Prep U Psychiatric-Anxiety and Anxiety Disorders

The nurse is assessing a client with anxiety. Which behavior might indicate that the client has moderate anxiety?

The client is nervous and agitated.

Which question in the assessment of a client with anxiety is most clinically appropriate?

"How do you feel about everything that is happening in your life right now?"

A nurse is giving a presentation on mental health promotion to college students. One student asks the nurse to explain the difference between normal anxiety and an anxiety disorder. Which response is best?

"People with anxiety disorders generally find that the anxiety interferes with daily activities."

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."

A client comes to the emergency department because the client thinks the client is having a heart attack. Further assessment determines that the client is not having a heart attack but is having a panic attack. When beginning to interview the client, which question would be most appropriate for the nurse to ask?

"What did you experience just before and during the attack?"

Anxiety disorder is considered chronic and generalized when excessive anxiety and worry about two or more life circumstances exist for at least ...

6 months

What is the term for the change that takes place in response to a stressor?

Adaptation

The most important factor in the person's stress response is what?

Adaptive coping strategies

A client is currently experiencing panic. Which acation would be most appropriate for the nurse to do?

Allow the client to pace

Panic disorder is treated with cognitive-behavioral techniques, deep breathing, and relaxation, in addition to what?

Antidepressants

Which medication classifications used in the treatment of panic disorder can cause physical dependence?

Benzodiazepines

A client spends hours stacking and unstacking towels. The client is repeatedly checking to make sure that the towels are in order of color. What term is used to identify this behavior?

Compulsion

Clients taking benzodiazepines need education about what?

Concomitant use of alcohol

In teaching a client who has been prescribed a benzodiazepine for panic disorder, the nurse must be certain to do what?

Educate the client that this medication has a high risk for withdrawal symptoms, and the client should not discontinue without a doctor's supervision.

Nursing interventions for physical stress related illness should include what?

Establishing daily routines of meals and sleeping

While conducting a class on anxiety and stress reduction, a nurse describes the symptoms of anxiety (including panic), informing the class that the physical symptoms of a panic attack can mimic what?

Heart attack

A nurse is assessing a client with anxiety. Which signs and symptoms would the nurse attribute to sympathetic nervous stimulation? Select all that apply.

Heart racing Hypertension

Which is considered a tricyclic antidepressant (TCA) used in the treatment of clients with panic disorder?

Imipramine

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

An adolescent client reveals that she is about to take a math test from her tutor. Nursing assessment reveals mild anxiety. The nurse explains that this level of anxiety does what?

Is conducive to concentration and problem solving

When assessing a client with anxiety, the nurse should recognize that anxiety may often be a result of what?

Medications

During which type of anxiety does a person's perceptual field actually increase?

Mild

Relaxation techniques help clients with anxiety disorders because they can promote what?

Reduction of autonomic arousal

A client is diagnosed with panic disorder. When considering the neurochemical theory of the disorder, which would the nurse expect to administer as the drug of choice initially?

Selective serotonin reuptake inhibitors

A client who has been diagnosed with panic disorder visits the clinic and experiences a panic attack. The client tells the nurse, "I'm so nervous. My hands are shaking, and I'm sweating. I feel as if I'm having a stroke right now." What would be the priority intervention at this time?

Stay with the client while remaining calm.

The nurse is caring for a client who is being treated in the emergency department for a panic attack. Which nursing intervention would be most appropriate?

Stay with the client, emphasizing that the client is safe and that the nurse will remain with the client.

Which would be an appropriate intervention of a client experiencing a panic attack?

Staying with the client and speaking in short sentences

The nurse understands that a certain level of anxiety is required in a client for effective learning. Which anxiety-related symptom indicates the client may be able to learn effectively?

The client has heightened awareness.

A client reports the client has been experiencing increased stress at work. The client has been managing the stress by drinking 2-3 glasses of wine per evening. Despite the nurse recommending that drinking alcohol is not an effective way to manage the stress, the client reports it is unlikely that the client will be able to stop. Which statement explains why this will be difficult for the client?

The client has no adaptive coping mechanisms.

The nurse can be confident that the admitted client diagnosed with an anxiety disorder will respond well to treatment when the client which of the following conditions are present?

The client states, "I understand what I need to do, and I'm ready to do it so I'm back to normal."

In speaking with a client with moderate anxiety, the client becomes tangential discussing unrelated topics. To help the client's attention from wandering, which is an effective intervention?

The nurse should speak in short and simple sentences.

A nurse is talking with a client who has experienced panic attacks. The client asks the nurse, "What causes these attacks?" Which information would the nurse most likely integrate into the response about the etiology of panic disorders?

There is evidence of a substantial familial predisposition to panic disorder

After teaching a group of mental health nursing students about the care of a client experiencing a panic attack, the instructor determines that additional education is required when the students identify which as an appropriate intervention?

Touching the client in an attempt to comfort the client

Which would not be an initial intervention for the client with acute anxiety?

Touching the client in an attempt to comfort the client

Which client, presenting with a report of vague physical symptoms, should be assessed for possible anxiety by the nurse?

an Asian American client

Which nursing intervention is focused on the primary goal of anxiety management and treatment?

assessing the client's ability to implement stress management techniques effectively

A nurse is seeing a client who is having severe to panic level anxiety after a physical assault months previously. The client tells the nurse, "When the panic starts I feel like I am watching myself through a window." The nurse can most accurately describe this experience as:

depersonalization.

A nurse is seeing a client who is experiencing symptoms of moderate anxiety. She tells the nurse she and her parents disagree over her sexual orientation. Which theory would best explain the course of the client's anxiety?

interpersonal

An adolescent who is seeing the school health nurse states, "I won't be able to hang out with my friends on Friday night because I have two essays due Monday." What level of anxiety is the adolescent experiencing?

mild

A school health nurse is meeting with the parents of a 6-year-old child who has been selectively mute. The nurse is offering the parents education regarding this problem. The nurse can tell the parents that what is true about selective mutism?

selective mutism is associated with social anxiety

Which statement, made by a client diagnosed with an anxiety disorder, should trigger the nurse's concern about the client's understanding of the use of defense mechanisms?

"When I have a problem, I just deny it until it goes away."

The nurse can document correctly that a client diagnosed with an anxiety disorder is experiencing moderate anxiety when the nurse observes the client doing what?

Pacing and repeatedly asking staff what time the "doctor will be here."

The nurse has read in a client's admission record that the client has been taking propranolol for psychiatric, rather than medical, reasons. The nurse should recognize that the client likely has a history of which mental health condition?

Panic disorder

A nurse is caring for a client who has panic attack. The nurse takes the client in a small, isolated room. How would this intervention benefit the client? Choose the best answer.

The client would have an enhanced sense of security.

Which assessment question is most likely to allow the nurse to differentiate between anxiety disorder due to a general medical condition and psychological factors affecting a medical condition?

Establishing whether the client's anxiety preceded the medical problem or whether the medical problem appeared first

Which factor has the least influence on achieving mental health for the client who has anxiety disorder?

The client is often late to school and makes poor grades in most of the client's subjects.

A group of nursing students are reviewing signs and symptoms of anxiety. The students demonstrate a need for additional review when they identify what?

Tearfulness

A client experiencing stress has tachycardia and tachypnea. On the basis of the physiological model of the general adaptation syndrome, in which stage is this client?

Resistance

The nurse is providing care for a psychiatric-mental health client who has a diagnosis of anxiety. Which statement by the nurse is likely the most therapeutic intervention?

"Anxiety is a feeling that is experienced by everyone at some point and it can never be completely removed from one's life."

A nurse is seeing a client prior to discharge after being admitted to hospital for suicidal ideation. As the nurse begins the discharge process, the client closes the eyes and begins rapid, shallow breathing. The client also begins to shake and perspire profusely. Which actions should the nurse take? Select all that apply.

Talk to the client in a comforting manner. Take the client to a quiet space. Reassure the client of being safe.

A nurse assesses a client and determines that the client is experiencing mild anxiety based on what?

The client is aware and alert

Which level of anxiety helps the client focus the client's attention to learn, problem solve, think, act, feel, and protect himself or herself?

Mild

A client is experiencing moderate anxiety. Which manifestation would the nurse most likely observe? Select all that apply.

1. The client can sustain attention on a particular focus. 2. The client verbally states, "For some reason, I am feeling anxious now."

A nurse is preparing a plan of care for a client with anxiety. Which would the nurse likely include? Select all that apply.

1. Using appropriate coping skill 2. Identifying treatment modalities 3. Involving family for support, if appropriate 4. Providing supportive feedback

What does desensitization refer to?

A systematic way to replace a panic response with a relaxation response

Which client is most likely to be at risk for drug dependence and difficulties with withdrawal?

A woman who has been taking lorazepam for several months after witnessing a traumatic motor vehicle accident

A client responds to bad news regarding test results by crying uncontrollably. What is the term for this response to a stressor?

Coping mechanism

A young parent tells the nurse, "I can't stop smoking. That is what I do to make myself feel better." What is the term used to describe this behavior?

Coping mechanism

Which should be included in a teaching plan for a client prescribed a benzodiazepine?

Rise slowly from a lying or sitting position

When a client is experiencing panic, which is the priority intervention?

Move the client to a quiet environment.

Which medication classification has been found to be effective in reducing or eliminating panic attacks?

Antidepressants

A hospitalized client states that the client is having difficulty resting. Which intervention would help promote rest?

Assisting the client with deep-breathing exercises

A nursing instructor is describing the care of a client with acute anxiety to a class of nursing students. The instructor determines that more education is necessary when the students identify which intervention as appropriate?

Providing the client with a comforting touch

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

When discussing various types of anxiolytic medications with a client, the nurse recognizes that which medication has the lowest potential for abuse?

Buspirone

The mental health nurse is gathering a health history on a new client. The client is constantly pacing the floor and is concerned only with stating that the client is about to die. The nurse would classify this level of anxiety as what?

Moderate

A client with generalized anxiety disorder states that the client is worried about the client's job. The client never feels like the client has control over the client's responsibilities, even though the client puts in extra hours. The client adds that the client is afraid the client will be fired. Which response by the nurse is most therapeutic?

"Has something changed at work that is causing you to worry?"

The nurse recognizes that who is the client most likely experiencing generalized anxiety disorder (GAD)?

40-year-old who has reported numerous absences from work, muscle aches, and difficulty falling asleep for the last 8 months

A client approaches the nurse on an inpatient psychiatric hospital unit crying, trembling, and feeling nauseous. The client states, "I've tried everything, I still feel so anxious." Which action by the nurse would be most appropriate?

Administer the prescribed PRN anxiolytic medication.

A client has sought treatment because of the overwhelming anxiety the client experiences regarding the safety of the client's young children. The client admits that the client will not normally let the client's children leave the client's sight for fear that they will be abducted, abused, or injured. The client is unable to function at work as a result of this anxiety. The nurse would recognize that this client experiences which condition?

Anticipatory anxiety

All of the following pharmacological agents are useful in treating anxiety disorders except which ones?

Calcium channel blockers

A client comes in for a therapy session and begins to have a panic attack. The therapist asks the client to relax in the chair and then gently asks the client to imagine the client in a very safe and calm place. This technique, often useful in anxiety disorders, is called what?

Deep breathing

When assessing an elderly client who has newly been diagnosed with an anxiety disorder, the mental health nurse's priority is to carry out which task?

Determine the client's risk for self-harm or harm to others

A client diagnosed with anxiety disorder has been prescribed benzodiazepine drugs. The nurse is explaining the possible side effects of the medications. Which side effects of the drug explained by the nurse is correct? Select all that apply.

Dry mouth Blurred vision Constipation

A client states that the client has just had an argument with the client's spouse over the phone. What can the nurse expect that the client's sympathetic nervous system has stimulated the client's adrenal gland to release?

Epinephrine

The nurse is planning a presentation to a group of nursing students on the topic of anxiety disorders. Which would the nurse include when describing panic disorder?

Individuals may believe they are having a heart attack when a panic attack occurs.

During the admission assessment of a 27-year-old client who has been diagnosed with an anxiety disorder, the nurse observes that the client is becoming increasingly restless and agitated. How should the nurse respond to this development?

Inform the client that the assessment can be postponed if the client is finding it overwhelming.

A group of students is reviewing information about the etiology of generalized anxiety disorder (GAD). The students demonstrate understanding of this information when they identify which as representing the bases for this disorder?

Intense worry and stress about work or simple family life

A client diagnosed with panic disorder has been receiving medication therapy, which is being discontinued. A nurse would be alert for possible withdrawal symptoms if the client was receiving what?

Lorazepam

A nurse determines that a client who is experiencing anxiety is using relief or primitive survival behaviors. The nurse determines that the client is experiencing which degree of anxiety?

Severe

A 30-year-old client who has been unemployed secondary to the client's 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 anxiety disorder

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

Which condition involves a persistent, irrational fear attached to an object or situation that objectively does not pose a significant danger?

Specific phobia

When a parent observes the parent's young child heading toward a busy road the parent becomes stressed, feeling the parent's heart pounding, breathing heavily, and hands becoming wet with perspiration. Which physiological system is activated with the parent's "fight or flight" reaction to this danger?

Sympathetic nervous system

A client who experiences panic anxiety around dogs is sitting in a room with a dog and the client's nurse therapist. The nurse therapist is using which behavioral intervention for this type of anxiety?

Systematic desensitization