Mental Health Exam 3 Prep U Questions

A 44-year-old man with a successful corporate career has been going through a time of intense job stress. In recent weeks, he has confided in his wife that he believes his firm's financial oversight committee exists solely to monitor every aspect of his personal performance and that the committee's financial mandate is simply a deception and cover-up of its true purpose. A nurse would recognize that this man may be experiencing which subtype of delusional disorder? a) Persecutory b) Somatic c) Conjugal d) Grandiose

A

A client brought to the outpatient department by a family member is diagnosed with obsessive-compulsive disorder (OCD). What characteristic of OCD does the nurse expect to find during the assessment of the client? a) Rituals that interfere with occupational function. b) Reduced body and mind coordination. c) Decrease in the level of intelligence. d) Increase the amount of time spent with the family.

A

A client is being seen in the health clinic. The nurse observes a shuffling gait, drooling, and slowness of movement. The client is currently taking an antipsychotic for treatment of schizophrenia. The nurse knows that which of the following side effects is occurring? a) Pseudoparkinsonism b) Dystonic movements c) Akathisia d) Neuroleptic malignant syndrome

A

A client with obsessive-compulsive disorder has been taking fluoxetine for one month. The client tells the nurse, "These pills are making me sick. I think I'm getting a brain tumor because of the headaches." Which response by the nurse would be most appropriate? a) "These medications have side effects that can cause increased headaches." b) "Have you been practicing your deep breathing and relaxation exercises?" c) "Let's talk about how often you have been performing the rituals lately." d) "Tell me how many times you have washed your hands today."

A

A mental health client has been prescribed clozapine (Clozaril) for the treatment of schizophrenia. The nurse should be alert to which of the following potentially life-threatening adverse effects of this medication? a) Agranulocytosis b) Palpitations c) Weight loss d) Hemorrhage

A

A woman diagnosed with obsessive-compulsive disorder comes to the clinic with her husband. During the visit, the husband states, "She's always checking and rechecking to make sure that all of the appliances are turned off before we go out. It's nerve-wracking. We can never get out of the house on time. Isn't checking once enough?" An understanding of which of the following would the nurse need to incorporate into the response? a) The client performs the ritual to relieve anxiety temporarily. b) The woman's behavior reflects a need for safety. c) The woman is attempting to use thought stopping to decrease her behavior. d) The client is attempting to exert control over the situation.

A

How does the nurse help to decrease anxiety and build confidence in a client with obsessive-compulsive disorder (OCD)? a) Help the client find alternative methods to deal with anxiety. b) Permit minimal interactions with other clients during the therapy. c) Provide the client with a quiet and dimly lit room. d) Provide opportunities to perform tasks usually avoided by the client.

A

The nurse is assessing a client who wants an amputation of his healthy left arm. The client feels that the left arm "does not belong" to the body and it feels unnatural. What condition does the nurse identify in this client? a) Body identity integrity disorder b) Body dysmorphic disorder c) Major depressive disorder d) Illness anxiety disorder

A

The nurse is assessing the physiological effects of severe obsessive-compulsive disorder (OCD) in a client. What does the nurse expect to find during assessment? a) The client is unable to maintain adequate personal hygiene. b) The client reports unwanted weight gain. c) The client is energetic and completes activities quickly. d) The client sleeps for 8 to 10 hours a day.

A

The nurse is assisting a client with behavior therapy for OCD. What nursing intervention may help enhance self-esteem? a) Provide opportunities for the client to accomplish an activity. b) Ask client to perform deep breathing exercises instead of ritual behaviors. c) Interrupt the client when performing a ritualistic behavior. d) Reduce instances of stimuli that activate compulsive behavior.

A

The nurse is educating the client's family about compulsive behavior. What does the nurse tell them? a) The behavior neutralizes anxiety caused by obsessive thoughts. b) The behavior eventually leads to insanity. c) The client's thoughts and behaviors are realistically connected. d) The client stops the ritual only when prompted by external stimuli.

A

The nurse is interviewing a client with schizophrenia when the client begins to say, "Kite, night, right, height, fright." The nurse documents this as which of the following? a) Clang association b) Stilted language c) Verbigeration d) Neologisms

A

What does desensitization refer to? a) A systematic way to replace a panic response with a relaxation response b) Exposing the client to an anxiety-producing stimulus for 1 to 2 hours (flooding) c) Teaching the client to ignore or become immune to anxiety-producing situations d) A cognitive technique for replacing a worry with a positive statement

A

Which of the following is considered a tricyclic antidepressant (TCA) used in the treatment of clients with panic disorder? a) Imipramine (Tofranil) b) Lorazepam (Ativan) c) Sertraline (Zoloft) d) Fluoxetine (Prozac)

A

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) Dry mouth c) Agitation d) Vomiting e) Constipation

A, B, E

The nurse is planning to give health-related education to adolescents with posttraumatic stress disorder (PTSD). What topics should the nurse discuss specifically for these clients? Select all that apply. a) Ill effects of alcoholism and drug abuse b) Importance of exercise c) Methods to improve concentration d) Maintenance of personal hygiene e) Healthy balanced diet

A, C, E

A 55-year-old man was admitted to the psychiatric unit after an incident in a department store in which he accused a sales clerk of following him around the store and stealing his keys. He was subdued by the police after destroying a window display because voices had told him that it was evil. As the nurse approached the client, he says, "You're all out to get me, and you're one of them. They're Rostoputians and grog babies here." This demonstrates what? a) Echolalia and echopraxia b) Suspiciousness and neologisms c) Illusions and loss of ego boundaries d) Loose associations and flight of ideas

B

A client diagnosed with delusional disorder who uses excessive health care resources most likely has which type of delusions? a) Erotomanic b) Somatic c) Grandiose d) Jealous

B

A client diagnosed with schizophrenia states to the nurse, "My intestines are being eaten by snakes." This statement represents which type of delusion? a) Persecutory delusion b) Somatic delusion c) Grandiose delusion d) Referential delusion

B

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

A client who has been admitted for an appendectomy states, "I'm really afraid of the surgery because my mother died when she was admitted for an emergency surgery." When preparing to work with the client concerning her anxiety about the surgery, you recognize what? a) The client has "signal anxiety," which is always the first symptom of anxiety. b) The client is expressing her fear about the surgery. Her fear is her body's physiologic and emotional response to a known danger. c) The client is expressing "free-floating anxiety" and needs to have medication in order to bring it under control. d) The client has "trait anxiety," and this reflects her anger toward her mother's surgeon.

B

A client with schizophrenia is prescribed clozapine because other prescribed medications have been ineffective. After educating the client and family about the drug, the nurse determines that the education was successful when they state which of the following? a) "We need to watch to make sure that he doesn't lose too much weight." b) "We'll need to make sure that he has his blood count checked at least weekly." c) "He needs to have an electrocardiogram periodically when taking this drug." d) "He might develop toxic levels of the drug if he smokes cigarettes."

B

A female client is diagnosed with panic disorder. The client tells the nurse that she hasn't left her house in more than a month because she was afraid of another attack. She visited the mental health clinic today only because her son brought her. Which nursing diagnosis would be a priority for this client? a) Powerlessness related to symptoms of anxiety b) Social Isolation related to fear of recurrence of anxiety symptoms c) Decisional Conflict related to fear of leaving the house d) Ineffective Family Coping related to symptoms of anxiet

B

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) Moderate b) Severe c) Panic d) Mild

B

A nurse is interviewing a client who is suffering from posttraumatic stress disorder (PTSD). Which intervention would help the nurse ensure the client's comfort during the interview? a) Ask the client to describe the traumatic event in detail. b) Keep environmental noises to a minimum. c) Instruct the client not to move around in the room. d) Sit close to the client to facilitate effective communication.

B

All of the following pharmacological agents are useful in treating anxiety disorders except which ones? a) Tricyclic antidepressants b) Calcium channel blockers c) Benzodiazepines d) SSRIs

B

During a client interview, a client diagnosed with delusional disorder states, "I know my wife is being unfaithful to me with her colleague from work. I've found hotel room receipts. I've even followed her and her colleague." The nurse interprets the client's statements as suggesting which type of delusion? a) Mixed b) Jealous c) Unspecified d) Grandiose

B

Generalized anxiety disorder (GAD) is characterized by what? a) Flashbacks and feelings of unreality b) Excessive worry or anxiety lasting more than 6 months c) Fear of going outdoors d) Behavioral changes in response to panic attacks

B

Schizoaffective disorder has symptoms typical of both schizophrenia and which of the following type of disorder? a) Substance use disorders b) Mood disorders c) Anxiety disorders d) Eating disorders

B

Severe levels of anxiety result in what? a) A heightened sense of awareness b) Distorted sensory awareness c) Impaired ability to concentrate d) Mild forgetfulness

B

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) "Can you describe how you felt physically during the attack?" b) "Do you have any problems going out alone to public places?" c) "Are you concerned there will be more panic attacks?" d) "What do you think is the origin of the panic you felt?"

B

The nurse is assessing a client whose hands are red and cracked from repeated hand washing and cleaning. What finding does the nurse identify with obsessive-compulsive disorder(OCD)? a) The client is indulging in attention seeking behaviors. b) The client has a fear of acquiring infections. c) The client is inflicting injury on self to punish others. d) The client has recently started using a different detergent.

B

The nurse is caring for a client diagnosed with kleptomania. What behavior does the nurse expect of this client? a) The client underwent three surgeries to modify the shape of their nose. b) The client gets a thrill from stealing and not getting caught. c) The client's home is cluttered with apparently useless things. d) The client has a tendency for compulsive buying.

B

The nurse is caring for a client receiving fluvoxamine and behavior therapy for obsessive compulsive disorder (OCD). What outcome does the nurse expect of this client? a) Identify the cause of anxiety after 1 week. b) Able to sleep for at least 4 hours per night after 5 days. c) Establish adequate nutrition after 1 to 2 days. d) Identify individual strengths and abilities after 2 weeks.

B

The nurse is caring for a client who has been under severe stress while caring for her elderly mother, who is in the advanced stages of Alzheimer's disease. The nurse explains that the client is adapting to the stress that she is experiencing because of which of the following? a) Acceptance of others' help in caring for her mother b) Ability to survive in the midst of severe stress c) Capability in setting reasonable personal goals d) Success at being able to solve problems

B

The nurse is caring for a client with obsessive-compulsive disorder (OCD). What are the expected outcomes for the client who has been stabilized by medication and behavior therapy? a) Identify stresses and anxieties. b) Continue follow-up therapy as needed. c) Verbalize knowledge of illness and treatment plan. d) List strengths and abilities to the nursing staff.

B

The nurse is using the Yale-Brown obsessive-compulsive scale to assess a client diagnosed with obsessive-compulsive disorder (OCD). What assessment findings indicate severe OCD in the client? a) Anxiety is manageable if compulsive ritual is interrupted. b) Obsessive intrusions occur more than 8 times a day. c) Occupational performance is slightly impaired but manageable. d) Obsessive thoughts can be diverted or stopped with some effort.

B

What kind of behavior does the nurse anticipate when treating a client obsessed with blasphemous thoughts? a) Counting each step taken. b) Praying repeatedly. c) Vacuuming in a particular direction. d) Continually washing and scrubbing.

B

Which of the following is a cardiovascular response of the sympathetic nervous system? a) Bradypnea b) Tachycardia c) Bradycardia d) Hypotension

B

Which of the following is the most common obsession experienced by a client diagnosed with obsessive-compulsive disorder (OCD)? a) Fear of snakes b) Fear of contamination c) Fear of water d) Fear of abandonment

B

Which of the following should be included in a teaching plan for a client prescribed a benzodiazepine? a) Stop taking drug if sedation develops b) Rise slowly from a lying or sitting position c) Consume caffeine in moderation d) Maintain a fluid restriction

B

Which term describes feelings of being disconnected from oneself as seen in a panic attack? a) Derealization b) Depersonalization c) Agoraphobia d) Automatisms

B

While doing the routine basic physical assessment of a client with posttraumatic stress disorder (PTSD), the nurse finds that the client appears totally numb with a blank stare. What does this sign most likely indicate? a) The client may have lost consciousness. b) The client may have dissociative symptoms. c) The client may be under the influence of illicit drugs. d) The client may have improved with psychotherapy.

B

The nurse documents that the goals of individual therapy for a client diagnosed with shared delusional disorder have been achieved when the client (Select all that apply.) a) Restates for the nurse how he will manage his medication when he is discharged b) Voluntarily attends all unit gatherings c) States,"I feel better about myself since I've been here." d) States, "having others give me their advice really seems to help." e) He reports that he no longer allows himself to dwell on his delusional thoughts

B, C

The nurse is assessing an older client with late onset of obsessive-compulsive disorder (OCD). What assessment does the nurse perform for this client? Select all that apply. a) Assess client for onychophagia. b) Assess for degenerative disorders. c) Obtain history of recent infections. d) Assess for possible brain injury. e) Check for a family history of OCD.

B, C, D

When explaining the difference between anxiety and fear, the mental health nurse shares that (Select all that apply.) a) Depression is a risk factor for developing anxiety b) Anxiety is likely to result from an attempt to overcome stress c) Anxiety involves experiencing subjective, uncomfortable feelings resulting from unknown causes d) Fear results in objective, physical responses caused by real danger e) Obsessive-compulsive behavior is often the result of abandonment

B, C, D

When preparing to educate a client regarding a newly prescribed antipsychotic medication, the nurse does which of the following? Select all that apply. a) Discusses the increased difficulty the medication has on conception for both genders b) Encourages the use of sugar-free gum to help manage dry mouth c) Advises the client to discuss any concerns regarding sexual dysfunction d) Suggests methods to minimize the potential for weight gain e) Identifies lifestyle adjustments that the resulting lethargy may require

B, C, D, E

The nurse is caring for a client undergoing cognitive behavior therapy for obsessive-compulsive disorder (OCD). How does the cognitive model describe the client's thought process? Select all that apply. a) The client believes they have no personal responsibilities. b) The client wants to control own thoughts. c) The client has intolerance for uncertainty. d) The client lacks religious sentiments. e) The client overestimates the threats caused by the thoughts.

B, C, E

A client checks and rechecks the lock on the door five times before leaving home. What statement by the client indicates that this behavior is a result of obsessive-compulsive disorder (OCD)? a) I think the lock is not secured. b) This part of the town is unsafe. c) I check until my anxiety subsides. d) There is nothing wrong in rechecking.

C

A client diagnosed with schizophrenia is having delusions that he is being plotted against by the government. This would be documented as which of the following types of delusion? a) Somatic b) Nihilistic c) Persecutory d) Grandiose

C

A client has been prescribed clozapine (Clozaril) for treatment of schizophrenia. The client must be taught to monitor which blood levels weekly while taking this drug? a) Hemoglobin b) Hematocrit c) WBC d) Platelets

C

A client with obsessive-compulsive disorder (OCD) is preparing for exposure and response prevention behavioral therapy. What does the nurse recommend as the first step? a) Seek assistance of family to complete daily activities. b) Follow a written schedule with specified times for completion. c) Chronicle situations that trigger obsessions. d) Learn deep breathing exercises.

C

A nurse is preparing an in-service program for a group of psychiatric-mental health nurses about schizophrenia. Which of the following would the nurse include as a major reason for relapse? a) Stigmatization of mental illness b) Accessibility to community resources c) Nonadherence to prescribed medications d) Lack of family support

C

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) Is pathologic and warrants postponing the test b) May be transferred to her tutor and result in test anxiety c) Is conducive to concentration and problem solving d) Will interfere with her cognitive abilities

C

During a home visit, the nurse finds that her older adult client has amassed a large quanity of newspapers and magazines. When the nurse offers to remove some of the newspapers, the client becomes anxious. What disorder does the nurse suspect? a) Body dysmorphic b) Oniomania c) Hoarding d) Body identity integrity

C

During an admission assessment, a client with schizoaffective disorder states that he hears the voice of God in his head and the voice is telling him that he is worthless. What would the nurse document this symptom as? a) Alogia b) Delusion c) Hallucination d) Avolition

C

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) problem-solving. c) visualization. d) cognitive therapy.

C

Panic disorder is treated with cognitive-behavioral techniques, deep breathing, and relaxation, in addition to which of the following? a) CNS depressants b) Anticonvulsants c) Antianxiety medications d) Antipsychotics

C

Susan has begun to wash her hands every hour on the hour because she fears that if germs become embedded in her skin, she will contract cancer. Which of the following would best describe Susan's behavior? a) Acute stress disorder b) An obsession c) A compulsion d) A panic attack

C

The nurse is caring for a client with dermatillomania. What symptoms of this disorder does the nurse recognize in this client? a) Dry cracked hands b) Very short nails c) Excoriation of the skin d) Loss of hair in patches

C

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

C

The nurse is teaching a client with schizoaffective disorders about his prescribed medication therapy. The nurse determines that additional education is needed when the client states which of the following? a) "If I notice any strange muscle movements, I should call my provider." b) "I need to change my position slowly when getting up from lying down." c) "One day, I won't have to worry about taking any medication." d) "I need to make sure that I drink enough fluids throughout the day."

C

The nurse working with a client who is newly diagnosed with schizophrenia would include which of the following in the client's education? a) "Schizophrenia has been found to be nonresponsive to medications, and we will work mostly on helping you with daily activities." b) "Schizophrenia is caused by pathology in the cerebellum, and there are medications that are helpful in this area." c) "Schizophrenia is an illness that involves neurotransmitters, most particularly the dopamine system." d) "Schizophrenia is curable if the correct medication and dosages are achieved."

C

Which medication classification has been found to be effective in reducing or eliminating panic attacks? a) Antipsychotics b) Antimanics c) Antidepressants d) Anticholinergics

C

Which of the following would not be included in the plan of care for a client diagnosed with acute anxiety? a) Providing the client with a safe, quiet, and private place b) Encouraging the client to verbalize feelings and concerns c) Touching the client in an attempt to comfort him d) Approaching the client in a calm, confident manner

C

A client is diagnosed with posttraumatic stress disorder (PTSD). What questions should the nurse ask the client to elicit information about the symptoms? Select all that apply. a) "Do you have a past history of any surgery?" b) "Do you have any family for support?" c) "Do you get irritated by trivial issues?" d) "Do you have recurrent and intrusive thoughts of the trauma?" e) "Do you feel detached from others?"

C, D, E

The nurse is assessing a client who performs ritualistic counting of objects in their surroundings. What does the nurse tell the client about obsessive-compulsive disorder (OCD) and its treatment? Select all that apply. a) Avoid discussing obsessions with the family or friends. b) Tolerating anxiety during treatment is harmful to health and well-being. c) Do not skip medication; it is an important part of the treatment. d) Learn and practice deep breathing and guided imagery. e) Talk openly with the nurse about obsessions, compulsions, and anxiety.

C, D, E

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) Agoraphobia b) Panic disorder c) Obsessive-compulsive disorder d) Social phobia

D

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

D

A client diagnosed with schizophrenia states, "I want to go home, go home, go home." This is an example of which of the following speech patterns? a) Neologisms b) Word salad c) Clang association d) Verbigeration

D

A client has been on Haldol for 5 years when she is admitted to the inpatient unit for a recent exacerbation of her schizophrenic symptoms. Upon assessment, she has akathisia, dystonia, a stiff gait, and rigid posture. When considering interventions for the client's symptoms, which of the following would be most appropriate? a) Give her Navane instead of Haldol. b) Remove the Haldol to see whether it is the reason for these symptoms. c) Let her symptoms go, because they are normal and can't be changed. d) Consult with the psychiatrist and suggest that she be placed on an anticholinergic drug.

D

A client has been taking neuroleptic medications for many years as a treatment for schizophrenia. The client is exhibiting tongue protrusion, facial grimacing, and excessive blinking. These manifestations are characteristic of ... a) Neuroleptic malignant syndrome b) Akathisia c) Dystonia d) Tardive dyskinesia

D

A client is diagnosed with delusional disorder, erotomanic subtype. Which of the following is considered to be the only satisfactory intervention? a) Order of protection b) Incarceration c) Legal charge of harassment d) Separating the client from the loved object

D

A client is diagnosed with schizophreniform disorder. The nurse is reviewing the client's medical record and finds that his symptoms have been present for at least ... a) 1 week b) 1 year c) 6 months d) 1 month

D

A client with schizophrenia is receiving antipsychotic therapy. The nurse understands that which of the following is a medical emergency should it develop in the client? a) Tardive dyskinesia b) Akathisia c) Parkinsonism d) Neuroleptic malignant syndrome

D

A hospitalized client with schizophrenia is receiving antipsychotic medications. While assessing the client, the nurse identifies signs and symptoms of a dystonic reaction. Which agent would the nurse expect to administer? a) Propranolol (Inderal) b) Risperidone (Risperdal) c) Aripiprazole (Abilify) d) Diphenhydramine (Benadryl)

D

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) Panic b) Moderate c) Mild d) Severe

D

A nurse has completed an assessment of a client who is experiencing significant stress. The assessment revealed intense anger and acting-out behaviors, along with statements of negative emotions. Which nursing diagnosis would be most appropriate? a) Hopelessness b) Disturbed thought processes c) Low self-esteem d) Ineffective coping

D

A nurse is developing a plan of care for a client diagnosed with delusional disorder. Which of the following would the nurse need to keep in mind? a) The delusions have probably just recently developed. b) Female clients with delusional disorder often act on their delusions. c) Psychopharmacologic agents are quite helpful in alleviating the delusions. d) Clients with delusional disorder typically have problems with medication compliance.

D

Following an assessment of a client with posttraumatic stress disorder (PTSD), the nurse concludes that the client is at risk for suicide. What would be the immediate goals of management for this client? a) The client will demonstrate effective ways of dealing with stress. b) The client will express emotions nondestructively. c) The client will establish a social support system in the community. d) The client will be physically safe.

D

The client's diagnosis of schizoaffective disorder is supported when the nurse documents a) Diagnosis testing confirmed a right parietal brain lesion b) The client's wife reported that her husband "repeated everything I said" for 48 hours c) The client's mother shares that "he never missed work" even with the disorder d) The client reports "hearing voices" for the last three months

D

The nurse is caring for a client in an inpatient mental health setting. The nurse notices that when the client is conversing with other clients, he repeats what they are saying word for word. The nurse interprets this finding and documents it as which of the following? a) Echopraxia b) Neologisms c) Tangentiality d) Echolalia

D

What does the nurse teach the client with obsessive-compulsive disorder (OCD) about relaxation techniques? a) Help to eliminate ritualistic behavior completely. b) Apply relaxation techniques when anxiety subsides. c) Ask a friend to assist with relaxation therapy. d) Practice relaxation techniques whenever possible.

D

What intervention does the nurse implement to enable the client with repetitive behavior to complete daily activities? a) Allow family to participate in the activity. b) Limit stimuli that activate repetitive behavior in the client. c) Ask the client to set a time-frame to complete tasks. d) Verbally direct the client during the activity.

D

When developing a plan of care for a client diagnosed with panic disorder, which of the following would be considered the priority nursing diagnosis? a) Social Isolation b) Anxiety c) Powerlessness d) Risk for Self-Harm

D

Which clients would most likely require inpatient treatment? Select all that apply. a) A client with PTSD who is irritable and has outbursts of anger b) A client who is finding it difficult to cope with the loss of a job c) A client who has hyperarousal following a motor vehicle accident d) A client with PTSD who has suicidal thoughts e) A client with PTSD who is overwhelmed by flashbacks

D, E

A client with a panic disorder has been prescribed a benzodiazepine medication. Which of the following would the nurse emphasize as a risk associated with using this medication? a) Withdrawal symptoms b) Fecal impaction c) Agitation d) Dietary restrictions

A

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) Acute stress disorder b) Posttraumatic stress disorder c) Amnesic stress disorder d) Dissociative stress disorder

A

What finding during the assessment indicates the effect of obsessive-compulsive disorder (OCD) in the client? a) The client does not get adequate sleep. b) The client reports weight gain. c) The client is a productive worker. d) The client has many friends and socializes often.

A

Nearly which percentage of adults is affected by anxiety disorders? a) 40% b) 25% c) 55% d) 10%

B

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) "How do you feel about everything that is happening in your life right now?" c) "What can I give you to make you feel less anxious right now?" d) "Does your anxiety make you feel less valuable and competent as a person?"

B

A client is diagnosed with generalized anxiety disorder and is prescribed medication therapy. Which agent would the nurse expect to administer to the client to obtain the quickest relief from anxiety symptoms? a) Imipramine b) Venlafaxine c) Alprazolam d) Buspirone

C

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." Which of the following would the nurse do first? a) Tell the client that the attack will soon pass. b) Move the client to a safe environment. c) Stay with the client while remaining calm. d) Teach the client deep breathing techniques to calm her.

C

The mental health nurse explains that the difference between an obsession and a compulsion is that only the ... a) Client experiencing compulsions has insight into the disorder b) Client experiencing an obsession usually experiences delusions as well c) Compulsion involves repeating a purposeful action d) Obsession responds well to psychiatric treatment

C

The nurse is assessing a client who has been receiving treatment for obsessive-compulsive disorder (OCD). What finding helps the nurse to evaluate the effectiveness of the treatment? a) The client completes repetitive behavior faster. b) The client has discontinued medications. c) The client is able to carry out all responsibilities. d) The client's family is experiencing increased anxiety.

C

What signs of stabilization does the nurse recognize during the follow-up visit of a client undergoing behavior therapy for obsessive-compulsive disorder (OCD)? a) The client recognizes and lists strengths and abilities. b) The client verbalizes conflicting thoughts and fears. c) The client completes daily routine within a specified time. d) The client identifies stresses and anxieties.

C

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) Buspirone (BuSpar) d) Alprazolam (Xanax)

C

Which of the following extrapyramidal side effects is noted by the client having bradykinesia and a shuffling gait? a) Akathisia b) Acute dystonia c) Pseudoparkinsonism d) Tardive dyskinesia

C

Which of the following would be an appropriate intervention of a client experiencing an anxiety attack? a) Turning on the lights and opening the windows so that the client does not feel crowded b) Leaving the client alone c) Staying with the client and speaking in short sentences d) Turning on stereo music

C

The nurse is assessing a client who lost his family and all material possessions in an earthquake. After reviewing the history, the nurse suspects that the client has posttraumatic stress disorder (PTSD). Which statements of the client might lead the nurse to make this interpretation? Select all that apply. a) "I am not able to remember anything these days." b) "I get migraine like headaches frequently." c) "I prefer being alone, all by myself." d) "I often have nightmares about the earthquake." e) "I am not able to sleep at night."

C, D, E

A client had been withdrawn in his room for three days, not eating or sleeping, prior to his admission to your inpatient unit. When you interview him, the client demonstrates difficulty answering questions, appears to have no facial expressions, and cannot follow simple instructions. Together, these symptoms are commonly referred to as ... a) thought disorder. b) positive symptoms. c) delusions. d) negative symptoms.

D

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) Biofeedback c) Relaxation exercise d) Systematic desensitization

D

The nurse is caring for a client who is a rape victim. The client has been undergoing psychotherapy for the stress she is experiencing as a result of this incident. The client has started making accusations against her family members of abusing her. Family members insist the accusations are groundless. What may the client be experiencing? a) Dissociative identity disorder b) Fugue c) Posttraumatic stress disorder d) False memory syndrome

D

The nurse is caring for clients with obsessive-compulsive disorder (OCD). Which progressive and debilitating disorder is most commonly seen with a late onset? a) Ordering b) Oniomania c) Onychophagia d) Hoarding

D

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) engage in goal-directed activity. b) motivate to make a change. c) to feel and think. d) calm restlessness. e) to focus attention to learn.

A, B, C, E

A nurse is caring for a client with dissociative disorder. The nurse tells the client, "Hello, Sally, I'm Robin, your nurse. It is 9 o'clock in the morning now. You are in room number 303. My name is Robin, I'm your nurse." What is the most appropriate reason for the nurse to repeat this statement? a) The client may need to be reoriented. b) The client may have short-term memory loss. c) The client may have difficulty hearing. d) The client may not understand the language.

A

A nurse is caring for a mugging victim who has developed posttraumatic stress disorder (PTSD). The nurse suggests that the client learn techniques of self-defense. How will this intervention be helpful to the client? a) It may help the client develop a sense of safety. b) It may help the client deal with sleep-related issues. c) It may help prevent flashbacks associated with the traumatic incident. d) It may help the client express feelings related to the traumatic incident.

A

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) Social phobia b) Panic disorder c) Agoraphobia d) Obsessive-compulsive disorder

A

A client is admitted to the hospital with PTSD. When approaching the client for the first time, the nurse speaks softly and gently, in a nonthreatening manner. What is the most appropriate reason for this behavior of the nurse? a) To prevent the risk of triggering fears in the client b) To learn about the client's experience c) To calm the client and prevent an outburst of anger d) To help the client sleep better

A

A client relates that she has been under increased stress at work and that the only way she knows to manage her anxiety is by drinking a few glasses of wine each evening. The nurse suggests she stop drinking because of the negative effects of alcohol consumption. Which of the following statements explains why this will be difficult for the client? a) She has no coping mechanism to replace drinking alcohol. b) Drinking alcohol is more socially acceptable than taking medications. c) She is probably physically dependent on alcohol. d) A few glasses of wine each night is not necessarily a problem.

A

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) "Has something changed at work that is causing you to worry?" 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) "Why do you think you'll be fired?"

A

A client with posttraumatic stress disorder (PTSD) has the feeling that he is a burden to the nurse and other healthcare personnel looking after him. What would be the most appropriate response from the nurse? a) "Expressing your feelings will de-stress you and we want you to get well soon." b) "Looking after you is our work. We are strong enough to tolerate your behavior." c) "Calm down and avoid talking, as this will make you angry." d) "You need to control your anger. Your outbursts will not be tolerated."

A

A client with posttraumatic stress disorder (PTSD) tells the nurse, "I deserved to be abused that way. I feel I am the one responsible for that incident. I don't have any hopes in life. I no longer mean anything to anybody." Based on these statements, which is the most appropriate nursing diagnosis? a) Chronic low self-esteem b) Risk for suicide c) Ineffective coping d) Risk of mutilation

A

A client with posttraumatic stress disorder has been referred for cognitive processing therapy. What would be the predominant symptom in a client for whom this therapy would be useful? a) Feelings of guilt and self-blame b) Excessive irritability and outbursts of anger c) Inability to remember the details of the traumatic event d) Avoidance of thoughts related to the traumatic event

A

A nurse has completed an assessment of a client who is experiencing significant stress. The assessment revealed intense anger and acting-out behaviors, along with statements of negative emotions. Which nursing diagnosis would be most appropriate? a) Ineffective coping b) Low self-esteem c) Disturbed thought processes d) Hopelessness

A

A nurse is assessing a client with dissociative disorder. Which of the following would be the most likely cause of dissociative disorder in the client? a) The client has been a victim of rape. b) The client has been taking anxiolytic drugs. c) The client has had a head injury in the past. d) The client has been involved in illicit drug use.

A

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) "People with anxiety disorders generally find that the anxiety interferes with daily activities." b) "Normal anxiety occurs in response to everyday stressors." c) "Normal anxiety does not result in feelings of dread or restlessness." d) "People with anxiety disorders experience a fight-or-flight response when threatened."

A

A nurse observes that a client with posttraumatic stress disorder (PTSD) is experiencing dissociative symptoms. What instruction should the nurse give to the client to prevent being stuck in a daze? a) "Look around the room." b) "Come and sit with me for awhile." c) "Try and express your feelings." d) "Try to sleep."

A

All except which of the following are considered clinical symptoms of anxiety? a) Tearfulness and sadness b) Extreme restlessness c) Palpitations d) Motor excitement

A

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) Is conducive to concentration and problem solving b) Is pathologic and warrants postponing the test c) Will interfere with her cognitive abilities d) May be transferred to her tutor and result in test anxiety

A

Anxiety disorder is considered chronic and generalized when excessive anxiety and worry about two or more life circumstances exist for at least ... a) 6 months b) 12 months c) 4 months d) 2 months

A

Clients taking benzodiazepines need education about which of the following? a) Potentiation of alcohol effects b) Avoiding cheeses and smoked meats c) Avoiding spending too much time in the sun d) Interactions with monoamine oxidase inhibitors (MAOIs)

A

During an interview, a rape victim says, "I don't think of anything else but the incident. I think I have had enough problems in life and there is no purpose for my life, either. Now all I need is to go back to the Lord Almighty." The nurse advises the client to be admitted in the psychiatric facility. What would be the reason for the nurse to ask the client to be admitted? a) The client may have suicidal ideation. b) The client may be unable to cope with the stress. c) The client may have negative feelings about herself. d) The client may be extremely depressed.

A

Heather is beginning a new job and is feeling anxious about her performance. Which of the following types of anxiety can improve functioning? a) Mild b) All anxiety decreases functioning c) Moderate d) Severe

A

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 remain with the client until the anxiety is reduced. c) The nurse should speak in a soft and calm voice. d) The nurse should take the client to a non-stimulating environment.

A

Sharon is admitted for an appendectomy. As the nurse enters the room to prep Sharon for surgery, she is breathing rapidly, sweating, restless, and anxious. The nurse's most therapeutic intervention at this time would be to a) speak to Sharon with simple, short directions in a soothing voice, and do not ask her to make choices about positioning or comfort. b) leave the room, providing silence for Sharon until she regains her composure. c) provide Sharon with information about her surgery, telling her what to expect when she comes out of the recovery room. d) provide Sharon with instructions; however, provide very limited choices about positioning/comfort measures.

A

The nurse documents that a client diagnosed with an anxiety disorder is experiencing moderate anxiety when ... a) Observed pacing and repeatedly asking staff what time the "doctor will be here." b) Reporting, "I just can't relax; I've got thing to do." c) Heard telling another client that, "There is nothing they can do for me; I just know it's really bad." d) Has difficulty actually verbalizing his anxious feelings

A

The nurse is assessing a 6-year-old child whose parents died in a terrorist attack. The nurse suspects that the child has developed posttraumatic stress disorder (PTSD). Which specific behavioral manifestation leads the nurse to interpret this? a) The child often acts as a terrorist with a toy gun during play time. b) The child constantly weeps. c) The child enjoys watching violent scenes on television. d) The child avoids eating.

A

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) Phobic disorders b) Stress disorders c) Obsessive-compulsive disorder d) Post-traumatic stress disorder

A

Which of the following is the primary concern for a client with panic-level anxiety? a) Safety b) Social support c) Emotional needs d) Physiologic needs

A

Which of the following would not be an initial intervention for the client with acute anxiety? a) Touching the client in an attempt to comfort him b) Use of open-ended communication techniques c) Encouraging the client to verbalize feelings and concerns d) Maintaining a nonstimulating environment

A

A client admitted to the hospital with posttraumatic stress disorder (PTSD) is referred for group therapy. What would be the goals of therapy for the client? Select all that apply. a) To reduce symptoms b) To improve functional ability c) To facilitate the outburst of emotions d) To improve quality of life e) To suppress the memories of the stressful event

A, B, D

The survivors of an earthquake have been referred to the psychiatric clinic for counseling and evaluation of posttraumatic stress disorder (PTSD). Which of these clients are likely to develop PTSD?Select all that apply. a) An adolescent b) An older adult c) A young adult with social support d) A child with a history of parental depression e) A child with a history of physical abuse

A, B, D, E

The nurse is preparing to give a group therapy session for clients with posttraumatic stress disorder (PTSD). Which clients are most likely to be included in the group therapy session? Select all that apply. a) A client who is a victim of a car accident. b) A client who has witnessed a murder. c) A client who has watched the news about a major flood in another country on television. d) A client who has read disturbing news in the newspaper. e) A client who has lost his wife and children in a natural disaster.

A, B, E

On observing a client diagnosed with posttraumatic stress disorder (PTSD), the nurse suspects that the client is dissociating. What questions should the nurse ask the client, to confirm the suspicion? Select all that apply. a) "Can you see me?" b) "Are you woken up by nightmares?" c) "Are you able to hear me?" d) "Have you been taking drugs recently?" e) "How many hours do you sleep a day?"

A, C

A client is diagnosed with posttraumatic stress disorder (PTSD). The client is a survivor of a bomb blast. Which symptoms of PTSD is the nurse likely to find in the client? Select all that apply. a) Feeling detached from others b) Visiting places of the event triggers memories of the trauma c) Reexperiencing the trauma through dreams d) Losing a sense of control over one's life e) Showing irritability and outbursts of anger

A, C, D, E

A nurse is caring for a client with posttraumatic stress disorder (PTSD) who is treated with cognitive-behavioral therapy. What changes in behavior should the nurse expect in the client during the first week of therapy? Select all that apply. a) The client will have decreased anxiety and fear. b) The client will establish contact with family and friends. c) The client will stop taking alcohol and drugs. d) The client will be able to identify the traumatic event. e) The client will show an increased ability to cope with the stress.

A, D

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 an abnormal response to everyday stress." b) "Anxiety is a sense of psychological distress." c) "Anxiety is a physiologic response to stress." d) "Anxiety is a normal response to everyday stress."

B

A client with dissociative disorder is referred for psychotherapy. What would be the main focus of therapy for this client? a) To combat feelings such as guilt and self-blame b) To reassociate with conciousness c) To have a positive outlook toward life d) To help the client face troublesome thoughts

B

A nurse who has worked with a client diagnosed with generalized anxiety disorder (GAD) when he was an inpatient on 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 states which of the following? 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've learned having a beer after I get home from work helps me relax." d) "I'm still drinking coffee; I can't quit after drinking it all these years."

B

After interviewing a client about social supports, the nurse determines that the client is experiencing emotional support from these social supports based on which statement? a) "I received a small community grant for groceries." b) "I'm glad I have someone that I can talk to." c) "The person who cut my lawn was great!" d) "The senior center gave me a booklet about my medications."

B

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) Sleep pattern disturbance related to recurrent nightmares c) Anxiety related to illusions d) Unrealistic fear of fire related to conversion reaction

B

Generalized anxiety disorder (GAD) is characterized by what? a) Flashbacks and feelings of unreality b) Excessive worry or anxiety lasting more than 6 months c) Behavioral changes in response to panic attacks d) Fear of going outdoors

B

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) Severe b) Moderate c) Mild d) Euphoria

B

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

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) "With the development of more life skills and a demonstration of continued success in life, your anxiety will shrink and eventually disappear." b) "Anxiety is a feeling that is experienced by everyone at some point and it can never be completely removed from one's life." c) "If you address the causes of your anxiety head-on, you will find that you can recover from it without medications or therapy." d) "Every time you feel anxious, try to focus on how much easier your life would be if you didn't experience anxiety so often."

B

When explaining the difference between anxiety and fear, the mental health nurse shares that (Select all that apply.) a) Obsessive-compulsive behavior is often the result of abandonment b) Anxiety is likely to result from an attempt to overcome stress c) Fear results in objective, physical responses caused by real danger d) Depression is a risk factor for developing anxiety e) Anxiety involves experiencing subjective, uncomfortable feelings resulting from unknown causes

B, C, E

A client experiencing high stress has tachycardia and tachypnea. On the basis of the physiological model of the general adaptation syndrome, in which stage is this client? a) Stress b) Alarm reaction c) Resistance d) Exhaustion

C

A client in a psychiatric clinic has a history of two distinct personality states. The client is also unable to remember important personal information. What is the client likely to be suffering from? a) Acute stress disorder b) Derealization disorder c) Dissociative identity disorder d) Dissociative amnesia

C

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) Relaxation exercise b) Implosion therapy c) Systematic desensitization d) Biofeedback

C

A client with posttraumatic stress disorder (PTSD) has destructive thoughts and has potentiailty for self-harm or suicide. What instruction should the nurse give to the client to ensure the client's safety? a) "Eat candy when you have disturbing thoughts." b) "Go to the terrace for some fresh air when you have disturbing thoughts." c) "Come and sit with me when you are fearful or have disturbing thoughts." d) "Try to sleep when you have disturbing thoughts."

C

A client with posttraumatic stress disorder (PTSD) is having a flashback experience of a traumatic event. On being asked, the client holds the nurse's hand. What should the nurse interpret from this behavior? a) The client may be taking a defensive posture. b) The client may be dissociating. c) The client may be benefiting from supportive touch. d) The client may be extremely terrified.

C

A client with posttraumatic stress disorder (PTSD) is treated with exposure therapy. What change is most likely expected in the client after receiving this therapy? a) The client may be able to sleep better. b) The client may become more socially active. c) The client may be able to control his thoughts and feelings about the event. d) The client may stop having dreams associated with the traumatic event.

C

A nurse assesses a client and determines that the client is experiencing mild anxiety based on which of the following? a) Focused attention on a small area b) Feelings of unreality c) Aware and alert d) Selectively inattentive

C

A nurse is assessing an adult client in a psychology clinic. The client appears very disturbed. On obtaining the history, the nurse finds that the client has lost his job and is thus not able to meet the financial demands of the family. The client doesn't have any other complaints. What is the most appropriate diagnosis of this client? a) Reactive attachment disorder b) Posttraumatic stress disorder c) Adjustment disorder d) Acute stress disorder

C

A nurse is caring for a client who is experiencing a flashback of a violent event and is curled up in bed. What should the nurse do? a) Touch the client's arm to sympathize with the client. b) Leave the client alone to help him sort out his thoughts. c) Use supportive touch after asking for the client's permission. d) Ask the client to lie down properly.

C

A nurse is caring for a client with posttraumatic stress disorder (PTSD). The client does not express his emotions and is not willing to talk to anybody. What nursing action would be most appropriate to help the client express his feelings? a) Ask the client to talk to a family member. b) Refer the client for electroconvulsive therapy. c) Ask the client to write down all feelings and emotions on a piece of paper. d) Ask the client to retell the experience without crying.

C

A nurse works in a psychiatric clinic. A client who lost his spouse during a robbery at their home one month ago approaches the nurse for consultation. How would the nurse differentiate posttraumatic stress disorder (PTSD) from acute stress disorder? a) The symptoms may be exacerbated by other life events. b) The symptoms include reexperiencing, avoidance, and hyperarousal. c) The symptoms began 3 months after the trauma. d) The symptoms often fluctuate in intensity and severity

C

A nurse works in a psychiatric clinic. During a counseling session, the nurse finds that the client who has posttraumatic stress disorder (PTSD) is unable to identify the intensity of his emotions. The client states that extreme emotions appear out of nowhere and with no warning. What suggestion should the nurse provide to help the client get in touch with his emotions? a) "Use grounding techniques to diminish the feelings." b) "Practice deep-breathing exercises to distract yourself from the feelings." c) "Use a journal or a log to write down your feelings." d) "Practice relaxation techniques to reduce intensity or diminish the feelings."

C

Relaxation techniques help clients with anxiety disorders because they do what? a) Increase sympathetic stimulation b) Release cortisol c) Reduce autonomic arousal d) Increase metabolic rate

C

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) Assessing the client's insight into his or her condition and gauging orientation and judgment b) Obtaining a set of vital signs including apical heart rate and oxygen saturation c) Determining whether there is potential for the client to harm himself or herself or others d) Determining the client's understanding of factors that contribute to his or her anxiety

C

The nurse recognizes that the client most likely experiencing generalized anxiety disorder (GAD) is a ... a) 30-year-old business executive who reports being anxious about attending the meetings and social events that are his job responsibilities 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) 70-year-old whose spouse died 1 year ago who has "no desire to leave my house" and reports severe fatigue

C

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

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

D

A client with post traumatic stress disorder (PTSD) has been referred for employment. Why might the nurse fear that the client will not be capable of sustaining the job long term? a) The client may not be able to do the work properly. b) The client may have memory loss which would affect effectiveness at work. c) The client may not be healthy enough to start a job. d) The client may not be able to work under a supervisor.

D

A client with posttraumatic stress disorder (PTSD) is treated with exposure therapy. What change is most likely expected in the client after receiving this therapy? a) The client may become more socially active. b) The client may be able to control his thoughts and feelings about the event. c) The client may be able to sleep better. d) The client may stop having dreams associated with the traumatic event.

D

A client with posttraumatic stress disorder (PTSD) tells the nurse, "I deserved to be abused that way. I feel I am the one responsible for that incident. I don't have any hopes in life. I no longer mean anything to anybody." Based on these statements, which is the most appropriate nursing diagnosis? a) Risk of mutilation b) Ineffective coping c) Risk for suicide d) Chronic low self-esteem

D

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 be able to demonstrate relaxation techniques. c) The client would return to rational thought. d) The client would have an enhanced sense of security.

D

A nurse is counseling a client who lost his family members in a cyclone. Which statement by the client suggests that he is likely to develop posttraumatic stress disorder (PTSD)? a) "I don't feel like eating without my son." b) "I feel lonely without my parents." c) "I don't know what to do without my family." d) "I am fine, I am over it."

D

A nurse is performing a follow-up assessment of a male client who had been treated for posttraumatic stress disorder (PTSD) a year ago. The client tells the nurse that he is not able to maintain relationships with women and that his relationships last for a very short time. What is the most likely reason for this problem? a) The client has dissociative identity disorder. b) The client is extremely irritable in nature. c) The client has extremely negative notions about himself. d) The client has issues with developing trust.

D

A nurse is performing a follow-up assessment of a male client who had been treated for posttraumatic stress disorder (PTSD) a year ago. The client tells the nurse that he is not able to maintain relationships with women and that his relationships last for a very short time. What is the most likely reason for this problem? a) The client has extremely negative notions about himself. b) The client is extremely irritable in nature. c) The client has dissociative identity disorder. d) The client has issues with developing trust.

D

In teaching a client who has been prescribed a benzodiazepine for panic disorder, the nurse must be certain to do what? a) Educate the client that this medication will interact with certain food groups. b) Instruct the client to come in every other week to get blood drawn and monitor for agranulocytosis. c) Instruct the client that if he has palpitations, he should contact his physician immediately because of the risk for dysrhythmias with this medication. d) Educate the client that this medication has a high risk for withdrawal symptoms, and he should not discontinue without a doctor's supervision.

D

The nurse is assessing a client with anxiety. Which behavior might indicate that the client has moderate anxiety? a) The client is focused in an activity. b) The client is unable to communicate verbally. c) The client has impaired cognitive skills. d) The client is nervous and agitated.

D

The nurse is preparing to care for a client under severe stress, caused by her caregiver duties for her elderly aunt diagnosed with leukemia. When assessing the client's psychological domain, which question would the nurse ask first? a) "Are you feeling overwhelmed by caring for your aunt?" b) "Tell me about your depressed moods." c) "How long have you been caring for your aunt?" d) "Let's talk about what you have been feeling."

D

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) Diazepam (Valium) b) Lorazepam (Ativan) c) Alprazolam (Xanax) d) Buspirone (BuSpar)

D

Which of the following is a parasympathetic effect of anxiety? a) Muscle tension b) Decreased urine output c) Constipation d) Hyperactive bowel sounds

D

Which of the following medication classifications used in the treatment of panic disorder can cause physical dependence? a) Serotonin-norepinephrine reuptake inhibitors (SNRIs) b) Tricyclic antidepressants (TCAs) c) Selective serotonin reuptake inhibitors (SSRIs) d) Benzodiazepines

D