Mental Health Chapter 15 Post Test
A Gulf War veteran is entering treatment for post-traumatic stress disorder. What assessment is of greatest importance to this particular client? Find out if the client uses acting-out behavior. Establish whether the client has chronic hypertension related to high anxiety. Ascertain how long ago the trauma occurred. Determine the use of chemical substances for anxiety relief.
Determine the use of chemical substances for anxiety relief. Substance abuse often coexists with post-traumatic stress disorder. It is often the client's way of self-medicating to gain relief of symptoms.
A client is diagnosed with generalized anxiety disorder (GAD). The nursing assessment supports this diagnosis when the client reports which information? Repeated verbalizing prayers results in a relaxed feeling. Being unable to work for the last 12 months. Eating in public makes the client extremely uncomfortable. Symptoms started right after being robbed at gunpoint.
Being unable to work for the last 12 months. GAD is characterized by symptomatology that lasts 6 months or longer. None of the other descriptions would support the diagnosis.
A client frantically reports to the nurse that "You have got to help me! Something terrible is happening. I can't think. My heart is pounding, and my head is throbbing." The nurse should assess the client at what level of anxiety? mild. panic. moderate. severe.
severe. Severe anxiety is characterized by feelings of falling apart and impending doom, impaired cognition, and severe somatic symptoms such as headache and pounding heart. Mild and moderate levels of anxiety do not demonstrate these feels while panic is even more intense than the scenario implies.
When a client is prescribed lorazepam 1 mg po four times a day (qid) for 1 week for generalized anxiety disorder, the nurse should which intervention as the priority? question the physician's order because the dose is excessive. explain the long-term nature of benzodiazepine therapy. teach the client to limit caffeine intake. tell the client to expect mild insomnia.
teach the client to limit caffeine intake. Caffeine is an antagonist of antianxiety medication. None of the other options present accurate information regarding lorazepam.
A client experiencing a panic attack keeps repeating, "I'm dying, I can't breathe.". What action by the nurse should be most therapeutic initially? Asking the client what he means when he says, "I am dying." Encouraging the client to take slow, deep breaths Offering an explanation about why the symptoms are occurring Verbalizing mild disapproval of the anxious behavior
Encouraging the client to take slow, deep breaths Slow diaphragmatic breathing can induce relaxation and reduce symptoms of anxiety. Often the nurse has to tell the client to "breathe with me" and keep the client focused on the task. The slower breathing also reduces the threat of hypercapnia with its attendant symptoms. The client needs help to regain composure and stabilize vital signs; the only option that addresses these issues is the correct option.
Panic attacks in Latin American individuals often involve demonstration of which behavior? Blushing Repetitive involuntary actions Offensive verbalizations Fear of dying
Fear of dying Panic attacks in Latin Americans and Northern Europeans often involve sensations of choking, smothering, numbness or tingling, as well as fear of dying. This information directs you to the correct options.
The record mentions states that the client habitually relies on rationalization. The nurse might expect the client to present with what behavior? Behaves in ways that are the opposite of his or her feelings. Misses appointments. Justifies illogical ideas and feelings. Makes jokes to relieve tension.
Justifies illogical ideas and feelings. Rationalization involves justifying illogical or unreasonable ideas or feelings by developing logical explanations that satisfy the teller and the listener. None of the other options present with this behavior.
A client who is demonstrating a moderate level of anxiety tells the nurse, "I am so anxious, and I do not know what to do." Which response should the nurse make initially? "Try not to think about the feelings and sensations you're experiencing." "Let's try to focus on that adorable little granddaughter of yours." "Why don't you sit down over there and work on that jigsaw puzzle?" "What things have you done in the past that helped you feel more comfortable?"
"What things have you done in the past that helped you feel more comfortable?" Because the client is not able to think through the problem and arrive at an action that would lower anxiety, the nurse can assist by asking what has worked in the past. Often what has been helpful in the past can be used again. While distraction may be helpful in some situations, it is not the initial intervention.
The nurse caring for a client experiencing a panic attack anticipates that the psychiatrist would order a stat dose of which classification of medications? Anticholinergic medication. Standard antipsychotic medication. A short-acting benzodiazepine medication. Tricyclic antidepressant medication.
A short-acting benzodiazepine medication. A short-acting benzodiazepine is the only type of medication listed that would lessen the client's symptoms of anxiety within a few minutes. Anticholinergics do not lower anxiety; tricyclic antidepressants have very little antianxiety effect and have a slow onset of action; and a standard antipsychotic medication will lower anxiety but has a slower onset of action and the potential for more side effects.
The plan of care for a client who has elaborate washing rituals specifies that response prevention is to be used. Which scenario is an example of response prevention? Telling the client that he or she must relax whenever tension mounts Not allowing the client to seek reassurance from staff Having the client repeatedly touch "dirty" objects Not allowing the client to wash hands after touching a "dirty" object
Not allowing the client to wash hands after touching a "dirty" object Response prevention is a technique by which the client is prevented from engaging in the compulsive ritual. A form of behavior therapy, response prevention is never undertaken without physician approval. None of the other options reflect accurate information regarding this form of therapy.
A cultural characteristic that may be observed in a teenage, female Hispanic client in times of stress would include what behavior? Report both nausea and vomiting Exhibit stoic behavior Suddenly tremble severely Laugh inappropriately
Suddenly tremble severely Ataque de nervios (attack of the nerves) is a culture-bound syndrome that is seen in undereducated, disadvantaged females of Hispanic ethnicity. None of the other options are associated with this cultural response to stress.
The nurse anticipates that the nursing history of a client diagnosed with obsessive compulsive disorder (OCD) will reveal what common assessment data? (Select all that apply.) Select all that apply. An eating disorder A previous suicide attempt A history of sexual abuse A history of childhood trauma A sibling with the disorder
an eating disorder A sibling with the disorder history of sexual abuse a history of childhood trauma a sibling with the disorder Sexual and physical abuse in childhood or trauma increases the risk of this disorder. Genetics are strongly associated with this disorder. First-degree relatives have twice the risk. OCD tends to occur along with anxiety disorders 76% of the time. Other comorbid conditions include major depressive disorder, bipolar disorder, and eating disorders. Suicide while a concern is not among the most common issues for the client diagnosed with OCD.
