anxiety disorders ch19 prep u-pn
The psychiatric mental health nurse has taught a client with obsessive-compulsive disorder (OCD) about the use of cue cards. This intervention will allow the client to:
counter obsessive thinking with positive messages.
During an interview, the client states, "I feel so guilty, and I'm so ashamed of what I did." The nurse interprets this as
negative emotion.
Which statement by the nurse demonstrates an understanding of the role automatisms have in a panic attack?
"The client taps her fingers very rapidly when she is feeling anxious
The psychiatric mental health nurse is participating in an interdisciplinary meeting about an inpatient client with severe obsessive-compulsive disorder. It comes to light that some members of the care team are allowing the client unlimited time to complete her rituals while others are enforced strict limits. What is the team's best response?
Agree on specific limits that will be consistently enforced
A hospitalized client states that the client is having difficulty resting. Which intervention would help promote rest?
Assisting the client with deep-breathing exercises
The mental health nurse explains that the difference between an obsession and a compulsion can correctly be identified as what?
Compulsion involves repeating a purposeful action
Clients taking benzodiazepines need education about what?
Concomitant use of alcohol
The efforts one takes to manage situations that have been appraised as being potentially harmful or stressful refers to ...
Coping
A 42-year-old client was recently diagnosed with hypertension. Which of the following occurrences would be a positive reaction to the acute stress of this new diagnosis?
Decreasing dietary sodium and fat intake
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?
Dissociative identity disorder
The psychiatric mental health nurse is planning the care of a client whose elaborate room entry and exit rituals have led to a diagnosis of obsessive-compulsive disorder (OCD). What action by the nurse best addresses possible psychodynamic aspects of the etiology?
Exploring the characteristics of the client's defense mechanisms
A client states that he is "paralyzed by guilt" because of his sexual thoughts. Further assessment reveals that the thoughts consume nearly all of the client's energy and time. Which action would be most appropriate for the nurse to do?
Facilitate interventions that address the client's obsessions
A nurse is caring for clients with posttraumatic stress disorder (PTSD). Negative alterations in cognition and mood associated with the traumatic event are important features of PTSD. Knowing this, which symptoms is the nurse likely to find in such clients? Select all that apply. You Selected:
Having negative beliefs about oneself Getting angry with little or no provocation Inability to remember important aspects of the traumatic event
A client diagnosed with obsessive-compulsive disorder (OCD) is attempting to resist a compulsion. Based on this finding, the nurse should assess the client for ...
Increased anxiety
The nurse is assessing a client and finds two enlarged supraclavicular lymph nodes. The nurse asks the client how long these enlarged nodes have been there. The client states, "I can't remember. A long time I think. Do I have cancer?" The nurse is aware that that body responds to stress. Which is an immediate physiologic response to stress the nurse would expect to see in this client?
Increased blood pressure
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?
Ineffective coping
When a client is experiencing severe anxiety, which of the following is the priority intervention?
Move the client to a quiet environment
An 80-year-old woman is slated for total hip replacement the following day, and is experiencing a large amount of stress around her potential surgical outcomes. Which of the following is most likely to be uninvolved in the physiological response to her stress?
Parathyroid
The psychiatric mental health nurse has received a referral from a community health nurse regarding a client who appears to have hoarding disorder. When planning this client's care, the nurse should prioritize what consideration?
Promoting the client's safety in the home environment
Which medication classification has been used to treat social phobia?
Selective serotonin reuptake inhibitors (SSRIs)
A 30-year-old client who has been unemployed secondary to anxiety disorder states that the client would like to have a job where the client is alone and no one needs to evaluate the client's work. The nurse interprets these comments as an indicator of what?
Social phobia
The nurse is assessing a client with anxiety. Which behavior might indicate that the client has moderate anxiety
The client is nervous and agitated.
A client with obsessive-compulsive disorder (OCD) has been taught thought-stopping techniques. The nurse should recognize what potential benefit of this intervention?
The client will be able to take control of obsessions
The nurse is planning the care of a client who has been referred for the treatment of trichotillomania. What outcome should the nurse prioritize when planning care?
The client will demonstrate healthy skills for coping with anxiety
The nurse is providing care for a client who has obsessive-compulsive disorder (OCD). What aspect of this client's history was the most likely contributor to its etiology?
The client's mother had OCD
You are caring for a 4-day-old set of conjoined twins and their parents. The infants are doing well at this point, but the parents are each in a heightened anxiety state after being told that when the babies are separated one of them may become permanently disabled. By the statements the parents are making, the nurse knows they are cognitively appraising the situation their family is in. While talking with the parents, you note that the father of the babies has an aggressive stance, is speaking in a loud voice, and makes several hostile statements such as, "I'd like to strangle that doctor who told us our babies would be okay." You know that this father's cognitive appraisal has led to what?
The development of negative emotions
The nurse at the student health center is seeing a group of nursing students who are interested in reducing their stress level. The nurse identifies guided imagery as an appropriate intervention. What does guided imagery involve?
The mindful use of a word, phrase, or visual image, which allows oneself to be distracted and temporarily escape from stressful situations
A nurse is working with the family of a client with obsessive-compulsive disorder (OCD). Which concept should the nurse incorporate in the teaching plan?
The thoughts, images, and impulses tend to worsen with stress.
A teenage girl has been diagnosed with obsessive-compulsive disorder (OCD) that manifests with excessive handwashing. The client's father is exasperated, stating, "The simplest solution would be to take away her access to soap and water." How should the nurse best interpret the father's suggestion?
This action would cause the client significant anxiety and distress
A nurse is visiting an elderly client at home. The client has been seen hoarding, and the smell is offensive when the nurse comes to visit. Which is an indicator of hoarding?
a single path throughout the yard and house
The nurse has been working with a client who has obsessive-compulsive disorder (OCD) and the nurse is meeting the client's mother and father for the first time. During this interaction, the nurse should:
assess the parents' willingness to assist with behavioral techniques the client has been taught.
A nurse refers a client with posttraumatic stress disorder (PTSD) to group therapy. Group therapy will likely be more beneficial than individual therapy for this client because group therapy may:
help the client better express feelings
A nurse detects that a client is experiencing panic-level anxiety. Which intervention should be immediately implemented?
provide calm, brief, directive communication
