chapter 18: anxiety

A client with panic disorder who has been prescribed sertraline in conjunction with alprazolam comes to the clinic for a follow-up. The client states, "I stopped taking the alprazolam about two days ago. I was feeling really sleepy and tired." Which symptom would alert the nurse to suspect possible withdrawal? (Select all that apply.) A) Apprehension B) Irritability C) Dry, flushed skin D) Weight gain E) Muscle flaccidity

A) Apprehension B) Irritability

.If a client is experiencing "moderate" anxiety, which clinical manifestations will the nurse observe? (Select all that apply.) A) Can sustain attention on a particular focus. B) Verbally states, "For some reason, I am feeling anxious now." C) Flights of ideas and confusion noted. D) Because of inadequacy of observed data, they make distorted inferences. E) May pace, run, or fight violently if asked to perform a task they do not want to perform.

A) Can sustain attention on a particular focus. B) Verbally states, "For some reason, I am feeling anxious now."

A nurse is preparing a presentation about social anxiety disorder. Which information will the nurse include when describing a person with this condition? (Select all that apply.) A) Fear that others will judge them negatively B) Openly speak up in crowds to reduce fear C) Are insensitive to other's criticism D) Demonstrate a distorted view of their own strengths E) Exaggerate personal flaws

A) Fear that others will judge them negatively D) Demonstrate a distorted view of their own strengths E) Exaggerate personal flaws

The nurse is planning a presentation to a community group on the topic of anxiety disorders. Which statement would the nurse include when describing panic disorder? A) Individuals may believe they are having a heart attack when a panic attack occurs. B) People with panic attacks often have fewer attacks if they also have agoraphobia. C) Typically, individuals experience this disorder after the age of 30 years. D) Persons rarely have an underlying comorbid condition of depression.

A) Individuals may believe they are having a heart attack when a panic attack occurs.

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? A) Stay with the client while remaining calm B) Move the client to a safe environment C) Tell the client that the attack will soon pass D) Teach the client deep breathing techniques to calm her

A) Stay with the client while remaining calm

A nurse is preparing an in-service presentation about panic disorders and associated theories related to the cause. When describing the cognitive behavioral concepts associated with panic disorders, which issue would the nurse expect to address? A) Personal losses B) Conditioned response C) Early Separation D) Dysfunctional family communication

B) Conditioned response

A nurse is explaining to a client the signs and symptoms associated with anxiety. The client demonstrates an understanding of the information when they identify which symptoms as cognitive symptoms? (Select all that apply.) A) Edginess B) Feelings of unreality C) Difficulty concentrating D) Tunnel vision E) Apprehensiveness F) Speech dysfluency

B) Feelings of unreality C) Difficulty concentrating D) Tunnel vision

The nurse has instructed a client with panic disorder about how to use the technique of positive self-talk. The nurse determines that the client has understood the instructions when the client verbalizes which statement to use during an impending panic attack? A) "I am feeling very nervous right now." B) "I can handle this anxiety; it will be over shortly." C) "I am taking medication to eliminate these symptoms." D) "Relax your muscles, relax your muscles."

B) I can handle this anxiety; it will be over shortly.

A nurse is developing a plan of care for a client with panic disorder that will include pharmacologic therapy. Which medication does the nurse most likely expect to administer? A) Benzodiazepine B) Selective serotonin reuptake inhibitor (SSRI) C) Monoamine oxidase inhibitor (MAOI) D) Tricyclic antidepressant (TCA)

B) Selective serotonin reuptake inhibitor (SSRI)

When caring for a client with panic disorder, the nurse knows that which neurotransmitters are implicated in this disorder? (Select all that apply.) A) Dopamine B) Serotonin C) Norepinephrine D) Gamma-aminobutyricacid(GABA) E) Acetylcholine (Ach)

B) Serotonin C) Norepinephrine D) Gamma-aminobutyricacid(GABA)

A client comes to the emergency department because he thinks he is having a heart attack. The 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? A) "Are you feeling much better now that you are lying down?" B) "What did you experience just before and during the attack?" C) "Do you think you will be able to drive home?" D) "What do you think caused you to feel this way?"

B) What did you experience just before and during the attack?

A nurse who has worked with a client diagnosed with a generalized anxiety disorder (GAD) when he was an inpatient in the psychiatric unit sees the client in the waiting room of the outpatient psychiatric clinic. The client tells the nurse how things have been going since he was discharged. The nurse determines that the client's therapy has been effective when the client makes which statement? A) "I am still experiencing quite a bit of stress at home and at work; things are different at home than they were in the hospital." B) "When my mother-in-law comes over now, I go out to my workshop and work on one of my projects." C) "I'm still drinking coffee; I can't quit after drinking it all these years." D) "I've learned having a beer after I get home from work helps me relax."

B) When my mother-in-law comes over now, I go out to my workshop and work on one of my projects.

A client with a panic disorder has been prescribed a benzodiazepine medication. Which risk would the nurse emphasize as being associated with using this medication? A) Dietary restrictions B) Withdrawal symptoms C) Agitation D) Fecal impaction

B) Withdrawal symptoms

A group of new nurses is reviewing information about anxiety disorders in preparation for their first day on the job. The nurses demonstrate understanding of the material when they make what statement? A) Anxiety disorders rank second to depression in psychiatric illnesses being treated. B) Women experience anxiety disorders more often than do men. C) Most anxiety disorders tend to be short term with individuals achieving full recovery. D) Anxiety disorders are more common in children than in adolescents.

B) Women experience anxiety disorders more often than do men

A nurse was confronted by pharmacy staff about a medication error that was detected in the automated dispensing device. The medication administered to a client receiving palliative care may have caused an earlier demise because the medication decreases the client's respiratory rate significantly when given at the administered dose. Which of the following statements by the nurse displays the use of rationalization? A) "Thank you for pointing this error out. I will fill out an incident report immediately." B) "Please don't tell my supervisor. She will put me on probation if she knows this information." C) "I didn't think I needed to disclose this error since the client is going to die anyway." D) "Are you sure I made this error? I can't recall this incident."

C) "I didn't think I needed to disclose this error since the client is going to die anyway."

During an interview with a nurse, the client reports an intense fear of spiders, stating, "I can't be near them. I get so upset. I start to sweat and hyperventilate if I see one." The nurse documents this as what finding? A) Algophobia B) Entomophobia C) Arachnophobia D) Cynophobia

C) Arachnophobia

A nurse determines that a client who is experiencing anxiety is using relief behaviors. The nurse determines that the client is experiencing which degree of anxiety? A) Mild B) Moderate C) Severe D) Panic

C) Severe

A nurse is providing to a client information about the etiology of generalized anxiety disorder (GAD). The client demonstrates an understanding of this information when they identify which item as representing the basis for this disorder? A) Inaccurate environmental danger assessment B) Exposure to multiple stressful life events C) Kindling caused by overstimulation D) Intense worry and stress about work family life.

D) Intense worry and stress about work family life.

A client is diagnosed with panic disorder. The client hasn't left the house in more than a month because the client is afraid of being attacked. The client visited the mental health clinic today only because a family member came along. Which nursing diagnosis would be a priority for this client? A) Powerlessness related to symptoms of anxiety B) Decisional Conflict related to fear of leaving the house C) Ineffective Family Coping related to symptoms of anxiety D) Social Isolation related to fear of recurrence of anxiety symptoms

D) Social Isolation related to fear of recurrence of anxiety symptoms

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? A) Demonstrate empathy for the client by trying to mimic the client's state of anxiety. B) Tell the client that you must leave to go report his symptoms to the psychiatrist on duty. C) Tell the client this is an acute exacerbation with a positive prognosis and low morbidity. D) Stay with the client, emphasizing that he is safe and that you will remain with him.

D) Stay with the client, emphasizing that he is safe and that you will remain with him.