual when anxiety is high. Encouraging the client to continue touching the chairs for as long he desires until fatigue sets in is a nontherapeutic approach; some limits must be set by the client and nurse together. Removing chairs from the hall, thereby relieving the client of the necessity of touching every other one, will increase the client's anxiety because the client uses the ritual as a defense against anxiety.
A client who suspects that she is 6 weeks pregnant appears mildly anxious as she is waiting for her first obstetric appointment. What symptom of mild anxiety does the nurse expect this client to experience? 1 Dizziness 2 Breathlessness 3 Abdominal cramps 4 Increased alertness
4 Increased alertness Increased alertness is an expected common behavior that occurs in new or different situations when a person is mildly anxious. Dizziness, breathlessness, and abdominal cramps are all common signs of moderate to severe anxiety.
A client who suspects that she is 6 weeks pregnant appears mildly anxious as she is waiting for her first obstetric appointment. What symptom of mild anxiety does the nurse expect this client to experience? 1 Dizziness 2 Breathlessness 3 Abdominal cramps 4 Increased alertness
4 Increased alertness Increased alertness is an expected common behavior that occurs in new or different situations when a person is mildly anxious. Dizziness, breathlessness, and abdominal cramps are all common signs of moderate to severe anxiety.
