Psych Nursing Anxiety Disorders PrepU
A nurse is conducting a group session in the behavioral health unit for three clients on the topic of anxiety. The nurse determines that the session was successful based on which statement by the clients? "Anxiety and fear are the same." "Anxiety cannot be completely eliminated from my life." "Anxiety is always harmful and not productive in my life." "Fear is feeling threatened by an unknown entity."
"Anxiety cannot be completely eliminated from my life."
A 25-year-old client tells the nurse that the client has been worried and tearful lately because of pressures at work. The client states, "My partner tells me that it's 'stress' and 'anxiety,' but doesn't everyone have that? What is anxiety anyway?" Which response would be most appropriate for the nurse to provide about the nature of anxiety? "Anxiety is an abnormal response to everyday stress." "Anxiety is a sense of psychological distress." "Anxiety is a physiologic response to stress." "Anxiety is a normal response to everyday stress."
"Anxiety is a sense of psychological distress."
The nurse is educating a client with generalized anxiety disorder about nutrition as a supporting factor in controlling the disorder. Which client statement indicates that further education is required? "I should only drink tea or coffee and avoid cola products." "I will limit the amount of foods that are higher in fat." "Foods that contain high amounts of refined sugar should be limited." "Food and drinks with high sodium content should be avoided."
"I should only drink tea or coffee and avoid cola products." This statement is misleading because both tea and coffee contain caffeine, which can exacerbate symptoms of anxiety. People with generalized anxiety disorder are often advised to limit or avoid caffeine, as it can act as a stimulant and potentially worsen anxiety symptoms.
A client is prescribed alprazolam for the treatment of anxiety disorder, and the nurse is educating about the administration of the medication. Which statement made by the client indicates that further education is required? "I will not drink alcohol while taking this medication." "I will use sugar free candy or gum when my mouth is dry." "I should avoid the use of caffeine or caffeine products." "I will take my over-the-counter diphenhydramine when I have allergy symptoms."
"I will take my over-the-counter diphenhydramine when I have allergy symptoms." The reason for this is that both alprazolam (a benzodiazepine) and diphenhydramine (an antihistamine) have sedative effects. When taken together, they can intensify drowsiness and central nervous system (CNS) depression. The client should be educated about potential drug interactions and to consult with the healthcare provider before taking any over-the-counter medications while on alprazolam
The nurse reviews techniques to enhance cognitive functioning for a client with a panic disorder. Which client statement indicates that teaching has been effective? "I should list the things that I can do to stop an attack." "I will take shallow breaths and walk around the room." "I will use positive coping statements that I have prepared." "I will talk about my symptoms when I feel an attack coming on."
"I will use positive coping statements that I have prepared." "I will use positive coping statements that I have prepared." Using prepared positive coping statements helps reframe negative thoughts and can reduce the intensity of a panic attack. The other options do not directly relate to enhancing cognitive functioning during a panic attack. Not "I will talk about my symptoms when I feel an attack coming on." Talking about one's symptoms during the onset of a panic attack can actually heighten the client's focus on the physical sensations and increase anxiety. While it's crucial for individuals to communicate their experiences and symptoms with healthcare providers, during an acute panic attack, the immediate goal is to use techniques to decrease the anxiety. Positive coping statements, on the other hand, redirect the mind away from the physical sensations and the panic. They serve as grounding affirmations that can help interrupt and counteract the cycle of panic. So, while discussing symptoms can be therapeutic in a broader context, during an acute episode, using grounding techniques or positive coping statements is typically more beneficial.
A 25-year-old pregnant mother of two children under age 6 is very protective and will not allow her children to play outdoors for fear of tick bites. She is worn out from cleaning the house from top to bottom every day. She asks the nurse how she can stop worrying so much. What is the most appropriate response for the nurse? "Have you considered spraying your children with an insect repellent?" "Tell me your concerns about the children playing in your backyard." "Why do you worry about the children getting tick bites?" "Have you sprayed your backyard for ticks or other pests?"
"Tell me your concerns about the children playing in your backyard."
A client diagnosed with panic disorder is being admitted to the psychiatric-mental health unit for panic attacks. Which client outcome would be appropriate in the immediate phase of care? "The client will respond to relaxation techniques with staff assistance and demonstrate a decreased anxiety level within 2 to 3 days." "The client will demonstrate the ability to perform relaxation techniques." "The client will reduce own anxiety level without staff assistance." "The client will be free from panic attacks."
"The client will respond to relaxation techniques with staff assistance and demonstrate a decreased anxiety level within 2 to 3 days."
A psychaitric-mental health nurse is preparing a presentation for a group of colleagues on anxiety disorders. As part of the presentation the nurse plans to discuss the concept of interoceptive conditioning. Which information would the nurse most likely include in this discussion? There is an association between physical symptoms and a panic attack. A person links an adverse event with a previous neutral event. The person experiences a phobic avoidance of the event. A recent loss is the initiating event that leads to a panic attack.
"There is an association between physical symptoms and a panic attack." Interoceptive conditioning refers to the process where certain bodily sensations become triggers for anxiety or panic due to previous associations with such attacks. For instance, if a person once had a panic attack when their heart was racing (for whatever reason), they might start to fear the sensation of a racing heart, thinking it's a sign of another impending panic attack. Over time, just feeling their heart rate increase (even if it's due to something benign like having just climbed a set of stairs) can then trigger anxiety or a full-blown panic attack. 身体症状和惊恐发作之间存在关联。" 内感受调节是指某些身体感觉由于之前与此类攻击的关联而成为焦虑或恐慌的触发因素的过程。 例如，如果一个人曾经在心跳加速时（无论出于何种原因）发生过恐慌症，他们可能会开始害怕心跳加速的感觉，认为这是另一次即将发生的恐慌症的征兆。 随着时间的推移，仅仅感觉到心率增加（即使是由于一些良性的事情，比如刚刚爬了一段楼梯）就会引发焦虑或全面的惊恐发作。
What part of the brain is thought to be involved in the production of anxiety as a result of the identification of incoming sensory information as threatening? Cerebellum Cerebral cortex Brainstem Amygdala
Amygdala
The nurse is providing care for a psychiatric-mental health client who has a diagnosis of anxiety. Which statement by the nurse is likely the most therapeutic intervention? "Anxiety is a feeling that is experienced by everyone at some point and it can never be completely removed from one's life." "With the development of more life skills and a demonstration of continued success in life, your anxiety will shrink and eventually disappear." "Every time you feel anxious, try to focus on how much easier your life would be if you didn't experience anxiety so often." "If you address the causes of your anxiety head-on, you will find that you can recover from it without medications or therapy."
Anxiety is a feeling that is experienced by everyone at some point and it can never be completely removed from one's life." Anxiety is a feeling that is experienced by everyone at some point and it can never be completely removed from one's life." This statement is empathetic, realistic, and non-judgmental. It normalizes the experience of anxiety while not minimizing the client's feelings. The other options either provide false hope, place unnecessary pressure on the client, or potentially discourage seeking appropriate treatment. why it is incorrect for "Every time you feel anxious, try to focus on how much easier your life would be if you didn't experience anxiety so often." Minimization: This statement can be perceived as minimizing the client's feelings. It's suggesting that they simply wish the anxiety away by thinking of a life without it. This can be invalidating for someone who is experiencing distress from anxiety. Pressure: This statement inadvertently places a burden on the client. It implies that they should just be able to "snap out of it" or redirect their thoughts easily, which isn't always feasible for someone in the midst of a distressing anxious episode. Counterproductive: The directive to constantly contrast one's current state with a hypothetical, anxiety-free state might inadvertently increase feelings of inadequacy or frustration.
The nurse is educating a client and family about managing panic attacks after discharge from treatment. The nurse includes which in the discharge teaching? Select all that apply. Continued development of positive coping skills Weaning off of medications as necessary Lessening the amount of daily responsibilities Continued practice of relaxation techniques Development of a regular exercise program
Continued development of positive coping skills Continued practice of relaxation techniques Development of a regular exercise program
A client responds to bad news regarding test results by crying uncontrollably. What is the term for this response to a stressor? Adaptation Homeostasis Coping mechanism Defense mechanism
Coping mechanism
A client is experiencing a panic attack. Which term describes sensing that things are not real? Automatisms Derealization Depersonalization Agoraphobia
Derealization
A client states that the client has just had an argument with the client's spouse over the phone. What can the nurse expect that the client's sympathetic nervous system has stimulated the client's adrenal gland to release? Endorphins Dopamine Epinephrine Testosterone
Epinephrine
Nursing interventions for physical stress related illness should include what? Assessing the need for increased dose of benzodiazepines Attending group therapy Establishing daily routines of meals and sleeping Fostering use of a social support system
Establishing daily routines of meals and sleeping
Nursing interventions for physical stress related illness should include what? Assessing the need for increased dose of benzodiazepines Attending group therapy Establishing daily routines of meals and sleeping Fostering use of a social support system
Establishing daily routines of meals and sleeping
Which assessment question is most likely to allow the nurse to differentiate between anxiety disorder due to a general medical condition and psychological factors affecting a medical condition? Reviewing the client's previous medication administration record and the client's current list of medications Questioning the client about the clinician who first diagnosed the medical problem Asking the client to provide a detailed explanation of his or her medical problem to determine if the presentation is typical of the problem Establishing whether the client's anxiety preceded the medical problem or whether the medical problem appeared first
Establishing whether the client's anxiety preceded the medical problem or whether the medical problem appeared first
A nurse is assessing the vital signs of a client in the cardiac clinic. The nurse observes the client's blood pressure and heart rate are higher than what is normally expected for this client. The client tells the nurse, "I'm always so nervous when I come to the clinic." The nurse interprets the client's statement and vital signs as reflecting which situation? Fight-or-flight response Severe anxiety Defense mechanism Exhaustion
Fight-or-flight response The client's statement and the elevated blood pressure and heart rate are reflective of the "Fight-or-flight response." This is a physiological reaction that occurs in response to a perceived harmful event or threat. It triggers the body's sympathetic nervous system, leading to the release of stress hormones, such as adrenaline, which cause an increase in heart rate, blood pressure, and other changes that help a person react quickly to the perceived threat (even if it's just a stressful situation like a visit to the clinic). The scenario provided describes a client whose heart rate and blood pressure are elevated when they visit the clinic, and they express feeling "nervous" about the visit. The term "severe anxiety" would indeed involve physiological changes, including elevated heart rate and blood pressure. However, the "fight-or-flight response" specifically refers to the body's physiological reaction to perceived threats or stressors, which includes these changes among its primary symptoms. When given a choice between "severe anxiety" and "fight-or-flight response" in the context of this scenario, "fight-or-flight response" is the more precise answer because it directly points to the physiological response to a stressful situation (in this case, visiting the clinic). While the nervousness the client feels can be labeled as anxiety, the specific physiological changes (elevated BP and heart rate) are direct manifestations of the fight-or-flight response. The question is more focused on the physiological reaction rather than the emotional state.
Which is one characteristic that differentiates generalized anxiety disorder (GAD) and panic disorder? In panic disorder, the person suffers from a chronic state of elevated anxiety. Panic disorders are more easily treated than GAD. In GAD, the person usually does not experience eruptions of acute anxiety. GAD is characterized by occasional, unexpected panic attacks.
In GAD, the person usually does not experience eruptions of acute anxiety.
A client with a blood injection injury phobia requires an intravenous (IV) catheter for fluids and medications. Which action would the nurse take to ensure for this client's safety? Insert the IV catheter with the client in bed. Assist the client to sit in a chair before inserting the IV catheter. Distract the client with a television program while inserting the IV catheter. Coach the client to take deep breaths while the IV catheter is being inserted.
Insert the IV catheter with the client in bed. Clients with this type of phobia are at risk for vasovagal reactions, which can lead to fainting. Having the client in bed minimizes the risk of injury if they were to faint. The other options might not prevent a fainting episode and could potentially put the client at more risk这种恐惧症的客户有发生血管迷走反应的风险，这可能会导致昏厥。
A nursing instructor is describing the care of a client with acute anxiety to a class of nursing students. The instructor determines that more education is necessary when the students identify which intervention as appropriate? Providing the client with a comforting touch Providing the client with a safe, quiet, and private place Encouraging the client to verbalize feelings and concerns Approaching the client in a calm, confident manner
Providing the client with a comforting touch The option "Providing the client with a comforting touch" may need further education. While touch can be therapeutic for some clients, it's not always appropriate for those with acute anxiety, especially without their consent. A person experiencing acute anxiety might perceive touch as invasive or threatening, potentially escalating their anxiety. Always ask permission before initiating touch and be sensitive to non-verbal cues that indicate whether or not touch is welcome. The other options are appropriate interventions for a client with acute anxiety.
Relaxation techniques help clients with anxiety disorders because they can promote what? Reduction of autonomic arousal Increase in sympathetic stimulation Release of cortisol Increase in the metabolic rate
Reduction of autonomic arousal
Relaxation techniques help clients with anxiety disorders because they can promote what? Reduction of autonomic arousal Increase in sympathetic stimulation Release of cortisol Increase in the metabolic rate
Reduction of autonomic arousal
The nurse is teaching about postoperative wound care. As the wound is uncovered, the client begins mumbling, breathing rapidly, and trying to get out of bed, and the client does not respond when the nurse calls his name. The nurse determines that the client is experiencing anxiety. Which of the following should be the nurse's first action? Ask the client to describe his feelings Proceed with wound care quickly Replace the dressing on the wound Get the assistance of another nurse
Replace the dressing on the wound. This action serves to immediately address the stimulus (the uncovered wound) that seems to be escalating the client's anxiety. Once the immediate stimulus is addressed and the wound is covered again, the nurse can then further assess and assist the client in managing the anxiety.
After reviewing various etiologic theories associated with panic disorder, the nurse demonstrates understanding of the psychodynamic theory, identifying which as the underlying cause? Separation or loss Conditioning Heritability Activation of stress hormone
Separation or loss Explanation: Psychodynamic theories often emphasize early relationships and experiences, particularly separation or loss, as factors that contribute to the development of panic and other anxiety disorders. These theories suggest that unresolved childhood conflicts or traumas, such as separation anxiety, can lead to symptoms in adulthood. The other options, like conditioning, heritability, and activation of stress hormone, are more related to behavioral, genetic, and biological theories, respectively.
A client says to the nurse, "I just can't talk in front of the group. I'm trembling and I feel like I'm going to pass out." The nurse assesses the client's anxiety to be at which level? Mild Moderate Severe Panic
Severe
A client can protect himself from the negative effects of stress with which of the following? Practicing wellness Social and emotional resources Previous experiences Medication
Social and emotional resources
A client experiences panic attacks when confronted with riding in elevators. The nurse is teaching the client ways to relax while incrementally exposing the client to getting on an elevator. Which technique will the nurse employ to assist the client with overcoming the phobia? Systematic desensitization Flooding Cognitive restructuring Combination therapy
Systematic desensitization
A group of nursing students are reviewing signs and symptoms of anxiety. The students demonstrate a need for additional review when they identify what? Palpitations Extreme restlessness Motor excitement Tearfulness
Tearfulness
A client is experiencing moderate anxiety. Which manifestation would the nurse most likely observe? Select all that apply. The client can sustain attention on a particular focus. The client verbally states, "For some reason, I am feeling anxious now." The client has flights of ideas and confusion. The client makes distorted inferences because of inadequacy of observed data. The client may pace, run, or fight violently if asked to perform a task the client does not want to perform.
The client can sustain attention on a particular focus. The client verbally states, "For some reason, I am feeling anxious now."
A client reports the client has been experiencing increased stress at work. The client has been managing the stress by drinking 2-3 glasses of wine per evening. Despite the nurse recommending that drinking alcohol is not an effective way to manage the stress, the client reports it is unlikely that the client will be able to stop. Which statement explains why this will be difficult for the client? The client is probably physically dependent on alcohol. Drinking alcohol is more socially acceptable than taking medications. The client has no adaptive coping mechanisms. A few glasses of wine each night is not necessarily a problem.
The client has no adaptive coping mechanisms.
The inpatient psychiatric nurse is reviewing the treatment plan for a client with a diagnosis of panic disorder. Which client behavior(s) demonstrate effective treatment? Select all that apply. The client verbalizes their medication purpose. There are decreased episodes of panic. The client has mastered five coping mechanisms. Quality of life is reported as satisfactory. The client participates in flooding treatment.
The client verbalizes their medication purpose. There are decreased episodes of panic. Quality of life is reported as satisfactory. he statement "The client participates in flooding treatment" on its own does not necessarily indicate effective treatment. Here's why: Participation vs. Outcome: Simply participating in a treatment doesn't indicate its effectiveness. The outcomes of the treatment (such as decreased episodes of panic or mastering coping mechanisms) are clearer indicators of effectiveness. Individual Variation: Flooding can be a therapeutic approach for certain phobias or anxieties, but its success can vary between individuals. Some clients might find flooding too intense or not beneficial for their specific needs. Context Matters: If the statement were "The client successfully completes flooding treatment and reports reduced anxiety," then it would be a clear indication of effective treatment. But merely participating does not provide enough information about the effectiveness of the intervention. In clinical practice, the focus is typically on observable or reported outcomes (reduced symptoms, improved coping, etc.) rather than simply on participation in a treatment modality.
The nurse is assessing clients in the behavioral health unit. For which client will the nurse identify that a prn medication should be administered to control anxiety? The client with a high anxiety level experiencing disorganized thoughts. A client that will be discharged home with a spouse today. A client that is experiencing mild anxiety prior to talking with the therapist. A client that is admitted and being oriented to the unit and states, "I am nervous."
The client with a high anxiety level experiencing disorganized thoughts.
The nurse is assessing a client who has panic disorder. When assessing the client's risk for suicide, the nurse should prioritize what assessment finding? The client's history reveals social isolation for the past 2 years. The client was diagnosed with panic disorder 5 years ago. The client has a new comorbidity of type 2 diabetes. The client's panic disorder has caused them to miss work.
The client's history reveals social isolation for the past 2 years. Social isolation can be a major risk factor for depression and suicide, as the individual might lack the support systems and interpersonal relationships that can act as protective factors against suicidal ideation and behaviors. The other options might contribute to the overall picture of the client's well-being and need for support, but social isolation is a more immediate concern in relation to suicide risk assessment.
A psychaitric-mental health nurse is preparing a presentation for a group of colleagues on anxiety disorders. As part of the presentation the nurse plans to discuss the concept of interoceptive conditioning. Which information would the nurse most likely include in this discussion? There is an association between physical symptoms and a panic attack. A person links an adverse event with a previous neutral event. The person experiences a phobic avoidance of the event. A recent loss is the initiating event that leads to a panic attack.
There is an association between physical symptoms and a panic attack.
Which statement about the assessment of persons with anxiety and anxiety disorders is most accurate? When an elder person has an onset of anxiety for the first time in his or her life, it is possible that the anxiety is associated with another condition. Panic attacks are the most common late-life anxiety disorders. An elder person with anxiety may be experiencing ruminative thoughts. Agoraphobia that occurs in late life may be related to trauma experienced or anticipated.
When an elder person has an onset of anxiety for the first time in his or her life, it is possible that the anxiety is associated with another condition.
A client is currently experiencing a panic attack. Which is the most therapeutic response by the nurse? "Just try to relax." "There is nothing here to harm you." "You are safe. Take a deep breath." "What are you feeling right now?"
You are safe. Take a deep breath" Rationale: Asking, "What are you feeling right now?" requires the person to introspect, analyze their feelings, and then articulate those feelings into words. This can be a complex process even without the influence of a panic attack. During an attack, such introspection and verbalization can be particularly challenging and may even add to the person's distress. The primary goal during a panic attack is to help the individual feel safe and to provide simple, calming interventions that help de-escalate the situation. Reassuring statements ("You are safe") combined with straightforward actions ("Take a deep breath") are often more effective in achieving this than asking the person to delve into and describe their emotional state.
Which nursing assessment is most appropriate for an older client presenting with reports of generalized anxiety? assess for depression assess for panic attacks assess for elder abuse assess for dementia
assess for depression This is particularly relevant because anxiety and depression often coexist, especially in older adults. Symptoms of anxiety can be a manifestation of underlying depression or vice versa. Older adults might not always express feelings of sadness but may instead report physical complaints, making it crucial to assess for depression.
A nurse detects that a client is experiencing panic-level anxiety. Which intervention should be immediately implemented? Teach relaxation techniques Administer anxiolytic medication Provide calm, brief, directive communication Gather a show of force in preparation for physical control
provide calm, brief, directive communication
