Module 31- Stress, Coping, Anxiety
Which ages should the nurse recognize as being more prone toward developing social anxiety disorder? A. 11-15 years old B. 16-18 years old C. 19-21 years old D. 9-11 years old
A. 11-15 years old
A new nurse becomes very anxious and experiences a pounding heart when thinking about being alone to care for high-acuity patients due to a staffing shortage. According to Selye's general adaptation syndrome (GAS), which stage is the nurse experiencing? A. Alarm B. Homeostasis C. Resistance D. Exhaustion
A. Alarm
The nurse is caring for a patient who has learned that her unborn baby will have Down syndrome. Which nursing intervention should increase the woman's ability to cope with the stressor? A. Provide literature on caring for the child. B. Refer the patient to a social worker. C. Assess the patient for depression. D. Monitor the patient for suicide.
A. Provide literature on caring for the child.
The nurse caring for clients with anxiety disorders understands that which is the most common reason that clients do not seek treatment? (Select all that apply.) A. They don't realize the impact on their life. B. Effective treatment is not available. C. They don't want to try treatments. D. Healthcare providers don't recognize it. E. Friends don't recognize it.
A. They don't realize the impact on their life. D. Healthcare providers don't recognize it. E. Friends don't recognize it.
A patient feeling distressed is asked to rate the feeling on a scale from 1 to 10, with 1 being no distress and 10 being unbearable distress. Which technique is the nurse using during this assessment? A. Inter-rater agreement B. Estimation C. Scaling D. Tensiometer
C. Scaling
Which treatment should the nurse expect to be ordered as first-line treatment for obsessive-compulsive disorder (OCD) in children when possible? A. Antipsychotic medications B. Deep brain stimulation D. Cognitive-based therapies D. Selective serotonin reuptake inhibitors
D. Cognitive-based therapies
The nurse is providing information to a client about the benefits of support groups. Which client statement indicates an understanding of the information? A. "A support group may help me put everything in perspective." B. "I will feel empowered because the leader will take control." C. "My struggles might not seem so bad after listening to others." D. "I can learn about other people's struggles."
A. "A support group may help me put everything in perspective."
A mother has brought her 12-year-old daughter for therapy. The daughter witnessed a horrific motor vehicle crash in which several people, including children, were killed. The mother, who was with the child at that time, says, "I don't understand why she still seems affected by the crash. I'm not." Which statement by the nurse is most appropriate to help the mother better understand the daughter's situation? A. "A young person's response can vary significantly from that of an adult." B. "A young person's negative experience can be erased by piling on positive events." C. "A young person's coping responses are part of the skills they are born with." D. "A young person's memory bank is much more detailed than an adult's."
A. "A young person's response can vary significantly from that of an adult."
A patient with a history of type 1 diabetes mellitus and coronary artery disease receives injuries from a motor vehicle crash. Which question should the nurse make a priority? A. "Are you having any chest pain?" B. "Do you have any abdominal discomfort?" C. "Are you experiencing difficulty breathing?" D. "Do you use an insulin pump?"
A. "Are you having any chest pain?"
The nurse observes an adult client pacing the room and wringing their hands. The client checks the lock on the exam room door 12 times after the nurse enters the room. Which assessment question would be appropriate when evaluating this client? (Select all that apply.) A. "Does this behavior interfere with your daily life?" B. "What would happen if you were dead?" C. "Are you easily annoyed?" D. "Does anyone in your family suffer from depression?" E. "How old were you when you first started this behavior?"
A. "Does this behavior interfere with your daily life?" E. "How old were you when you first started this behavior?"
A patient indicates that they have been having trouble sleeping, difficulty concentrating, and feeling excessive anxiety every day. Which question should the nurse ask to help to determine if the patient meets the DSM-5 criteria for generalized anxiety disorder? A. "How long have you been experiencing excessive anxiety about everyday problems?" B. "Do you believe that your anxiety is excessive in proportion to your circumstances?" C. "Have you also been experiencing panic attacks?" D. "Does the anxiety occur in relation to use of any specific substances such as marijuana?"
A. "How long have you been experiencing excessive anxiety about everyday problems?"
The nurse is preparing to speak with a family regarding the loss of their father. Which therapeutic statement should the nurse include after communicating the loss? A. "I am here to assist you during this difficult time." B. "I have notified the chaplain to come speak with you." C. "Your father's healthcare provider has been notified." D. "Would you like to tell me how you are feeling right now?"
A. "I am here to assist you during this difficult time."
A teenage patient has attended a community workshop on handling stress. Which statement by the teenager demonstrates understanding of the material presented? A. "I can choose how I react to stress." B. "Exercise can trigger the stress response." C. "Everyone reacts the same way to the same stressful situation." D. "Most people feel anxious all the time. It's the way the world is right now."
A. "I can choose how I react to stress."
While reviewing the goals in a client's plan of care, the client reports to the nurse that they want to be taken off antianxiety medication. Which statement by the client indicates that they are successfully meeting the identified goals and expected outcomes? (Select all that apply.) A. "I use what I learned in therapy to calm myself down when I start feeling anxious." B. "I have missed a lot of work recently." C. "I am taking a yoga class and a cooking class." D. "I feel good, not worried or anxious, most days." E. "I sleep well at night now."
A. "I use what I learned in therapy to calm myself down when I start feeling anxious." C. "I am taking a yoga class and a cooking class." D. "I feel good, not worried or anxious, most days." E. "I sleep well at night now."
The nurse reviews the use of a crisis hotline with a client who has a history of attempted suicide. Which information should the nurse include? A. "The service will allow you to remain anonymous." B. "You will be able to receive counseling through the service." C. "The crisis hotline will be able to identify your whereabouts to send you help." D. "The service can contact your healthcare provider to let them know you called."
A. "The service will allow you to remain anonymous."
The nurse is working with an older adult who is having side effects from medications for an anxiety disorder. The nurse wants to refer the client for psychotherapy, but the client is adamant and states, "I don't want to see a psychiatrist; that's for crazy people!" Which reassurance should the nurse give the client? (Select all that apply.) A. "Therapy added to medications has more success than medications alone." B. "Therapy can help manage the symptoms of anxiety." C. "Therapists see many people who do not have mental disorders." D. "Other professionals offer therapy besides psychiatrists." E. "With therapy, you can stop taking your medications right away."
A. "Therapy added to medications has more success than medications alone." B. "Therapy can help manage the symptoms of anxiety." C. "Therapists see many people who do not have mental disorders." D. "Other professionals offer therapy besides psychiatrists."
The healthcare provider has recommended that a patient who is experiencing panic attacks be referred for exposure-based cognitive-behavioral therapy (CBT). How should the nurse describe this therapy to the patient? A. "You will be exposed to the situation that causes you anxiety under the supervision of the mental health counselor." B. "Your mental health counselor will help you to learn how to stop destructive thoughts by visualizing a specific image, sensation, or circumstance." C. "A contract will be developed that outlines the behavioral changes that you and the mental health professional agree should take place." D. "Mindfulness strategies will be used to help you deal with the situation that causes your panic attacks."
A. "You will be exposed to the situation that causes you anxiety under the supervision of the mental health counselor."
The nurse is discussing the holistic approach to nursing care, specifically about the use of patient prayer and coping. The nurse should identify that which individuals experiencing depression are most likely to use prayer for healing? A. A 60-year-old unmarried woman with a high school education B. A 40-year-old married man C. A 19-year-old female college student D. A 12-year-old girl
A. A 60-year-old unmarried woman with a high school education
The nurse is researching clinical studies on obsessive-compulsive disorder (OCD) and finds that the majority of studies focus on Caucasian Americans. Which finding supports the fact that a limited number of studies on cultural differences between Caucasian Americans and other cultural or ethnic groups have been performed? A. African Americans and Hispanics are less likely to receive treatment for OCD. B. Caucasian Americans are more likely to acquire OCD than African Americans or Hispanics. C. African Americans and Hispanics were not permitted to participate in any OCD clinical trials. D. The prevalence of OCD in African Americans and Hispanics is less than for Caucasian Americans.
A. African Americans and Hispanics are less likely to receive treatment for OCD.
When caring for clients, the nurse should recognize that which area of the brain is also referred to as the "emotional brain"? A. Amygdala B. Hippocampus C. Hypothalamus D. Thalamus
A. Amygdala
After experiencing a traumatic event, a patient expresses feelings of distress. Which should the nurse assess first with this patient? A. Ask the patient to rate the distress using a scale. B. Assess for suicidal thoughts. C. Ask the patient to describe the event. D. Obtain the patient's vital signs.
A. Ask the patient to rate the distress using a scale.
A 45-year-old client with a history of anxiety disorders calls the office and reports sudden onset of chest pain. The client sounds panicked on the phone. Which should be the nurse's immediate response? (Select all that apply.) A. Asking the client for their address B. Asking the client what medications they have available to take C. Telling the client to take a deep breath and try to relax D. Telling the client that they are OK E. Asking the client when they can come to the office
A. Asking the client for their address C. Telling the client to take a deep breath and try to relax
A patient diagnosed with a panic disorder is being treated with an antidepressant, but reports that it is not helping him. The nurse anticipates that the healthcare provider may next order which medication? A. Atypical antipsychotic B. Selective serotonin reuptake inhibitor (SSRI) C. Nonbenzodiazepine D. Benzodiazepine
A. Atypical antipsychotic
A client recently diagnosed with anxiety would like to prevent further panic attacks. Which suggestion should the nurse include? (Select all that apply.) A. Avoiding caffeine B. Tracking patterns C. Not staying home alone D. Avoiding alcohol E. Quitting smoking
A. Avoiding caffeine B. Tracking patterns D. Avoiding alcohol E. Quitting smoking
The nurse is planning care for a client who has been prescribed cognitive-behavioral therapy (CBT) and medication for an anxiety disorder. Which complementary and alternative therapy should the nurse suggest? (Select all that apply.) A. Biofeedback and deep breathing B. Dried herbal preparations C. Massage and therapeutic touch D. Guided imagery and self-hypnosis E. Meditation and yoga
A. Biofeedback and deep breathing C. Massage and therapeutic touch D. Guided imagery and self-hypnosis E. Meditation and yoga
The nurse manager reports feeling drained and having little energy left after guiding the staff nurses through several difficult times, including high turnover. The nurse manager suspects she is experiencing which condition? A. Burnout B. Hypochondriasis C. Generalized anxiety disorder (GAD) D. Posttraumatic stress disorder (PTSD)
A. Burnout
Which potential risk factor should the nurse recognize for an older adult client to develop anxiety? (Select all that apply.) A. Chronic illness B. Death of a spouse C. Cognitive impairment D. Higher education E. Single
A. Chronic illness B. Death of a spouse C. Cognitive impairment E. Single
The nurse is teaching a client diagnosed with obsessive-compulsive disorder (OCD) on the different therapies that are available for the disorder. Which therapy is appropriate for the nurse to include? (Select all that apply.) A. Cognitive-behavioral therapy B. Herbal supplements, such as St. John's wort C. Antipsychotic medication D. Antihypertensive agents E. Hypoglycemic agents
A. Cognitive-behavioral therapy C. Antipsychotic medication
The nurse is caring for a client who has suffered no bodily injury after a home fire. Which additional action and psychosocial assessment should the nurse include in the plan of care? (Select all that apply.) A. Develop a follow-up plan. B. Provide discharge teaching. C. Identify coping mechanisms. D. Evaluate emotional status. E. Assess thought processes.
A. Develop a follow-up plan. C. Identify coping mechanisms. D. Evaluate emotional status. E. Assess thought processes.
An older woman who recently moved into an assisted living facility reports that she feels uneasy in the new setting, and is depressed and angry because she did not want to move to the facility. She also states that she is having difficulty addressing problems. Which indicator described by the patient should be considered a cognitive indicator of stress? A. Difficulty problem solving B. Feelings of unease C. Depression D. Anger
A. Difficulty problem solving
A new nurse is finding it difficult to adapt to the acute care unit where they are working. They perceive that the ability to control the stress created by the unit is beyond their control. Which type of coping should the nurse use to deal with this stress? A. Emotion-focused coping B. Problem-focused coping C. Approach coping D. Meaning-focused coping
A. Emotion-focused coping
The nurse is caring for a patient who states, "I did not handle that crisis very well. I do not know what I was thinking at the time." Which best describes the influence on the patient's self-efficacy? A. Emotional state B. Mastery experience C. Social persuasion D. Vicarious experience
A. Emotional state
An elementary school nurse is assessing a child for behaviors of obsessive-compulsive disorder (OCD). Which finding should alert the nurse to consider as a symptom? A. Expresses extreme fear that his parents will die. B. Has difficulty concentrating in class. C. Sits alone at lunchtime. D. Refuses to comply with uniform rules.
A. Expresses extreme fear that his parents will die.
The school nurse is concerned that an adolescent may be facing normal stressors along with some unexpected stressors due to the recent death of a parent. Which assessment tool should help to identify the impact of both normative and nonnormative stressors? A. Feel Bad Scale (FBS) B. Anxiety Disorders Interview Schedule for children and parents (ADIS-C/P) C. Revised Children's Anxiety and Depression Scale (RCADS) D. Spence Children's Anxiety Scale (SCAS)
A. Feel Bad Scale (FBS)
The nurse is admitting a client who was found wandering the streets. The nurse observes that the client is startled when approached and has been sobbing continuously. The nurse understands that which assessment finding correlates with suspected trauma? (Select all that apply.) A. Hypervigilance B. Perseveration C. Intense emotional reactions D. Echolalia E. Disorientation
A. Hypervigilance C. Intense emotional reactions E. Disorientation
A patient reports irritated, dry, and bleeding skin on their hands. While talking to the patient, the nurse orienting to the unit observes the patient go to the sink and wash their hands five times. Which action by the orienting nurse should cause the preceptor to provide teaching? A. Interrupting the patient's hand washing ritual B. Referring the patient for cognitive-behavioral therapy (CBT) C. Teaching the patient alternative coping mechanisms D. Administering selective serotonin reuptake inhibitor (SSRI) as ordered
A. Interrupting the patient's hand washing ritual
After establishing a therapeutic relationship, the nurse is counseling a patient with obsessive-compulsive disorder (OCD) regarding adaptive coping strategies. Which action should the nurse teach a patient to do instead of performing a ritual? A. Meditate. B. Count to ten. C. Take a deep breath. D. Drink a glass of water.
A. Meditate.
A patient who lost everything in a house fire questions the reason to continue living. Which action should the nurse make a priority? A. Obtain a referral for a mental health evaluation. B. Administer antianxiety medication, per order. C. Administer antidepressant medication, per order. D. Refer the patient to social services.
A. Obtain a referral for a mental health evaluation.
The nurse is working with a group of counselors offering services in a community affected by a disaster. Which type of crisis counseling should the nurse expect to be offered? A. Outreach B. Outclient C. Intervention D. Nontraditional
A. Outreach
A patient reports that they feel as if they are dying, they feel numb, and they fear that they are losing control. The family states that this episode started as they prepared to drive to an appointment that was an hour away. Which anxiety disorder should the nurse suspect the patient is most likely experiencing? A. Panic disorder B. Generalized anxiety disorder C. Somatic anxiety disorder D. Social anxiety disorder
A. Panic disorder
The nurse is presenting to a community group about mental disorders that are more common among women than among men. Which disorder should the nurse include? (Select all that apply.) A. Phobia B. Anxiety disorder C. Obsessive-compulsive disorder D. Insomnia E. Generalized anxiety disorder
A. Phobia B. Anxiety disorder E. Generalized anxiety disorder
Which clinical manifestation would the nurse expect to observe in a client with a compulsion to continually order and arrange objects? A. Places all spices in alphabetical order. B. Checks several times that appliances are off. C. Continually asks others for assurance. D. Repeatedly washes hands.
A. Places all spices in alphabetical order.
A first-year nursing student who goes to the university's counseling services hopes that anxiety levels experienced during tests can be reduced. The nurse counselor asks the student about first thoughts when a test is announced. Which kind of appraisal is the counselor having the student consider? A. Primary appraisal B. Anxiety appraisal C. Cognitive appraisal D. Secondary appraisal
A. Primary appraisal
The nurse is performing an initial interview on a patient being treated for OCD and asks the patient, "I noted that you reported a history of substance abuse. What substance should I record in your medical record?" Which part of the health history does the nurse's question cover? A. Psychosocial B. Medical C. Medication D. Mental health
A. Psychosocial
An older adult whose house was destroyed in a fire reports difficulty sleeping in a family member's house. Which action should the nurse take? A. Refer the client to the healthcare provider for an evaluation for sleep medication. B. Encourage the client to stay with other family members. C. Obtain a referral to a community center to increase the quality of daily activity. D. Instruct the client to exercise prior to going to bed.
A. Refer the client to the healthcare provider for an evaluation for sleep medication.
The nurse is working with a long-term patient who has struggled through many issues, including homelessness. The patient reports finding subsidized housing. The nurse responds, "You persisted until you found an apartment. Congratulations!" Which kind of independent intervention is the nurse implementing? A. Reinforcing positive coping efforts B. Validating the patient's feelings C. Identifying strategies to meet the patient's goals D. Implementing cognitive-behavioral therapy (CBT) interventions
A. Reinforcing positive coping efforts
The nurse is caring for a client experiencing a crisis. Which intervention should the nurse use first to promote a connection with the client? A. Scan for physical distress. B. Paraphrase the client's statements for validity. C. Avoid eye contact with the client. D. Offer the services of a chaplain.
A. Scan for physical distress.
The nurse is planning care for a client diagnosed with a severe anxiety disorder. Which nursing diagnosis is appropriate for the nurse to include in the plan of care? (Select all that apply.) A. Sleep Pattern, Disturbed B. Pain, Acute C. Health Management, Ineffective D. Body Image, Disturbed E. Social Interaction, Impaired
A. Sleep Pattern, Disturbed C. Health Management, Ineffective E. Social Interaction, Impaired
The nurse is completing an assessment of an older adult patient whose husband recently died. The patient states she had to move in with her daughter due to financial concerns. Which coping strategies should the nurse recognize as being the most effective for reducing stress and anxiety for this patient? A. Social coping strategies B. Individual coping strategies C. Personal coping strategies D. Emotion-focused strategies
A. Social coping strategies
The parents of a 5-year-old child tell the school nurse that they believe their child has developed a phobia. Which information shared with the school nurse should support a possible phobia? A. The child has refused to sleep with the lights off, expressing fear of the dark for the past 7 months. B. The child worries and frets whenever the mother is away for even short spans of time. C. The child is irritable and very tired most of the time. D. The child has told them that the child believes a monster lives in their closet and comes out at night.
A. The child has refused to sleep with the lights off, expressing fear of the dark for the past 7 months.
The nurse believes that a client with severe anxiety will benefit from cognitive-behavioral therapy (CBT). Which characteristic of CBT should the nurse consider? (Select all that apply.) A. The client can do CBT exercises. B. The client can change unhealthy thoughts. C. The client can remove stressors. D. The client can safely confront fears. E. The client can discontinue medications.
A. The client can do CBT exercises. B. The client can change unhealthy thoughts. D. The client can safely confront fears.
While assessing multiple clients, which client should the nurse determine to be at a risk for developing generalized anxiety disorder? (Select all that apply.) A. The client who reports excessive anxiety and worry about their job, relationship, and finances for the past 6 months B. The client who denies current stressors and drinks alcohol socially C. The client who has difficulty concentrating, sleep disturbances, and muscle tension D. The client who finds it hard to control worry and exhibits poor hygiene E. The client who reports no significant impairment in their social life, job, or other functioning due to worry and anxiety
A. The client who reports excessive anxiety and worry about their job, relationship, and finances for the past 6 months C. The client who has difficulty concentrating, sleep disturbances, and muscle tension D. The client who finds it hard to control worry and exhibits poor hygiene
The nurse is performing a physical examination on a patient diagnosed with obsessive-compulsive disorder (OCD). Which finding should alert the nurse that the patient is washing the hands excessively? A. The hands are cracking or bleeding. B. The patient is wearing gloves to avoid contaminants. C. The hands are discolored. D. The patient is complaining of numbness in the fingers.
A. The hands are cracking or bleeding.
The nurse is evaluating the treatment plan for a patient with obsessive-compulsive disorder (OCD). Which patient action demonstrates successful response to nursing care? A. The patient verbalizes increased social interaction and a decrease in missed events. B. The patient understands their reactions to environmental triggers. C. The patient understands that complete healing from OCD will occur within 6 months. D. The patient describes normal roles that they are not performing because of the disorder.
A. The patient verbalizes increased social interaction and a decrease in missed events.
The nurse is counseling a college student who indicates that they are feeling constantly stressed. Which information provided by the student should indicate a possible biogenic source of stress? A. The student drinks several cups of coffee throughout the day to stay alert. B. Final exams week has just begun, and the student must pass the exams to be successful this semester. C. The student has recently suffered a severe foot strain while running, limiting the ability to exercise. D. The student is currently eating more than normal, which they have done throughout their life when feeling stressed.
A. The student drinks several cups of coffee throughout the day to stay alert.
The nurse therapist is assessing an older adult. The client and the nurse are from different cultures. Which factor could complicate the nurse's assessment of the client? (Select all that apply.) A. The client's cognitive changes B. The client's age difference from the therapist C. The client's physical illness D. The client's normal, healthy cultural response E. The client's work experience
A. The client's cognitive changes C. The client's physical illness D. The client's normal, healthy cultural response
A patient is diagnosed with obsessive-compulsive disorder (OCD). Which item in the patient's health history would most likely have increased the risk for developing OCD? A. Tragic motor vehicle crash during childhood B. Paternal history of coronary artery disease (CAD) C. Maternal history of depression D. Human papillomavirus (HPV) immunization as an adolescent
A. Tragic motor vehicle crash during childhood
The home care nurse is following up on a client who experienced a significant crisis a few weeks prior. Which finding is most concerning to the nurse? A. Unwashed hair B. Dishes in the sink C. Newspapers stacked up D. Disheveled clothes
A. Unwashed hair
The nurse is teaching the family of a 6-year-old female patient who was recently diagnosed with obsessive-compulsive disorder (OCD). Which point should the nurse emphasize to the family? A. Up to 40% of children with OCD experience remission by early adulthood. B. OCD affects females more than males. C. Females tend to develop OCD earlier than males. D. OCD typically begins in early childhood.
A. Up to 40% of children with OCD experience remission by early adulthood.
The nurse is planning home care for a client with panic disorder. Which intervention should the nurse include in this client's plan of care? (Select all that apply.) A. Use of transcendental meditation B. Participation in cognitive-behavioral therapy C. Isolation at home in a quiet room D. Participation in massage and yoga E. Use of antianxiety medications as prescribed
A. Use of transcendental meditation B. Participation in cognitive-behavioral therapy D. Participation in massage and yoga E. Use of antianxiety medications as prescribed
Which manifestation should the nurse relate to anxiety in an adolescent? (Select all that apply.) A. Wants to be alone B. Sleeps more than usual C. Exhibits muscle tension D. Needs to urinate frequently E. Startles easily
A. Wants to be alone B. Sleeps more than usual D. Needs to urinate frequently E. Startles easily
The nurse is teaching a client who is experiencing anxiety about possible medications that can be used to manage the symptoms of anxiety. Which medication should the nurse discuss with the client? (Select all that apply.) A.Antipsychotic B. Benzodiazepine C. Beta blocker D. Cortisol E. Antidepressant
A.Antipsychotic B. Benzodiazepine C. Beta blocker E. Antidepressant
A patient has been prescribed a selective serotonin reuptake inhibitor (SSRI) for a recent diagnosis of obsessive-compulsive disorder (OCD). The patient asks the nurse why they are being prescribed an antidepressant. Which statement by the nurse provides an accurate response? A. "SSRIs don't directly address the OCD. It deals with the depression that underlies OCD behavior." B. "Antidepressants have been found to be effective for disorders such as OCD as well." C. "As is often the case, it's the unintended effects of SSRIs that address OCD behaviors." D. "SSRIs potentiate the effect of the naturally occurring inhibitory neurotransmitter GABA, promoting relaxation."
B. "Antidepressants have been found to be effective for disorders such as OCD as well."
An older adult client is asking the healthcare provider for a medication to deal with the anxiety they are feeling due to the recent deaths of two very close friends. They indicate that they used a benzodiazepine when they were younger and it worked fairly well. Which response by the nurse should address the client's request? A. "What dose of the medication did you take when you were younger, and how long did you take the medication?" B. "Benzodiazepines can cause a decrease in cognition, so we need to avoid the use of these medications if possible." C. "Thank you for letting me know. I will see if the provider wants to prescribe a benzodiazepine." D. "A benzodiazepine is a good choice when you are older, so I'll try to get that prescribed for you."
B. "Benzodiazepines can cause a decrease in cognition, so we need to avoid the use of these medications if possible."
The nurse is speaking with the unit director concerning the unit's requirement of obtaining some type of professional certification to maintain employment. Which statement by the nurse indicates a primary appraisal of this requirement? A. "While this is stressful to me, I think I can find one that will fit my experience and it will not be as difficult as I imagined." B. "I am very stressed by this requirement. Why do we have to obtain a certification?" C. "I do not agree with this requirement, but once I complete it, at least it will alleviate my current stress." D. "Can you help me to find some possible options that may be a good fit for me to meet this requirement?"
B. "I am very stressed by this requirement. Why do we have to obtain a certification?"
The nurse teaches the family of a child recently diagnosed with obsessive-compulsive disorder (OCD) what to expect from their child. Which statement by the parent indicates effective teaching? A. "I will interrupt my son's counting every morning." B. "I shouldn't accommodate or reinforce his OCD behavior." C. "My son will never get better." D. "My son only needs to take his medication and then his symptoms will disappear."
B. "I shouldn't accommodate or reinforce his OCD behavior."
The nurse working in a disaster relief center learns that a victim lost their vehicle in a flood. Which statement should the nurse make at this time? A. "It could have been worse." B. "I'm sorry this happened to you. Is there someone I can call for you?" C. "I know just how you feel." D. "You can always get another car."
B. "I'm sorry this happened to you. Is there someone I can call for you?"
A patient who experienced an emotional trauma is being assessed for stomach pain. Which question should the nurse ask first? A. "Have you been seeing a counselor?" B. "On a scale of 1 to 10, how would you rate your pain?" C. "Do you want to talk about the trauma you experienced?" D. "Are you currently taking any medications?"
B. "On a scale of 1 to 10, how would you rate your pain?"
The nurse is describing obsessive-compulsive disorder (OCD) and cultural differences to a community support group. Which statement should the nurse include? (Select all that apply.) A. "Members of minority groups are more likely to receive treatment for OCD." B. "The majority of clinical studies on OCD show that the majority of studies focus on Caucasian Americans." C. "The prevalence rate and many manifestations of OCD in many populations are similar to those experienced by Caucasian Americans." D. "African Americans and Hispanics are underrepresented in many clinical studies on OCD." E. "Religious differences do not play a role in development of OCD."
B. "The majority of clinical studies on OCD show that the majority of studies focus on Caucasian Americans." C. "The prevalence rate and many manifestations of OCD in many populations are similar to those experienced by Caucasian Americans." D. "African Americans and Hispanics are underrepresented in many clinical studies on OCD."
A patient was prescribed the selective serotonin reuptake inhibitor (SSRI) sertraline (Zoloft) for treatment of obsessive-compulsive disorder (OCD). When should the nurse expect to gradually taper the patient while observing for symptom exacerbation? A. 24-36 months B. 12-24 months C. 6-12 months D. 3-6 months
B. 12-24 months
The nurse assessing a family at a disaster relief center observes that the child is verbally unresponsive and is sucking their thumb. Which intervention by the nurse is the most appropriate? A. Reassure the child that everything will be okay. B. Ask the parents about the observed behavior of the child. C. Ignore the child's behavior. D. Refer the child for a mental health assessment.
B. Ask the parents about the observed behavior of the child.
Which medication should the nurse expect to be ordered to treat clients with anxiety? (Select all that apply.) A. Calcium channel blockers B. Beta blockers C. Antipsychotics D. Antidepressants E. Benzodiazepines
B. Beta blockers C. Antipsychotics D. Antidepressants E. Benzodiazepines
The nurse is teaching colleagues about obsessive-compulsive disorder (OCD). Which statement should the nurse include? A. Diagnosis of OCD is relatively easy. B. Children who have had a streptococcal infection may be at risk of developing the disorder. C. Signs and symptoms of OCD occur in older adults. D. Brain imaging in patients with OCD is normal.
B. Children who have had a streptococcal infection may be at risk of developing the disorder.
The nurse works in a crisis center several days a week. Which resource should the nurse use to find emergency housing for a homeless client? A. Health and Human Services B. Community agency C. Healthcare provider D. Family member
B. Community agency
The nurse working at a dementia unit is assessing an older adult client for obsessive-compulsive disorder (OCD). Which factor warrants further evaluation? A. Is demanding of healthcare assistants B. Constantly complains about general aches and pains C. Has several other medical conditions D. Recently lost a spouse
B. Constantly complains about general aches and pains
After implementing the ABCs of crisis counseling for a patient who experienced trauma, the healthcare team is preparing to discharge the patient home. Based on the plan for discharge, which stage of the ABCs of crisis counseling have been completed by the patient? A. Achieve rapport. B. Cope with the problem. C. Boil down the problem. D. Conclude treatment
B. Cope with the problem.
A psychotherapist is attempting to increase social interaction for a client with obsessive-compulsive disorder (OCD) who performs so many rituals that they are unable to attend any function with friends. Which strategy should the nurse suggest to the client to support the effort? (Select all that apply.) A. Teach the client to skip the rituals so that social interaction can occur. B. Devise a time schedule that allows for the ritual to be completed prior to a social event. C. Inform the client to take medication doses early to avoid the need for the ritual. D. Suggest inviting friends to a therapy session. E. Encourage the client to discuss their anxiety with friends and family.
B. Devise a time schedule that allows for the ritual to be completed prior to a social event. D. Suggest inviting friends to a therapy session. E. Encourage the client to discuss their anxiety with friends and family.
The nurse is caring for an American Indian patient who refuses analgesics for pain. Which action by the nurse is the most appropriate? A. Inform the patient the medication is a standard treatment. B. Encourage the patient to discuss their approach to pain. C. Discuss the effects the analgesic will have on the patient. D. Assess the mental status of the patient.
B. Encourage the patient to discuss their approach to pain.
The nurse is using the ABCs of crisis counseling while working with a family affected by a disaster. Which nursing intervention is part of the "C" stage? A. Establishing therapeutic communication B. Establishing short- and long-term coping mechanisms C. Developing a plan of care D. Providing validation
B. Establishing short- and long-term coping mechanisms
The nurse is caring for a client with obsessive-compulsive disorder (OCD). Which clinical manifestation would the nurse expect to see in this client? (Select all that apply.) A. Happy and overly excited affect B. Fear of contamination from touching others C. Signs of fear and increased anxiety D. Repetitive actions or motions E. Thoughts that may be considered taboo
B. Fear of contamination from touching others C. Signs of fear and increased anxiety D. Repetitive actions or motions E. Thoughts that may be considered taboo
The nurse is attempting to build a therapeutic relationship with a patient diagnosed with obsessive-compulsive disorder (OCD). Which point should the nurse emphasize to lower the patient's feelings of shame and anxiety? A. Perform ritualistic behavior unless something bad happens. B. Fears are stemming from the disease. C. Take medications appropriately and as prescribed. D. Actions are appropriate in response to a real threat.
B. Fears are stemming from the disease.
The nurse working at the scene of a disaster observes a victim pacing, breathing rapidly, and continuously looking around. Which should the nurse conclude the victim is experiencing at this time? A. Confusion B. Fight-or-flight response C. Disorientation D. Vulnerability
B. Fight-or-flight response
The nurse is attempting to promote effective role performance with a patient with obsessive-compulsive disorder (OCD). Which nursing intervention may help the patient discover why they feel compelled to perform compulsive behaviors? A. Encouraging the patient to have healthy conversations with family members about the disorder B. Having the patient describe normal roles that the patient is not performing because of the disorder C. Providing references to therapists or counselors who specialize in the treatment of OCD D. Providing a calm presence for the patient that will encourage the patient to verbalize fears
B. Having the patient describe normal roles that the patient is not performing because of the disorder
The nurse is preparing a teaching material for parents regarding symptoms of anxiety in children and adolescents. Which symptom, common to both age groups, should the nurse include? (Select all that apply.) A. Frequent need to urinate B. Headaches and body aches C. Shyness D. Excessive worrying E. Muscle tension F. Stomachaches
B. Headaches and body aches D. Excessive worrying E. Muscle tension F. Stomachaches
The nurse notes that a malfunction in the cortico-striato-thalamo-cortical (CSTC) circuit in the brain is a possible cause for obsessive-compulsive disorder (OCD). Which body system plays an important role according to studies of OCD's pathogenesis? A. Endocrine system B. Immune system C. Nervous system D. Limbic system
B. Immune system
The nurse is providing care to a client with obsessive-compulsive disorder (OCD). Which intervention is appropriate? (Select all that apply.) A. Establishing a loud and fun environment for the client. B. Including time in the daily routine to perform the ritual. C. Encouraging the client to verbalize feelings. D. Interrupting the ritual, using distraction. E. Assisting the client with developing new coping mechanisms.
B. Including time in the daily routine to perform the ritual. C. Encouraging the client to verbalize feelings. E. Assisting the client with developing new coping mechanisms.
The family of an older adult with Parkinson disease asks the nurse for herbal medications as a therapy for anxiety management. Which herbal product should the nurse mention is contraindicated for this client? A. Chrysanthemum tea B. Kava supplements C. Lavender tea D. Chamomile tea
B. Kava supplements
When conducting the physical examination of an adolescent client with symptoms of anxiety, the nurse should review the client's history for which condition? (Select all that apply.) A. Popular at school B. Language delay C. Family history of anxiety D. Developmental condition E. Depression
B. Language delay C. Family history of anxiety D. Developmental condition E. Depression
The nurse understands that clients with anxiety have which response that is caused in the brain due to oxidative stress (OS)? A. Dopamine increase B. Neuroinflammation C. Neurocompression D. Dopamine decrease
B. Neuroinflammation
The nurse is caring for an older adult patient who is exhibiting behaviors associated with obsessive-compulsive disorder (OCD). For which reason should the nurse expect the patient to undergo a thorough psychiatric assessment? A. This patient may require inpatient treatment. B. OCD is often comorbid with other mental disorders. C. OCD is uncommon in older adults. D. This patient could potentially harm self.
B. OCD is often comorbid with other mental disorders.
The nurse is caring for a client who has demonstrated a great deal of resilience during adversity. Which factor is most strongly associated with an individual's resilience? A. Biological determinants B. Optimistic sense of self-efficacy C. Emotional state D. Psychologic factor
B. Optimistic sense of self-efficacy
A client is undergoing exposure and response prevention (ERP) therapy for obsessive-compulsive disorder (OCD). Which would be appropriate as part of this therapy? A. Removing and hiding any objects that may trigger anxiety B. Playing with a dog for 5 minutes a day and increasing exposure each week C. Allowing verbalization of feelings in a group setting D. Stopping a ritual when in progress
B. Playing with a dog for 5 minutes a day and increasing exposure each week
The prenatal nurse is completing an assessment on a client who is currently at 20 weeks of gestation. The client indicates that she is struggling with an overwhelming sense of anxiety and fears that she is becoming depressed. Prior to becoming pregnant, the client had been taking a selective serotonin reuptake inhibitor (SSRI) but stopped the medication due to the pregnancy. Which intervention should the nurse suggest initially to help the client deal with the anxiety? A. Asking the healthcare provider to prescribe another SSRI that has been found not to increase the risk of birth defects B. Recommending cognitive-behavioral therapy C. Encouraging the client to find a good support system that can help her manage the anxiety D. Asking the healthcare provider about resuming the SSRI but at a lower dose
B. Recommending cognitive-behavioral therapy
A patient with obsessive-compulsive disorder (OCD) requires hospitalization for the treatment of the disorder. Which action should the nurse implement to alleviate the anxiety associated with this situation? A. Encourage the patient to participate in individual or family behavioral therapy or counseling. B. Remove triggers associated with the patient's obsession or compulsion. C. Encourage the patient to have health conversations with family members. D. Validate the patient's feelings without encouraging the patient's belief in a distorted reality.
B. Remove triggers associated with the patient's obsession or compulsion.
The nurse is caring for a patient who has experienced a natural disaster. The patient states, "I have been through tough times before and I will get through this." Which response to adversity should the nurse identify the patient is exhibiting? A. Denial B. Resilience C. Rationalization D. Sublimation
B. Resilience
A client is discussing recent difficulties with mild anxiety due to stress at work. They ask the nurse about ways that they can manage the anxiety, because they really do not want to take medication. Which intervention should the nurse include? (Select all that apply.) A. Speaking slowly and using a low-pitched voice with the client B. Teaching the client how to differentiate between different levels of stress C. Encouraging the client to use self-management and diversion techniques to cope with stress D. Instructing the client to reduce environmental stimuli E. Teaching the client how to recognize stress triggers
B. Teaching the client how to differentiate between different levels of stress C. Encouraging the client to use self-management and diversion techniques to cope with stress E. Teaching the client how to recognize stress triggers
The nurse is evaluating care provided to a client after experiencing a crisis. Which outcome is most reflective of the client's ability to effectively cope? A. The client has identified and removed risk factors for injury in the environment. B. The client expresses a gained sense of control over the crisis. C. The client maintains proper hygiene, nutrition, hydration, and other self-care tasks. D. The client reports feeling less anxiety after the crisis.
B. The client expresses a gained sense of control over the crisis.
The nurse is completing a chart audit for a patient hospitalized for treatment of a panic disorder. Which documentation in the patient's chart should meet the criteria for this anxiety disorder diagnosis? A. The patient discussed recent trouble concentrating, difficulty falling asleep, and difficulty relaxing during group therapy. B. The patient reports that the most recent panic attack was approximately 1 month ago, and they are very concerned that another may occur soon. C. The therapist reports that the patient indicated that they have been experiencing excessive anxiety about everyday problems for the last year. D. The patient indicated to a staff nurse that the panic attacks generally occur after use of recreational marijuana.
B. The patient reports that the most recent panic attack was approximately 1 month ago, and they are very concerned that another may occur soon.
The nurse is caring for a client in the clinic who has experienced exposure to trauma. Which describes the expected duration of the clinical manifestations of a crisis resulting from trauma? A. Consistent among different clients B. Usually time limited C. No time limit D. Should be resolved by 6 months
B. Usually time limited
The nurse is caring for a patient with obsessive-compulsive disorder (OCD) who is not responding to treatment with selective serotonin reuptake inhibitors (SSRIs). Which medication should the nurse expect to be ordered that may be helpful in treating this patient? A. sertraline (Zoloft) B. risperidone (Risperdal) C. paroxetine (Paxil) D. fluoxetine (Prozac)
B. risperidone (Risperdal)
The nurse teaches a client about medications used in the treatment of obsessive-compulsive disorder (OCD). Which client statement indicates appropriate understanding of the teaching session? A. "I will have to take medication for the rest of my life." B. "I may only have to take medication for 1-2 years and gradually be weaned off." C. "There are no side effects associated with this medication." D. "Medications are not effective in the treatment of OCD."
B. "I may only have to take medication for 1-2 years and gradually be weaned off."
A patient calls the crisis line asking for help because of "losing everything" after a disaster. Which question should the nurse make a priority? A. "Can you tell me about the event that you experienced?" B. "Do you feel able to care for yourself?" C. "Are you in a safe place?" D. "Do you have access to food?"
C. "Are you in a safe place?"
The nurse is providing care for a client who has been sexually assaulted. Which question will the nurse ask to determine the client's social support system? (Select all that apply.) A. "Do you have a best friend?" B. "Do your parents live nearby?" C. "Do you have someone you would like to stay with?" D. "Who do you know that you feel would be most helpful to you now?" E. "Is there someone you would like me to call?"
C. "Do you have someone you would like to stay with?" E. "Is there someone you would like me to call?"
The parent of a young child shares with the nurse that the child refuses to play outside, go to parks, or participate in family gatherings where a dog may be present for fear of getting bitten. Which question should the nurse ask to determine if this behavior meets the DSM-5 criteria for phobias? A. "Is your child frightened of all dogs?" B. "Does your child worry constantly about possibly encountering a dog?" C. "How long has your child been exhibiting this phobia?" D. "Does your child have a panic attack if a dog is nearby?"
C. "How long has your child been exhibiting this phobia?"
A parent tells the nurse that their child is very shy and asks if this will create problems for the child. How should the nurse respond to the parent's question? A. "Most children are shy at this age. I wouldn't be concerned about it." B. "You say that your child is shy. Can you tell me why you think that?" C. "Shyness can increase the risk for an anxiety disorder." D. "Shyness will resolve once your child settles in at school."
C. "Shyness can increase the risk for an anxiety disorder."
A client who has been diagnosed with obsessive-compulsive disorder (OCD) asks the nurse, "What is causing me to be this way?" Which response from the nurse is accurate? A. "The onset of OCD has been linked to childhood immunizations." B. "OCD is thought to be caused by damage to your brain during your mother's delivery." C. "The exact cause is unknown but it is thought to be a problem with the way impulses are transmitted in your brain." D. "It is caused by ingestion of food preservatives throughout your lifetime."
C. "The exact cause is unknown but it is thought to be a problem with the way impulses are transmitted in your brain."
The nurse is teaching a client who is diagnosed with obsessive-compulsive disorder (OCD) about medication therapy. Which statement should the nurse include? A. "If you take these medications, you will not have to meet with a psychologist." B. "You will definitely need to take these medications for the rest of your life." C. "The medication will be continued for 1-2 years before we check to see if the OCD is resolved." D. "The medications have no side effects, so you don't have to worry about that."
C. "The medication will be continued for 1-2 years before we check to see if the OCD is resolved."
A child is newly diagnosed with obsessive-compulsive disorder (OCD). Which precipitating factor may be related? A. A diagnosis of diabetes B. A failing test grade C. A recent strep throat infection D. Treatment for attention-deficit/hyperactivity disorder (ADHD)
C. A recent strep throat infection
The home care nurse is visiting a 78-year-old patient who reports problems with severe anxiety and who is currently taking an antidepressant. The patient asks the nurse, "I'm not happy. Is there anything I can do to feel better?" Which approach should the nurse discuss that could improve the patient's chances of successful coping? A. Changing to another antidepressant medication B. Substituting psychotherapy for the patient's current antidepressant C. Adding psychotherapy to pharmacologic therapy D. Adding another medication to maximize the medication effect
C. Adding psychotherapy to pharmacologic therapy
The nurse is working with a client who is having a panic attack. The client has been pacing back and forth in the back hallway for the past 45 minutes. How should the nurse immediately respond to this behavior? A. Attempting to divert the client with another type of activity B. Contacting the unit counselor to meet with the client immediately to discuss the cause of the panic C. Allowing the client to pace to help diffuse energy D. Administering anxiolytics as prescribed
C. Allowing the client to pace to help diffuse energy
A patient who was diagnosed with obsessive-compulsive disorder (OCD) has not responded well to the selective serotonin reuptake inhibitor (SSRI) prescribed. Which class of medication should the nurse expect the healthcare provider to order? A. Nonbenzodiazepine B. Benzodiazepine C. Antipsychotic D. Beta blocker
C. Antipsychotic
The nurse is caring for a patient who has experienced a crisis. Which intervention should the nurse incorporate into the plan of care to monitor the patient for self-neglect? A. Provide written instructions related to prescribed treatments. B. Assist the patient in identifying small tasks they can accomplish. C. Assess the patient's nutritional status. D. Contact a community resource to assist the patient in gaining independence.
C. Assess the patient's nutritional status.
After experiencing a natural disaster, a patient believes the event was punishment from God. Which member of the crisis team should the nurse consult? A. Healthcare provider B. Family therapist C. Chaplain D. Grief counselor
C. Chaplain
The nurse is conducting a nursing assessment for a patient diagnosed with obsessive-compulsive disorder (OCD). Which finding is indicative of the repetitive acts associated with OCD? A. Poor posture and altered motor skills B. Underweight and appears older than stated age C. Constant hand washing D. Poor grooming and stained clothing
C. Constant hand washing
The nurse receives a report on a client with severe obsessive-compulsive disorder (OCD) who is triggered by fear of germs. Which teaching should the nurse include in this client's plan of care? (Select all that apply.) A. Validating client's concern by providing statistics on secondary inpatient infections B. Implementing full protective personal equipment for all who enter the room to decrease fear C. Explaining the strategies that are implemented in the hospital setting to decrease germ exposure D. Sharing client's concern with all involved team members E. Allowing client to view healthcare workers performing hand hygiene prior to entering room
C. Explaining the strategies that are implemented in the hospital setting to decrease germ exposure D. Sharing client's concern with all involved team members E. Allowing client to view healthcare workers performing hand hygiene prior to entering room
A patient recently diagnosed with obsessive-compulsive disorder (OCD) requires cognitive-behavioral therapy (CBT). Because it has evidentiary support, which type of cognitive-behavioral therapy (CBT) should the nurse expect the patient to receive? A. Interpersonal therapy B. Eye movement desensitization and reprocessing therapy C. Exposure and response prevention D. Dialectical behavior therapy
C. Exposure and response prevention
A client reports a series of stressful events. They also report that they feel very hopeless and empty, are having difficulty solving even minor problems, and are fantasizing about what it would be like if all of these things had not happened. Which of these indicators of stress should be considered psychologic indicators? (Select all that apply.) A. Difficulty solving minor problems B. Fantasizing C. Feeling empty D. Hopelessness E. Helplessness
C. Feeling empty D. Hopelessness E. Helplessness
A client contacts the nurse asking to see the healthcare provider due to fears that they have "something terribly wrong." This client frequently professes the same fear that something is wrong in one body system or another, and has had multiple types of diagnostic testing over the years, which has not identified any medical issue. The client also reports vague symptoms such as difficulty sleeping, headache, muscle tension, feeling out of breath, and digestive issues. Which anxiety disorder should the nurse most likely expect that the client is experiencing? A. Panic disorder B. Phobias C. Generalized anxiety disorder D. Obsessive-compulsive disorder
C. Generalized anxiety disorder
The nurse is caring for an adolescent patient who expresses suicidal feelings related to confusion about their gender identity. Which type of crisis is the patient experiencing? A. Coping B. Biogenic C. Maturational D. Situational
C. Maturational
The nurse decides that they need to advocate for more mental health services for the homeless population. Which national organization should be most helpful to the nurse? A. Centers for Disease Control and Prevention (CDC) B. National Coalition for the Homeless C. National Alliance for the Mentally Ill (NAMI) D. National Alliance to End Homelessness
C. National Alliance for the Mentally Ill (NAMI)
The parents of a patient with agoraphobia have accompanied the patient to family therapy. Now the nurse therapist wants to recommend an outside organization that they can all join to get more support. Which is the most relevant resource for the nurse to recommend? A. National Institute of Mental Health (NIMH) B. American Association of Retired Persons (AARP) C. National Alliance on Mental Illness (NAMI) D. Alcoholics Anonymous (AA)
C. National Alliance on Mental Illness (NAMI)
A patient reports, "I can't get myself out of the house. I touch the door, and then I have to go wash my hands. Then I touch the door again, and I have to go back and wash my hands again." The nurse recognizes that this patient is experiencing symptoms associated with which anxiety disorder? A. Panic disorder B. Generalized anxiety disorder (GAD) C. Obsessive-compulsive disorder D. Posttraumatic stress disorder (PTSD)
C. Obsessive-compulsive disorder
A client who experienced a traumatic event continues to demonstrate difficulty with general problem solving. Which nursing intervention is most appropriate? A. Request pharmacologic intervention. B. Encourage group therapy. C. Obtain a mental health consult. D. Request extended hospitalization.
C. Obtain a mental health consult.
The nurse is caring for a client at risk for self-harm. Which nursing intervention is a priority? A. Isolate the client from other individuals. B. Inform the client that restraints will be used if necessary. C. Require that the client remain visible by the nurse's station. D. Monitor the client for ongoing threats.
C. Require that the client remain visible by the nurse's station.
At an inpatient facility, a patient with obsessive-compulsive disorder (OCD) counts the number of tiles on the floor each morning before going for breakfast. This ritual takes 30 minutes and the patient always misses breakfast. Which intervention by the nurse can assist the patient in arriving for breakfast prior to the meal ending? A. Cancel breakfast and make the patient wait until lunch to eat. B. Interrupt the patient's ritual and demand that the patient go for breakfast immediately. C. Teach time management techniques. D. Escort the patient to the dining area and place in restraints.
C. Teach time management techniques.
The nurse provides interventions to address a patient's anxiety after experiencing a house fire. Which finding should indicate to the nurse that care has been effective? A. The patient verbalizes awareness of effective coping strategies. B. The patient requests assistance from staff when necessary. C. The patient reports a reduction in stressful feelings. D. The patient remains free from injury or self-harm.
C. The patient reports a reduction in stressful feelings.
After a building collapse, a displaced resident expresses the desire to be left alone when asked about food and shelter. Which assessment should the nurse make about this person's response? A. The resident needs a mental health assessment. B. The resident does not need assistance. C. The statement is reflective of a coping pattern. D. The resident has an unpleasant personality.
C. The statement is reflective of a coping pattern.
Which statement by the nurse is most appropriate in regard to the etiology of obsessive-compulsive disorder (OCD)? A. Manifestations of OCD occur only in children. B. Children have a low chance of experiencing a remission of the disease. C. Typically begins in adolescence or early adulthood. D. Females are affected more than males.
C. Typically begins in adolescence or early adulthood.
A patient who is diagnosed with panic disorder has been placed on an atypical antipsychotic medication. The patient questions the prescription, saying, "I don't have hallucinations. Why did you put me on this drug?" Which reply by the nurse is accurate? A. "Atypical antipsychotics act as a dopamine agonist in the brain and inhibit serotonin reuptake, producing an antianxiety effect." B. "Atypical antipsychotics potentiate the effect of the neurotransmitter GABA, leading to promotion of relaxation." C. "Atypical antipsychotics selectively reduce effects of sympathetic nervous system stimulation." D. "Atypical antipsychotics promote reduction of compulsive behaviors and decrease agitation."
D. "Atypical antipsychotics promote reduction of compulsive behaviors and decrease agitation."
A client with obsessive-compulsive disorder (OCD) tells the nurses about checking the lock 10 times before leaving the house in the morning for work. The client's mother does not understand the reason for her son's behavior. Which statement from the nurse explains the rationale for this behavior? A. "He feels the need to check the safety of the home." B. "He thinks this behavior pleases you." C. "This activity brings him pleasure." D. "He does this to help with anxiety."
D. "He does this to help with anxiety"
The nurse is working with a patient who has recently been experiencing high levels of stress due to suspected drug use issues with their teenage daughter. Which statement by the patient should indicate to the nurse that they may be using the defense mechanism of projection? A. "My husband and I have been constantly fighting about this. I don't think he takes it seriously." B. "I know everyone thinks she is using drugs, but I know she isn't. It upsets me that people think she is doing drugs." C. "While I don't like it, it's just marijuana. It's not like she's abusing the hard stuff." D. "I know she wouldn't do drugs if her friends didn't encourage her to do so."
D. "I know she wouldn't do drugs if her friends didn't encourage her to do so."
The nurse is caring for a child who is displaced after their home caught fire. The parent states to the nurse, "I am concerned that my child has begun wetting the bed." Which is the most appropriate response by the nurse? A. "Bedwetting often occurs after trauma." B. "There is no need to worry; the issue will resolve itself." C. "Keep reassuring your child that they are safe and the bedwetting will eventually stop." D. "I will speak with the healthcare provider regarding this issue."
D. "I will speak with the healthcare provider regarding this issue."
A patient asks the nurse how cognitive-behavioral therapy will help to manage obsessive-compulsive disorder. Which is the most appropriate response from the nurse? A. "It will make you feel shameful, and therefore the behaviors will stop." B. "It will help you change your belief system." C. "It will teach you ways to increase your self-esteem." D. "It teaches techniques that will help you cope with anxiety."
D. "It teaches techniques that will help you cope with anxiety."
The nurse is presenting to colleagues about patients with obsessive-compulsive disorder (OCD) and asks the attendees to identify the treatment options. Which response by a colleague indicates the need for further teaching? A. "Try cognitive-behavioral therapy." B. "Take tricyclic antidepressants." C. "Use brain stimulation therapy." D. "Take benzodiazepines."
D. "Take benzodiazepines."
Which client should the nurse consider to be at highest risk for developing obsessive-compulsive disorder (OCD)? A. A client with a history of childhood obesity B. A student with poor school performance C. A spouse with OCD D. A client with a history of sexual assault
D. A client with a history of sexual assault
A 13-year-old client presents for a routine physical and refuses to change into a gown. The nurse notices vertical scars when pulling up the client's sleeve to take the blood pressure. The nurse should consider that the client is experiencing which condition? (Select all that apply.) A. Insomnia B. Irritability C. Anoxia D. Anxiety E. Stress
D. Anxiety E. Stress
The school nurse is especially concerned about a specific first-grade student. Which personality-related characteristic should the nurse identify as increasing the risk for development of an anxiety disorder? A. Being short B. Being overweight C. Being nearsighted D. Being shy
D. Being shy
A client who was laid off from work experiences anxiety about providing for his family's needs. Which action should the nurse take? A. Refer the client to the local food bank. B. Obtain a referral for crisis counseling. C. Request a prescription treat the client's anxiety. D. Contact social services.
D. Contact social services.
The nurse is evaluating a client who has been treated for obsessive-compulsive disorder (OCD). Which outcome would indicate the treatment is successful? A. States that the client applies lotion frequently to hands to treat skin irritation. B. States that no coworkers suspect that the client has OCD. C. Performs the same ritual with the same frequency but states that it is not interfering with life. D. Demonstrates an ability to effectively perform expected family functions.
D. Demonstrates an ability to effectively perform expected family functions.
The nurse is reviewing the chart of a patient who has a history of physical trauma. Which clinical manifestation should the nurse anticipate observing in the patient? A. Decreased awareness of surroundings B. Resistance C. Muted emotional reactions D. Difficulty problem solving
D. Difficulty problem solving
The nurse working at the disaster recovery site is approached by a woman who states, "I was just told my husband was in an accident. What happened to him?" The nurse knows that the patient's husband was seriously injured. Which is the nurse's priority action? A. Tell her that the information is confidential and cannot be released. B. Inform her that her husband was seriously injured. C. Inform her that someone will contact her. D. Escort the woman to a private area to talk.
D. Escort the woman to a private area to talk.
The nurse is obtaining a medical history on a patient with obsessive-compulsive disorder (OCD). Which repetitive behavior should the nurse be aware of that is associated with OCD but is a distinct and separate disorder? A. Checking B. Hand washing C. Ordering D. Hoarding
D. Hoarding
The nurse presents information about the "fear worry center" in the brain. Which information should the nurse include about how the fear center affects the risk for anxiety disorders? A. Oxygenation decreases the risk of anxiety disorders. B. Hormone secretion blocks the risk of anxiety disorders. C. Perfusion balances the risk of anxiety disorders. D. Hypersensitivity increases the risk of anxiety disorders.
D. Hypersensitivity increases the risk of anxiety disorders.
Which statement demonstrates an understanding of Maslow's hierarchy of needs, when a client prioritizes a choice to react to a stressor? A. Everyone chooses to satisfy basic requirements first. B. Coping with stressors is a part of safety needs. C. Self-esteem is the most important level of need. D. Individuals might have their own priorities.
D. Individuals might have their own priorities.
The nurse has completed an admission history for a patient with an anxiety disorder. According to DSM-5, the patient should be classified as having a generalized anxiety disorder based on which criterion? A. Recurrent unexpected panic attacks B. Anxiety about a stressor that is out of proportion to the actual threat or stressor C. Intense, persistent, irrational fear of a situation that compels avoidance of the stressor D. Intense tension and worry, even in absence of external stressors
D. Intense tension and worry, even in absence of external stressors
The nurse understands that which item describes how psychotherapy is effective at treating a client with an anxiety disorder? A. It teaches yoga for relaxation. B. It prescribes medication. C. It talks about improved fitness. D. It uncovers triggers.
D. It uncovers triggers.
The family of a client share with the nurse that the client has always been a hoarder, but since their father died, the behavior has now gotten to the point where the home is no longer safe. Which classification of disorders related to stress and coping does the client's behavior fit? A. Trauma- and stressor-related disorders B. Depression and depression-related disorders C. Anxiety disorders D. Obsessive-compulsive and related disorders
D. Obsessive-compulsive and related disorders
A client has a tendency to develop anxiety when giving a presentation at work. The client reports developing muscle tension, headaches, and occasional palpitations. Which coping strategy should the nurse recommend as the most effective for immediate stress reduction? A. Engaging in daily yoga therapy B. Performing progressive relaxation technique C. Using herbal therapy, including valerian D. Participating in deep-breathing exercises before the anticipated event
D. Participating in deep-breathing exercises before the anticipated event
The nurse is caring for a client experiencing acute confusion after a traumatic event. Which intervention should the nurse include in the plan of care? A. Provide the client written information about their medical status. B. Ensure the client is eating and drinking. C. Provide the client with simple tasks to perform. D. Repeat information in a calm manner.
D. Repeat information in a calm manner.
A client has presented to the healthcare provider with symptoms of hypertension. The client tells the nurse that for the past year they have been dealing with the legal ramifications of an accident that they caused while under the influence of alcohol. According to Selye's general adaptation syndrome (GAS), the client is in which stage of adaptation? A. Alarm B. Homeostasis C. Exhaustion D. Resistance
D. Resistance
The nurse is caring for a client admitted to the unit with severe depression. The client states, "My husband left me, and I feel lost." Based on the client's statement, which type of crisis is the client experiencing? A. Developmental B. Maturational C. Social D. Situational
D. Situational
A client diagnosed with obsessive-compulsive disorder (OCD) tells the nurse about having feelings of apprehension that are alleviated through frequent hand washing. The client's hands are red and swollen, and the nurse notes several areas of excoriation. Which nursing diagnosis is the priority for this client? A. Sleep Pattern, Disturbed B. Coping, Ineffective C. Anxiety D. Skin Integrity, Impaired
D. Skin Integrity, Impaired
The community nurse learns of a family who has moved into a homeless shelter. Which referral should the nurse make first? A. Primary healthcare provider B. Mental health services C. Clergyperson D. Social services
D. Social services
A teenage client with obsessive-compulsive disorder (OCD) washes his hands 15 times every hour. Which intervention should the nurse include in the plan of care? A. Removing all soap and hand gels from the home environment. B. Teaching to use hand gels instead of soap. C. Explaining that the behavior is unnecessary and is self-harm. D. Teaching to lubricate hands frequently.
D. Teaching to lubricate hands frequently.
During a home visit, the nurse evaluates a client recovering from generalized anxiety disorder (GAD). Which client observation indicates that additional intervention is required? A. The client walks 3 miles a day. B. The client is seeking full-time employment. C. The client takes diazepam (Valium) as prescribed. D. The client has withdrawn from cognitive-behavioral therapy (CBT).
D. The client has withdrawn from cognitive-behavioral therapy (CBT).
A college student presents to the counseling center because they are having difficulty dealing with having been informed that, due to continued poor grades, they are being dismissed from the college. Which statement by the student to the nurse counselor should indicate the use of the ego defense mechanism projection? A. "I don't think that all of the grades are accurate. If they aren't, then I can stay in school." B. "If my instructor had let me retake an exam I missed when I was sick, I wouldn't be in this situation." C. "While I'm very upset and my parents will be angry, I can just transfer to another school and still get my degree." D. "It's really not all my fault. The major I was in and the number of credit hours I was taking would be difficult for anyone to be successful."
B. "If my instructor had let me retake an exam I missed when I was sick, I wouldn't be in this situation."
A group of students who are studying for final exams are talking about ways to better deal with stressful events in life. One student suggests, "During the finals week, we should avoid biogenic stressors." How should the students follow that advice? (Select all that apply.) A. Don't stay up all night studying. B. Don't drink fluids with caffeine in them. C. Don't smoke cigarettes. D. Don't go outside into freezing temperatures. E. Don't worry about the test results.
B. Don't drink fluids with caffeine in them. C. Don't smoke cigarettes. D. Don't go outside into freezing temperatures.
A client experiencing a maturational crisis expresses the importance of prayer. Which question should the nurse ask to support the client's spiritual beliefs? A. "Do you go to church?" B. "Would you like me to notify the chaplain?" C. "Do you have a religious preference?" D. "Do you consider yourself spiritual?"
C. "Do you have a religious preference?"