Ch. 27 Anxiety and other disorders

A client with claustrophobia is undergoing therapy in which the therapist instructs the client to imagine anxiety-provoking situations in each session, and then a healthy response to that anxiety. Which response by the client indicates that the therapy is effective?

"I'm not having any discomfort while watching a movie in a theater."

Which of the registered nurse's statements characterizes social anxiety disorder?

"The client shows abnormal behavior due to excessive fear."

Which statement of the client supports the nurse's suspicion that the client has obsessive-compulsive disorder?

"i wash my hands every 15 minutes"

Which of the nurse's instructions would be beneficial to the client in the management of hair-pulling disorder? Select all that apply.

- "listen to soft music when you feel like pulling your hair" - "hold a paperweight in your hands when you feel like pulling your hair" - "read a book when you feel like pulling your hair"

Which actions of a child support the nurse's assumption that the child has generalized anxiety disorder? Select all that apply.

- The child sleeps for few hours at a time. - The child has reduced concentration.

A client is receiving treatment for generalized anxiety disorder. What outcomes in the client indicate that the nursing interventions are effective? Select all that apply.

- The client recognizes the signs of escalating anxiety. - The client manages anxiety while taking a challenging exam. - The client is able to make independent decisions about future studies.

Which type of phobias are included under specific phobias? Select all that apply.

- acrophobia - ophidiophobia - trichophobia

A client has neurodegeneration in the regions of the locus ceruleus and frontal cortex. Which physiological processes does the nurse expect to be altered in the client? Select all that apply.

- arousal - heart rate - respiratory activation - cognitive interpretations

which agents may increase the effect of antianxiety meds

- cimetidine - disulfiram - phenobarbital

Which symptoms does the nurse expect in a client experiencing anticipatory performance anxiety? Select all that apply.

- dry mouth - sweaty palms - trembling hands

A client tells the nurse, "I experience palpitations and sweating before starting exams and avoid taking exams." What does the nurse record about the condition of the client in the client's assessment report? Select all that apply.

- fear - anxiety - ineffective coping

What medications can be prescribed to quickly alleviate the symptoms of anxiety in a client who has developed tolerance to chlordiazepoxide? Select all that apply.

- fluoxetine - duloxetine

Which conditions are associated with the development of anxiety symptoms? Select all that apply.

- hyperthyroidism - pheonchromocytoma

What are the characteristic features of paroxetine that are to be taken into consideration while prescribing? Select all that apply

- its effect increases when taken with alcohol - it may cause over stimulation, so its dosafe must be titrated slowly

Which symptoms in a client diagnosed with panic anxiety disorder indicate that the client is experiencing hyperventilation? Select all that apply.

- light headedness - shortness of breath - tingling sensation in feet

The nurse administers cholecystokinin to a client for the diagnosis of gall bladder complications. The health history of the client indicates neurodegeneration in the hippocampal region of the brain. Which symptoms does the nurse expect due to the administration of cholecystokinin?

- palpitations - paresthesias - depersonalization

The nurse, while caring for a client with anxiety disorder, concludes that the client has side effects from clonidine therapy. Which symptoms support the nurse's conclusion? Select all that apply.

- sedation - dry mouth - hypotension

Which conditions can be effectively treated with the use of antianxiety agents? Select all that apply.

- status epilepticus - skeletal muscle spasms - acute alcohol withdrawal

A client expresses having attacks of extreme nervousness, usually once a week. The nurse finds that these attacks are not precipitated by any trigger factors. Which other symptoms in the client may indicate panic disorder? Select all that apply.

- sweating - trembling - accelerated heart rate

What characteristic symptoms does a client who has social phobia exhibit? Select all that apply

- the client has a fear of using public restrooms - the client is afraid to present a speech in an auditorium - the client gets embarrassed during stage performances

The nurse is caring for a client with intense physical discomfort. On interaction with the client, the nurse learns that the client has panic anxiety disorder. Based on what observations does the nurse make this conclusion? Select all that apply.

- the client has feelings of choking - the client has feelings of derealization - the client has feelings of being detached from the self

The nurse is caring for a client who has the fear of having a serious illness. On interaction, the nurse learns that the client has anxiety disorder. Based on what behaviors does the nurse conclude this finding? Select all that apply.

- the client looks at his or her throat in the mirror often - the client checks skin for the presence of lesions

A client tells the nurse, "I experience very severe chest pain and choking feelings frequently." What rating does the nurse record in the client's assessment report according to the Hamilton Anxiety Rating Scale (HAM-A)?

4

Which inhibitory neurotransmitter levels are elevated by the benzodiazepines to produce a calming effect?

GABA

The nurse is caring for a client who manifests with palpitations, chest pain, shortness of breath, and fear of dying. Which outcome indicates that the nursing care plan is effective?

The client is able to make independent decisions about their life

What would be the short-term goal of the nurse caring for the client diagnosed with ineffective impulse control?

The client will verbalize adaptive ways to cope with stress other than pulling out his or her hair.

Which symptom does the nurse expect in a client administered with yohimbine medication?

arousal

The nurse observes that a client who is diagnosed with anxiety disorder has tremors in his or her hand. Which area of the brain may be affected in the client?

basal ganglia

A client is depressed due to a scar on the face as a result of an accident. The client frequently looks at the scar in a mirror and gradually developed an interest in having more facial scarring. The medical data of the client reports excessive visits to plastic surgeons. Which disorder might have led to the peculiar habit of collecting the mirrors?

body dysmorphic disorder

Which area of the brain may be affected when a client with anxiety disorder shows symptoms related to respiratory activation and increased heart rate?

brainstem

Which client in a psychiatric ward does the nurse expect to have the risk of generalized anxiety disorder?

client 2

The nurse is reviewing the prescription of four clients with different anxiety disorders. Which client can have moderate results with lithium carbonate therapy?

client 4 hair pulling disorder

Which medication acts on the pathways that mainly originate from the neurons of the hippocampus and basal ganglia of brain?

diazepam

Which symptom would be a manifestation of hoarding disorder?

difficulty in parting with possessions

A client who is being treated for anxiety develops sexual dysfunction. Which medication in the prescription would need to be replaced?

fluoxetine

A client who has a fear of airplanes is undergoing treatment for phobic disorder. The therapist is describing various situations of airplane crashes and observing the increasing levels of anxiety in the client. Which therapy is associated with the interventions of this therapist?

implosion therapy

A client who has fear of darkness is exposed to a room with darkness for a long time during therapy. Which therapy is the client undergoing?

implosion therapy

While treating a client with anxiety disorder, the therapist mainly focuses on discussing the client's unconscious meaning association with anxiety. Which treatment modality is being provided to the client?

insight oriented psychotherapy

A client with anthophobia is admitted in a psychiatric ward. How should the nurse manage to prevent the aggravation of the client's condition?

instruct the family members not to bring flowers when visiting

While teaching about obsessive-compulsive disorder (OCD), the registered nurse says to the student nurses, "Active avoidance explains the behavioral patterns of a client with OCD." The nurse's statement is most consistent with what theory?

learning

What does the primary health-care provider instruct the nurse to do to help decrease the frequency of anxiety episodes in the client with panic anxiety disorder?

maintain a calm enviroment

Which neurotransmitter levels are increased in a client with anxiety disorders?

norepinephrine

Which neurotransmitter would be likely to increase in the client with panic disorder?

norepinephrine

During the assessment the client says, "I need to visit my daughter." The client repeats this sentence many times even without any context. What condition would the nurse suspect in the client?

obsessive compulsive disorder

Which medication does the primary health-care provider prescribe for safe and effective treatment of trichotillomania?

olanzapine

While caring for a client on antianxiety medication therapy for an anxiety disorder, the nurse instructs the client to rise slowly from a lying or sitting position. Which side effect is the nurse trying to reduce in the client by using this intervention?

orthostatic hypotension

A client has symptoms of unexpected and unspecified palpitations, sweating, trembling, and fear of losing control. What type of disorder is the client experiencing?

panic disorder

After interacting with the mother of an adolescent client, the nurse finds that the client masturbates frequently, watches pornographic films, and makes calls to phone sex operators often. Which complication does the nurse expect in the client based on these findings?

paraphilic disorder

A 14 year old child reports to the school nurse, "My mind goes blank and I get shaky and sweaty while taking tests." Which medication would be beneficial for the child in this situation?

propranolol

A female child who was once abused in a car by her paternal uncle developed ochophobia. Which theory explains the child's behavior?

psychoanalytic theory

The child's mother tells the nurse, "My child refuses to go to school and complains of headache, nausea, and vomiting." What condition does the nurse expect in the child based on this finding?

separation anxiety disorder

A client with a severe illness tells the nurse, "Please give me pills. I don't want injections." What does the nurse infer from the client's statement?

the client is experiencing belonephobia

While caring for a client with anxiety, the nurse suspects that the client has ineffective impulse control. Which behavior of the client supports the nurse's suspicion?

the client repeatedly pulls out his/her own hair

What would be the short-term goal for a client with anthophobia?

the client shall discuss the dreaded object with the primary health care provider within 1 week

A client with anxiety disorder is prescribed buspirone. The nurse explains to the client about safe drug administration. Which information, if not included in the medication instruction, may result in the therapy being perceived to be ineffective?

the drug shows its action in 10 to 14 days

While caring for a client who is experiencing recurrent unpredictable episodes of anxiety that manifest as sweating, trembling, chest pain, and dizziness, the nurse maintains a calm, nonthreatening and a matter-of-fact approach. What is the rationale behind this nursing intervention?

to develop a sense of security in the client