Anxiety Disorders

A client in a psychiatric facility is prescribed a selective serotonin reuptake inhibitor (SSRI) for depression. The client tells the nurse they have had three seizures after taking the drug for 2 weeks. What question would be appropriate to ask at this time? "Are you sure you have seizures or is it this your imagination?" "Do you take any herbs, such as St. John's wort or evening primrose?" "Have you stopped taking the drug to see if your seizures stop?" "Do any other members of your family have seizures?

"Do you take any herbs, such as St. John's wort or evening primrose?"

The nurse is working with a client with a generalized anxiety disorder who is experiencing a panic attack. What statements should nurse make to the client? Select all that apply. "Take some deep breaths." "I am here with you." "You are safe." "Try to calm down." "You are panicking."

"I am here with you." "You are safe." "Take some deep breaths."

A client has been diagnosed with an anxiety disorder and is refusing any form of prescribed therapy and medication. The client states, "I am going to try to use an internet support group since it is free." What is the best response by the nurse? "It won't work and you will just end up on medication and therapy anyway." "Everyone with an anxiety disorder should also be on medication to help the symptoms." "I need to reinforce that any advice obtained from the internet should be used with caution." "I think that is a great idea and should be a good substitute for formal therapy."

"I need to reinforce that any advice obtained from the internet should be used with caution."

A nurse is reinforcing education for a client who has been prescribed buspirone for long-term treatment of anxiety. The nurse determines that the education has been effective when which statement is made by the client? "I will not stop the medicine if I become pregnant." "I will take the medicine only when I feel an anxiety attack coming on." "I will not take the medicine with my meals." "I will not take the medicine with grapefruit juice."

"I will not take the medicine with grapefruit juice."

A client comes to the emergency department while experiencing a panic attack. Which response by the nurse would be most appropriate for the client at this time? "I'll keep explaining what's happening so you can understand." "Everything is under control now that you're here." "I'll stay with you until the attack subsides." "You should really try to lie down and rest now."

"I'll stay with you until the attack subsides."

The health care provider prescribes a new drug for a client with generalized anxiety disorder. Which teaching will the nurse provide? "This medication has helped many people so it should help you also." "Repeat for me how to take this medication as prescribed." "If this medication doesn't help, you can stop taking it anytime." "Taking this medication is the best way to control anxiety."

"Repeat for me how to take this medication as prescribed."

The nurse witnesses a client with a known anxiety disorder begin to hyperventilate and state, "My chest is hurting." Which nursing intervention is appropriate? Take the client to participate in a milieu activity for distraction. Escort the client to their room, and recommend taking a nap. Accompany the client to a quiet location, and provide instructions in short, simple statements. Encourage the client to have a conversation with another client on the unit.

Accompany the client to a quiet location, and provide instructions in short, simple statements.

A nurse notices that a client who came to the clinic for treatment of anxiety disorder has a strong body odor. What can the nurse do or say to help this client? Ask the client basic hygiene questions to determine how frequently he bathes. Offer the client a room where he can freshen up before the physician examines him. Prepare the client for his examination and then leave the room. Provide the client with personal care items that he can take home with him.

Ask the client basic hygiene questions to determine how frequently he bathes.

A client admitted for management of depression and anxiety has been taking fluoxetine and clonazepam for the past 2 years. The admission prescription is to taper down the dose of fluoxetine in preparation to switch to sertraline next week and to discontinue the clonazepam and switch to buspirone for anxiety. Which action does the nurse take first? Perform medication reconciliation based on the past and current prescriptions. Notify the health care provider of the conflict between fluoxetine and sertraline. Clarify the prescription for buspirone because it is an antidepressant, not an anxiolytic. Ask the health care provider to clarify the discontinuation of the clonazepam.

Ask the health care provider to clarify the discontinuation of the clonazepam.

The nurse is caring for a client who is agitated and is trying to get out of bed. What should the nurse do first to keep the client free of injury? Apply a vest restraint. Keep side rails up. Administer alprazolam 0.5 mg orally once a day. Ask the unlicensed assistive personnel to sit with the client.

Ask the unlicensed assistive personnel to sit with the client.

During a panic attack, a client runs to the nurse and reports breathing difficulty, chest pain, and palpitations. The client is pale with his mouth wide open and eyebrows raised. What should the nurse do first? Administer an I.M. anxiolytic agent. Set limits for acting out delusional behaviors. Orient the client to person, place, and time. Assist the client to breathe deeply into a paper bag.

Assist the client to breathe deeply into a paper bag.

The nurse in a psychiatric inpatient unit is caring for a client with obsessive-compulsive disorder. As part of the client's treatment, the psychiatrist orders lorazepam, 1 mg by mouth three times per day. During lorazepam therapy, the nurse should instruct the client to follow which advice? Avoid caffeine Stay out of the sun Maintain an adequate salt intake Avoid aged cheeses

Avoid caffeine

A physician's order states to administer lorazepam, 20 mg by mouth twice per day, to treat anxiety. How should the nurse proceed? Question the prescribing physician about the use of the drug because it isn't indicated for anxiety. Administer the dose after dissolving the tablet in 30 ml of diluent. Administer the first dose when the client requests it. Clarify the order with the prescribing physician because the amount prescribed exceeds the recommended dose.

Clarify the order with the prescribing physician because the amount prescribed exceeds the recommended dose.

A nurse is caring for a client who is scheduled to undergo electroconvulsive therapy (ECT) next week. The client has been taking a benzodiazepine for several months. Which nursing action is appropriate? Contact the health care provider who prescribed benzodiazepine. Ask the client whether the drug is still desired. Ask the charge nurse to clarify the order. Continue administering the medication.

Contact the health care provider who prescribed benzodiazepine.

The nurse is assisting with the development of a plan of care for a client with generalized anxiety disorder (GAD). Which intervention is important to include? Encourage the client to engage in activities that increase feelings of power and self-esteem. Promote the client's interaction and socialization with others. Encourage the client to use a diary to record when anxiety occurred, its cause, and which interventions may have helped. Assist the client to make plans for regular periods of leisure time.

Encourage the client to use a diary to record when anxiety occurred, its cause, and which interventions may have helped.

While shopping at a mall, a woman experiences an episode of extreme terror accompanied by anxiety, tachycardia, trembling, and fear of going crazy. A friend drives her to the emergency department, where a physician rules out physiological causes and refers her to the psychiatric resident on call. The nurse caring for this client would expect the health care practitioner to prescribe which medication to control the client's anxiety? Bupropion Lorazepam Paroxetine Haloperidol

Lorazepam

A client with post-traumatic stress disorder is prescribed sertraline, 50 mg, by mouth once daily. Which action will the nurse take when administering this drug? Select all that apply. If a dose is missed, take double the medication at the next appointed dose time. Oral concentrate should be given immediately after mixing with water, ginger ale, or lemon-lime soda. Advise using caution when performing hazardous tasks that require alertness or concentration. Teach the client to check with the health care provider before taking over-the-counter preparations. Administer the drug at bedtime.

Oral concentrate should be given immediately after mixing with water, ginger ale, or lemon-lime soda. Teach the client to check with the health care provider before taking over-the-counter preparations. Advise using caution when performing hazardous tasks that require alertness or concentration.

A client who lost her home and dog in an earthquake tells the admitting nurse that she finds it harder and harder to "feel anything." She says she cannot concentrate on the simplest tasks, fears losing control, and thinks about the earthquake incessantly. She becomes extremely anxious whenever the earthquake is mentioned and must leave the room if people talk about it. When reviewing the data, the nurse suspects this client has which disorder? Phobic disorder Posttraumatic stress disorder (PTSD) Functional neurologic symptom disorder Adjustment disorder

Posttraumatic stress disorder (PTSD)

A client with agoraphobia has been symptom-free for 4 months. The client returns to the health center with which classic signs and symptoms of this phobia? Severe anxiety and fear Insomnia and an inability to concentrate Withdrawal and failure to distinguish reality from fantasy Depression and weight loss

Severe anxiety and fear

A client presents to the nurses' station with symptoms of a panic attack, including shortness of breath, dizziness, trembling, and nausea. Which is the nurse's first intervention? Stay with the client, and offer support. Administer PRN antianxiety medication. Teach the client relaxation techniques. Help the client identify triggers for anxiety.

Stay with the client, and offer support.

Before eating a meal, a client with obsessive-compulsive disorder (OCD) must wash his or her hands for 18 minutes, comb his or her hair 444 strokes, and switch the bathroom light on and off 44 times. When creating the plan of care, what is the most appropriate goal for this client? Allow ample time for the client to complete all rituals before each meal. Systematically decrease the number of repetitions of rituals and the amount of time spent performing them. Increase the client's acceptance of therapeutic drug use. Omit one unacceptable behavior each day.

Systematically decrease the number of repetitions of rituals and the amount of time spent performing them.

While in the facility, a client with obsessive-compulsive disorder saves all used medicine cups and paper cups and arranges them in elaborate sculptures in the room. At home, the client saves mail and magazines and makes elaborate paper sculptures from them. Which outcome would indicate successful treatment for this client? The client throws away all disposable cups. The client keeps the cups in a bag in his room. The client is discharged and takes the cups home. The client goes home on pass and arranges magazines.

The client throws away all disposable cups.

While reviewing a client record, the nurse sees that the client has a documented history of microphobia. What behavior does the nurse anticipate the client exhibiting? covering the ears during a storm washing the hands repetitively avoiding riding in a car refusing to fly in an airplane

washing the hands repetitively

The nurse educator is discussing a case regarding a client with obsessive-compulsive disorder who tells the nurse that he or she must check the lock on his or her apartment door 25 times before leaving for an appointment. The nurse educator includes which information about what this behavior represents? The client's attempt to maintain the safety of his or her home The client's attempt to reduce anxiety The client's attempt to call attention to himself or herself The client's attempt to control his or her thoughts

The client's attempt to reduce anxiety

A client diagnosed as having panic disorder is admitted to the inpatient psychiatric unit. Until admission, he or she had been a virtual prisoner in the house for 5 weeks because of agoraphobia, afraid to go outside even to buy food. The nurse, when planning care for this client, determines which action as this client's overall goal? To help the client participate in group therapy To help control the client's symptoms To help the client perform self-care activities To help the client function effectively in his or her environment

To help the client function effectively in his or her environment

Which factor should the nurse be most concerned about when caring for a client taking an antianxiety medication? transient hypertension abrupt withdrawal constipation diarrhea

abrupt withdrawal

A client with generalized anxiety disorder is admitted to the facility. Which therapeutic modalities are typically used to treat this disorder? Select all that apply. electroconvulsive therapy buspirone therapy fluphenazine therapy biofeedback relaxation techniques

biofeedback buspirone therapy relaxation techniques

An 8-year-old child, diagnosed with obsessive-compulsive disorder, is admitted by the nurse to a psychiatric facility. When gathering data from the client, which behaviors would be characterized as compulsions? Select all that apply. feeding the dog the same meal every day checking and rechecking that the television is turned off before going to school repeatedly washing the hands routinely climbing up and down a flight of stairs three times before leaving the house brushing teeth three times per day Wanting to play the same video game each night.

checking and rechecking that the television is turned off before going to school repeatedly washing the hands routinely climbing up and down a flight of stairs three times before leaving the house

The nurse is obtaining data from a client with obsessive-compulsive disorder who reports not getting much sleep at night. What behavior does the nurse anticipate? dreams and flashbacks about a traumatic event checking the door locks multiple times experiencing attacks of breathlessness and increasing anxiety fear of leaving the room

checking the door locks multiple times

A client has a history of post-traumatic stress disorder (PTSD). What assessment finding does the nurse anticipate? ritualistic behaviors that must be accomplished dreams and flashbacks of an event an inability to leave the home environment sudden onset of anxiety that paralyzes the client

dreams and flashbacks of an event

A client sees a spider while raking leaves. Immediately, the client's heart begins beating rapidly and the client breaks into a sweat. To which condition is the client's response related? anxiety triggered by sustained physical exertion fear triggered by an attempt to go outside into a public place fear triggered by a known, specific object or event anxiety triggered by re-experiencing a previously frightening event

fear triggered by a known, specific object or event

A rape victim is being prepared for discharge. The nurse is aware that the client is at risk for posttraumatic stress disorder (PTSD) and instructs the client that it's important to report which symptoms associated with PTSD? Select all that apply. unusual talkativeness gingival and dental problems flight of ideas Difficulty concentrating sleep disturbances recurrent, intrusive recollections or nightmares

recurrent, intrusive recollections or nightmares sleep disturbances Difficulty concentrating

The nurse is caring for a client with acrophobia. Which client behavior does the nurse anticipate when preparing to conduct an assessment? retreats to another room upon seeing a spider avoids anything associated with the number 13 refuse to be alone refuses to climb ladders

refuses to climb ladders

Which therapeutic strategy is used to reduce anxiety in a client diagnosed with illness anxiety disorder? relaxation exercises pharmacological intervention electroconvulsive therapy suicide precautions

relaxation exercises

A client arrives on the psychiatric unit exhibiting extreme excitement, disorientation, incoherent speech, agitation, frantic and aimless physical activity, and grandiose delusion. Which nursing diagnosis takes highest priority for this client at this time? hopelessness ineffective coping disturbed personal identity risk for injury

risk for injury