Anxiety Disorders SCC Nursing 4th Quarter Psych

A client with a moderate level of anxiety is pacing quickly in the hall and tells the nurse, "Help me. I cannot take it anymore." What would be the best initial response? a) "It would be best if you would lie down until you are calmer." b) "Let us go to a quieter area where we can talk if you want." c) "Try doing your relaxation exercises to calm down." d) "I will get some medicine to help you relax."

A client describes anxiety attacks that usually occur shortly after work when he is preparing his evening meal. Which question would be most appropriate for the nurse to ask the client first in an effort to learn how he can be helped? a) "Do you think taking several slow, deep breaths would help?" b) "Have you tried walking to ease your anxiety?" c) "What do you do when you are anxious to help yourself feel better?" d) "What are you thinking about before you start to prepare supper?"

A nurse admits a client with a preliminary diagnosis of acute stress disorder to the mental health unit. Which assessment requires the nurse's immediate action? a) There are bruises on the client's body. b) The client reports not eating or sleeping for 2 days. c) The client was not given the opportunity to talk. d) The client states she has a desire to not live anymore.

An adult client diagnosed with anxiety disorder becomes anxious when she touches fruits and vegetables. What should the nurse do? a) Teach the woman to use cognitive behavioral approaches to manage her anxiety. b) Assist the woman to make a plan for her family to do the food shopping and preparation. c) Instruct the woman to avoid touching these foods. d) Ask the woman why she becomes anxious in these situations.

What should the nurse teach a client with generalized anxiety disorder to help the client cope with anxiety? a) issue avoidance and denial of problems b) rest and sleep c) withdrawal from role expectations and role relationships d) cognitive and behavioral strategies

The nurse is assessing a client with somatic symptom disorder who reports a fall. The nurse finds the client rubbing the left knee. What action should the nurse take first? a) Report the incident to the charge nurse and document the incident. b) Assess the client's injury, document the incident, and offer the client an antacid. c) Report the client's injury to the physician and document the incident. d) Assess the client's injury, notify the physician, and document the incident.

A client with acute stress disorder states to the nurse, "I keep having horrible nightmares about the car accident that killed my daughter. I should not have taken her with me to the store." Which response by the nurse is most therapeutic? a) "The accident just happened and could not have been predicted." b) "Do not keep torturing yourself with such horrible thoughts." c) "Stop blaming yourself. It is only hurting you." d) "Let us talk about something that is a bit more pleasant."

A painter who recently fractured his tibia worries about his finances because he can't work. To treat his anxiety, his physician orders buspirone, 5 mg by mouth three times per day. Which drugs interact with buspirone? a) Monoamine oxidase (MAO) inhibitors b) Antiparkinsonian drugs c) Antineoplastic drugs d) Beta-adrenergic blockers

The nurse is assessing a client who has just experienced a crisis. The nurse should first assess this client for which behavior? a) effective problem solving b) level of anxiety c) help-seeking d) attention span

After learning that a roommate is HIV-positive, a client asks a nurse about moving to another room on the psychiatric unit because he no longer feels "safe." What should the nurse do first? a) Move the client to another room. b) Move the client's roommate to a private room. c) Ask the client to describe his fears. d) Explain that such a move wouldn't be therapeutic for the client or for his roommate.

The client rushes out of the day room where he has been watching television with other clients. He is hyperventilating and flushed and his fists are clenched. He states to the nurse, "That bastard! He is just like Tom. I almost hit him." What would be the nurse's best response? a) "I am glad you left the situation. Go to your room and calm down. I will come in soon to talk." b) "I can see you are angry. Let me get you some lorazepam to help you calm down. Then we will talk about what happened." c) "Even if you are angry, you cannot use that language here." d) "You are angry, and you did well to leave the situation. Let us walk up and down the hall while you tell me about it."

During a shift report, a nurse learns that she will be providing care for a client who's vulnerable to panic attack. Treatment for panic attacks includes behavioral therapy, supportive psychotherapy, and medication such as: a) depressants. b) barbiturates. c) antianxiety drugs. d) amphetamines.

A nurse refers a client with severe anxiety to a psychiatrist for medication evaluation. The physician is most likely to order which psychotropic drug regimen on a short-term basis? a) Benztropine, 2 mg orally twice per day b) Chlorpromazine, 25 mg orally three times per day c) Buspirone, 15 mg two times per day 200 mg orally twice per day d) Alprazolam, 0.25 mg orally every 8 hours

When teaching a group of nurses about posttraumatic stress disorder (PTSD), a nurse-educator explains that this disorder: a) is most common in men ages 30 to 40. b) can occur at any age group. c) is most common in women ages 30 to 40. d) is most common in men ages 20 to 30.

During the admission assessment, a client with a panic disorder begins to hyperventilate and says, "I'm going to die if I don't get out of here right now!" What is the nurse's best response? a) "Just calm down. You're overly anxious." b) "You can rest alone in your room until you feel better." c) "You're having a panic attack. I'll stay here with you." d) "What do you think is causing your panic attack?"

A nurse admits a client with a preliminary diagnosis of acute stress disorder to the mental health unit. Which assessment requires the nurse's immediate action? a) There are bruises on the client's body. b) The client reports not eating or sleeping for 2 days. c) The client was not given the opportunity to talk. d) The client states she has a desire to not live anymore.

When teaching a group of nurses about posttraumatic stress disorder (PTSD), a nurse-educator explains that this disorder: a) is most common in women ages 30 to 40. b) is most common in men ages 30 to 40. c) is most common in men ages 20 to 30. d) can occur at any age group.

The client with a diagnosis of posttraumatic stress disorder tells the nurse he wishes that he had been on the airplane that crashed and killed his wife and children a month ago. The nurse assesses the client's statement to be an example of which symptom? a) numbing of responsiveness b) survivor guilt c) suicidal ideation d) dysfunctional grieving

A client is admitted to the psychiatric unit with a diagnosis of functional neurologic symptom disorder. Since witnessing a beating at gunpoint, the client is paralyzed. Which action should the nurse initially focus on when planning this client's care? a) Helping the client identify and verbalize his/her feelings about the incident b) Exploring personal relationships that may be related to the paralysis c) Teaching the client to deal with any limitations of the paralysis d) Helping the client identify any stressors or psychological conflicts

A nurse in a psychiatric inpatient unit is caring for a client with generalized anxiety disorder. As part of the client's treatment, the psychiatrist orders lorazepam, 1 mg by mouth three times per day. During lorazepam therapy, the nurse should remind the client to: a) avoid aged cheeses. b) maintain an adequate salt intake. c) avoid caffeine. d) stay out of the sun.

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

Which client statement indicates the need for additional teaching about benzodiazepines? a) "Diazepam can make me drowsy, so I should not drive for a while." b) "I cannot drink alcohol while taking diazepam." c) "Diazepam will help my tight muscles feel better." d) "I can stop taking the drug anytime I want."

A week ago, a tornado destroyed the client's home and seriously injured her husband. The client has been walking around the hospital in a daze without any outward display of emotions. The client is being admitted to the stress unit with the diagnosis of acute stress disorder. The client tells the nurse in a matter-of-fact manner that her husband is paraplegic, "but that is better than total paralysis." Which protective mechanism is the client exhibiting? a) suppression b) rationalization c) intellectualization d) denial

A client with obsessive-compulsive disorder reveals that he was late for his appointment "because of my dumb habit. I have to take off my socks and put them back on 41 times! I cannot stop until I do it just right." The nurse interprets the client's behavior as most likely representing an effort to obtain: a) control of his thoughts. b) safe expression of hostility. c) attention from others. d) relief from anxiety.

An adult client diagnosed with anxiety disorder becomes anxious when she touches fruits and vegetables. What should the nurse do? a) Assist the woman to make a plan for her family to do the food shopping and preparation. b) Teach the woman to use cognitive behavioral approaches to manage her anxiety. c) Instruct the woman to avoid touching these foods. d) Ask the woman why she becomes anxious in these situations.

Which nursing action would be therapeutic for the client being admitted to the unit with panic disorder? Select all that apply. a) Support the client's attempts to discuss feelings. b) Reassure the client of safety. c) Respect the client's personal space. d) Confront the client's dysfunctional coping behaviors. e) Touch the client to provide contact with reality.

A nurse refers a client with severe anxiety to a psychiatrist for medication evaluation. The physician is most likely to order which psychotropic drug regimen on a short-term basis? a) Chlorpromazine, 25 mg orally three times per day b) Benztropine, 2 mg orally twice per day c) Alprazolam, 0.25 mg orally every 8 hours d) Buspirone, 15 mg two times per day 200 mg orally twice per day

The nurse observes a client with a history of panic attacks is hyperventilating. The nurse should: a) tell the client to take several deep, slow breaths and exhale normally. b) instruct the client to put his head between his knees. c) give the client a low concentration of oxygen by nasal cannula. d) have the client breathe into a paper bag.

A client taking paroxetine 40 mg PO every morning tells the nurse that her mouth "feels like cotton." Which statement by the client necessitates further assessment by the nurse? a) "I am sucking on sugarless candy." b) "I am sucking on ice chips." c) "I am using sugarless gum." d) "I am drinking 12 glasses of water every day."

A woman has become increasingly afraid to ride in elevators. While in an elevator one morning, she experiences shortness of breath, palpitations, dizziness, and trembling. A physician can find no physiological basis for these symptoms and refers her to a psychiatric clinical nurse specialist for outpatient counseling sessions. Which type of therapy is most likely to reduce the client's anxiety level? a) Group psychotherapy b) Systematic desensitization c) Referral for evaluation for electroconvulsive therapy d) Psychoanalytically oriented psychotherapy

A client comes to the emergency department while experiencing a panic attack. What action by the nurse is most appropriate? a) Assuring the client that the symptoms will subside soon b) Assuring the client that everything is under control c) Talking continually to the client and explaining what is happening d) Staying with the client until the attack subsides

A client is diagnosed with obsessive-compulsive disorder. Which intervention should the nurse include when developing the care plan for this client? a) Preventing ritualistic behavior b) Increasing environmental stimulation c) Setting strict limits on compulsive behavior d) Giving the client time to perform rituals

A nurse is caring for a client with agoraphobia. Which signs and symptoms would the nurse anticipate? Select all that apply. a) Hallucinations. b) Tobacco use. c) Inability to leave home. d) Alcohol consumption. e) Panic attacks. f) Eating disorders.

The client, who is a veteran and has posttraumatic stress disorder, tells the nurse about the horror and mass destruction of war. He states, "I killed all of those people for nothing." Which response by the nurse is appropriate? a) "Maybe you did not kill as many people as you think." b) "War is a terrible thing." c) "You did what you had to do at that time." d) "How many people did you kill?"

A nurse is caring for a client with obsessive-compulsive disorder (OCD) with rituals of washing hands for 18 minutes, combing hair 444 strokes, and switching the bathroom light on and off 44 times prior to meals. What is the most appropriate long-term goal of care for this client? a) Allow ample time for the client to complete all these rituals before each meal. b) Systematically decrease the number of repetitions of rituals and the amount of time the client spends performing them. c) Maintain a daily routine of hygiene, nutrition, and sleep. d) Verbalize to the staff information learned about the client's illness and his or her ways of coping and reducing anxiety.

A 40-year-old client is admitted for a surgical biopsy of a suspicious lump in her left breast. When the nurse arrives to take the client to surgery, she is tearfully completing a letter to her two children. She tells the nurse, "I want to leave this for my children in case anything goes wrong today." Which response by the nurse would be most therapeutic? a) "In case anything goes wrong? What are your thoughts and feelings right now?" b) "I'm sure your children know how much you love them. You'll be able to talk to them on the phone in a few hours." c) "Try to take a few deep breaths and relax. I have some medication that will help." d) "I can understand that you're nervous, but this really is a minor procedure. You'll be back in your room before you know it."

A client was admitted to the inpatient unit 3 days ago with a flat affect, psychomotor retardation, anorexia, hopelessness, and suicidal ideation. The health care provider (HCP) prescribed 75 mg of venlafaxine extended release to be given every morning. The client interacted minimally with the staff and spent most of the day in his room. As the nurse enters the unit at the beginning of the evening shift, the client is smiling and cheerful and appears to be relaxed. What should the nurse interpret as the most likely cause of the client's behavior? a) The client's sudden improvement calls for close observation by the staff. b) The client is nearing discharge due to the improvement of his symptoms. c) The venlafaxine is helping the client's symptoms of depression significantly. d) The staff can decrease their observation of the client.

A client who recently developed paralysis of the arms is diagnosed with functional neurologic symptom disorder after tests fail to uncover a physical cause for the paralysis. Which intervention should the nurse include in the care plan for this client? a) Working with the client rather than with the family b) Teaching the client how to use nonpharmacologic pain-control methods c) Insisting that the client eat without assistance d) Exercising the client's arms regularly

A client diagnosed as having panic disorder with agoraphobia is admitted to the inpatient psychiatric unit. Until her admission, this client had been a virtual prisoner in her home for 5 weeks, afraid to go outside even to buy food. When planning care for this client, what is the nurse's overall goal? a) To help the client function effectively in her environment b) To help the client participate in group therapy c) To help the client perform self-care activities d) To help control the client's symptoms

A nurse notices that a client with obsessive-compulsive disorder washes his hands for long periods each day. How should the nurse respond to this compulsive behavior? a) By calling attention to or trying to prevent the behavior b) By discouraging the client from verbalizing his anxieties c) By setting aside times during which the client can focus on the behavior d) By urging the client to reduce the frequency of the behavior as rapidly as possible

A client is admitted to the acute psychiatric care unit after 2 weeks of increasingly erratic behavior. He has been sleeping poorly, has lost 8 lb (3.6 kg), is poorly groomed, exhibits hyperactivity, and loudly denies the need for hospitalization. Which nursing intervention takes priority for this client? a) Involving the client in unit activities b) Administering a sedative as ordered c) Providing adequate hygiene d) Decreasing environmental stimulation

A client is taking diazepam while establishing a therapeutic dose of antidepressants for generalized anxiety disorder. Which instruction should the nurse give to this client? Select all that apply. a) to take the medication on an empty stomach b) not to use alcohol while taking the drug c) to stop taking the drug if he experiences swelling of the lips and face and difficulty breathing d) to avoid eating cheese and other tyramine-rich foods e) to consult with his health care provider (HCP) before he stops taking the drug

A nurse notices that a client with obsessive-compulsive disorder dresses and undresses numerous times each day. Which comment by the nurse would be most therapeutic? a) "It's foolish to change your clothes so many times in one day." b) "I saw you change clothes several times today. That must be very tiring." c) "It bothers me to see you always so busy." d) "Dress only once per day so you won't be so tired."

Which group therapy intervention is of primary importance to a client with panic disorder? a) Discussing new ways of thinking and feeling about panic attacks b) Gaining hope that talking with others will reduce panic attacks c) Realizing that one is not the only person with panic attacks d) Learning about risk factors and other demographics associated with panic disorder

A client on the behavioral health unit spends several hours per day organizing and reorganizing his closet. He repeatedly checks to see if his clothing is arranged in the proper order. What term is commonly used to describe this behavior? a) Transference b) Exhibitionism c) Compulsion d) Obsession

A nurse is caring for a veteran with a history of explosive anger, unemployment, and depression since being discharged from the service. The client reports feeling ashamed of being "weak" and of letting past experiences control his thoughts and actions in the present. What is the nurse's best response? a) "It isn't too late for you to make changes in your life." b) "Many people who've been in your situation experience similar emotions and behaviors." c) "You can change your behavior if you're motivated to do so." d) "Weak people don't want to make changes in their lives."

A client is anxious following a robbery. The client is worried about identity theft and states, "I could lose everything. I cannot stand the fears I have. I reported everything, but I still cannot eat or sleep." Which intervention should the nurse implement first? a) Request a prescription for an antianxiety medication. b) Refer the client to a support group. c) Listen empathetically while the client discusses the fears. d) Provide a list of free legal resources.

A client diagnosed with anxiety disorder is ordered buspirone. Teaching instructions for buspirone should include: a) a warning that immediate sedation can occur with a resultant drop in pulse. b) a warning about the drug's delayed therapeutic effect, which occurs in 14 to 30 days. c) a warning about medication-related incidence of neuroleptic malignant syndrome. d) a reminder of the need to schedule blood work 1 week after initiating therapy to check blood levels of the drug.

A young school-age girl whose mother and aunt have been diagnosed as having bipolar disorder and whose father is diagnosed with depression is brought to the clinic because of problems with behavior and attention in school and inability to sleep at night. The child says, "My brain does not turn off at night." The child is diagnosed as experiencing attention deficit hyperactivity disorder (ADHD) with a possibility of bipolar disorder as well. What should the nurse say to the father to explain what the provider said? Select all that apply. a) "ADHD involves difficulty with attention, impulse control, and hyperactivity at school, home, or in both settings." b) "Your provider does not know how to diagnose your child's illness since she has symptoms of both bipolar disorder and ADHD." c) "Your child was diagnosed as having ADHD because of her attention and behavior problems at school." d) "Your provider is considering a bipolar diagnosis because of your child's family history of bipolar disorder and her sleep issues." e) "The child's description of her inability to sleep is irrelevant to diagnosing her condition since she stays up late."

Performing a physical examination on a client experiencing anxiety, what advice can a nurse give to help the client combat the effects produced by the sympathetic nervous system? Select all that apply. a) "Reduce your sodium intake." b) "Increase your fiber intake." c) "Exercise daily." d) "Eat small, frequent meals." e) "Increase your fluid intake."

A client admitted to the psychiatric unit for treatment of a panic attack comes to the nurses' station in obvious distress. After finding the client short of breath, dizzy, trembling, and nauseated, a nurse should first: a) administer an antianxiety medication, as ordered, and instruct the client to lie down in his room. b) assure the client that his symptoms will disappear after he lies down and relaxes. c) escort the client to a quiet area and suggest that he use a relaxation exercise he's been taught. d) ask the client why he is upset.

A client is scheduled for cardiac catheterization the next morning. His physician ordered temazepam, 30 mg by mouth at bedtime, for sedation. Before administering the drug, the nurse should know that: a) sedatives reduce excitement; hypnotics induce sleep. b) sedatives don't depress respirations; hypnotics do. c) sedatives interact with few drugs; hypnotics interact with many. d) sedatives cause predictable responses; hypnotics cause unpredictable ones.

An adolescent admitted for panic attacks tells the nurse that an uncle has been making sexual advances. The client begs the nurse to not say anything because of what the uncle may do. What should be the nurse's initial response? a) "The law requires me to make a report so you can be protected." b) "He can't hurt you here, and we'll make sure you're safe." c) "Have you told anyone else what is happening?" d) "You have a right not to report this, so I will not either."

An 8-year-old child, diagnosed with obsessive-compulsive disorder, is admitted by the nurse to a psychiatric facility. During the admission assessment, which behaviors would be characterized as compulsions? Select all that apply. a) Brushing teeth three times per day. b) Routinely climbing up and down a flight of stairs three times before leaving the house. c) Checking and rechecking that the television is turned off before going to school. d) Wanting to play the same video game each night. e) Feeding the dog the same meal every day. f) Repeatedly washing the hands.

An elderly client hospitalized 4 days ago for treatment of acute respiratory distress has become confused and disoriented. The client has been picking invisible items off blankets and has been yelling at the daughter who is not in the room. The family tells the nurse that the client has been treated for anxiety with alprazolam for years, but alprazolam is not on the current medication list. Which safety measures should be implemented? Select all that apply. a) The client will be placed in soft restraints. b) The client will be placed on withdrawal precautions and treatment started immediately. c) A prescription should be obtained to help with the hallucinations. d) The daughter should not visit until the client is better. e) The client's medical and mental status will be evaluated frequently and treated as needed.

A client periodically has acute panic attacks. These attacks are unpredictable and have no apparent association with a specific object or situation. During an acute panic attack, the client may experience: a) a decreased perceptual field. b) heightened concentration. c) a decreased respiratory rate. d) a decreased heart rate.

What action is most appropriate when dealing with a client who is expressing anger verbally, is pacing, and is irritable? a) Discuss alternative strategies for when the client is angry in the future. b) Convey empathy and encourage ventilation. c) Use calm, firm directions to get the client to a quiet room. d) Put the client in restraints.

Lorazepam is commonly given along with a neuroleptic agent. What is the purpose of administering the drugs together? a) To increase a client's level of awareness and concentration b) To reduce anxiety and potentiate the neuroleptic's sedative action c) To counteract the neuroleptic's extrapyramidal effects d) To manage depressed clients

A client with posttraumatic stress disorder states, "You do not know what I have been through. What can you do?" The nurse should respond: a) "Perhaps you will feel better if you can become interested in a hobby once again." b) "I would like to help you if you will let me." c) "I have not been through what you have, but I will be better able to understand if you tell me more about it." d) "I need to refer you to a survivors' group where you will feel more comfortable."

A client is diagnosed with agoraphobia without panic disorder. Which type of therapy would most the nurse expect to see included in the plan of care? a) group therapy b) insight therapy c) behavior therapy d) psychoanalysis