MOOD AND AFFECT: ANXIETY

A client with agoraphobia becomes increasingly anxious, often panics, and can no longer leave the house. The client is admitted to the psychiatric unit of the local hospital. What is a realistic short-term nursing objective for this client?

Feeling safe in the unit

A client admitted to the high-risk unit with a threatened abortion anxiously asks the nurse, "Could this have happened because I had the flu?" How should the nurse respond?

"Tell me why you feel this way. Do you think that you did something to cause the bleeding?"

A client exhibits blurred and double vision and muscular weakness, and diagnostic tests are prescribed. The client is informed that a diagnosis of multiple sclerosis (MS) has been made. The client becomes visibly upset. How should the nurse respond?

"That must have really shocked you. Tell me what the healthcare provider told you about it."

A nurse is preparing an intramuscular injection to be administered to a 2-year-old child. What approach is the most therapeutic?

"This might hurt, but it's important that you be very still."

A client who is admitted to the high-risk unit with severe preeclampsia anxiously asks the nurse, "Will my baby be all right?" How should the nurse respond?

"We'll be constantly monitoring your baby's condition. I'll let you listen to the baby's heartbeat."

A 10-year-old boy who is about to begin chemotherapy for acute myelogenous leukemia (AML) tells the nurse that he is old enough to refuse treatment. What is the nurse's most appropriate response?

"You seem frightened. Let's talk about it."

A client who is scheduled for a muscle biopsy tells the nurse, "They better give me a general anesthetic. I don't want to feel anything." What is the most therapeutic response by the nurse?

"You seem to be worried about the test."

A 30-month-old boy who was transferred to a regional hospital has not seen his parents for 2 weeks. He now responds to the staff with friendliness and affection. When his mother visits he turns away from her and ignores her. What should the nurse explain to the mother?

"Your little boy misses you very much; give him time and he'll reach for you."

During a home visit to a client, the nurse identifies tremors of the client's hands. When discussing this assessment, the client reports being nervous, having difficulty sleeping, and feeling as if the collars of shirts are getting tight. Of the additional assessment findings, which one should the nurse report to the practitioner?

Fluttering in the chest

Which personality disorder is characterized by anxious, fearful behavior?

Dependent personality disorder

A client who is to undergo dilation and curettage and conization of the cervix for cancer appears tense and anxious. What is the best approach for the nurse to support the client emotionally?

Asking whether something is troubling the client and whether she'd like to talk about it

Which side effect may be experienced by a client taking an antianxiety agent?

Ataxia

A client is scheduled for head and neck surgery. Although the healthcare provider has explained the surgery, the client still has moderate to severe anxiety. Which action should the nurse take initially?

Attempt to discover what the client is concerned about

A client with a borderline personality disorder is admitted to the mental health unit. What should the nurse do to maintain a therapeutic relationship with the client?

Be firm, consistent, and understanding and focus on specific target behaviors

A nurse is caring for a client with generalized anxiety disorder. Which factor should be evaluated to determine the client's present status?

Behavior

Two 20-year-old female clients on the psychiatric unit have become very much attached to each other and are found in bed together. They become angry and sarcastic when the nurse asks one of them to return to her own bed. How can the nurse best address this situation?

By adopting a matter-of-fact, nonjudgmental attitude and setting limits on the behavior

Which treatment strategy is beneficial for a client with panic disorder?

Debriefing technique

A client who suspects that she is 6 weeks pregnant appears mildly anxious as she is waiting for her first obstetric appointment. What symptom of mild anxiety does the nurse expect this client to experience?

Increased alertness

Which is a symptom of generalized anxiety?

Insomnia

A client with a 20-year history of excessive alcohol use is admitted to the hospital with jaundice and ascites. A priority nursing action during the first 48 hours after the client's admission is to do what?

Monitor the client's vital signs

A nurse who is caring for a client after head and neck surgery is concerned with the client's anger and depressive episodes about the effects of surgery. Which action indicates the client is reaching acceptance?

Performing self-care of the tracheal stoma

An older adult client is talking to the nurse about his Vietnam experiences and shares that he still has flashbacks. While sitting with him the nurse notices that he is jumpy and exhibits startle reactions and poor concentration. The nurse identifies these as symptoms of what?

Posttraumatic stress disorder (PTSD)

Which nursing intervention is indicated for a client with an anxiety disorder?

Promoting verbalization of feelings by the client

A nurse is caring for a client with a somatoform disorder. What should the nurse anticipate that this client will do?

Redirect the conversation with the nurse to physical symptoms

Many clients who call a crisis hotline are extremely anxious. The nurse answering the hotline phone considers that which characteristic distinguishes posttraumatic stress disorders from other anxiety disorders?

Reexperiencing the trauma in dreams and flashbacks

A nurse who is talking to a client suspects the client has agoraphobia. Which of these responses by the client support the nurse's suspicion? Select all that apply.

The client is afraid to walk in parking lots. The client is afraid to venture out of the house alone The client refuses to use a public bus for transportation.

A client who was recently admitted to the psychiatric unit with the diagnosis of an obsessive-compulsive disorder engages in a handwashing ritual. When the nurse interrupts the ritual, the client becomes angry and acts out. What is the most probable cause for this behavior?

The client is feeling overwhelmed in this situation.

A woman who is 28 weeks pregnant calls the clinic to report that she is frightened because she has begun leaking breast milk. What is the best response?

This can be a normal occurrence during pregnancy

A woman who is 28 weeks pregnant calls the clinic to report that she is frightened because she is leaking breast milk. The best response is to tell her what?

This can be a normal occurrence during pregnancy

A client's hands are raw and bloody from a ritual involving frequent hand washing. Which defense mechanism does the nurse identify?

Undoing