Question 1

A nursing instructor is teaching about the symptoms of agoraphobia.Which student statement indicates that learning has occurred?

Accepted Answer

Rationale: The onset of the symptoms of agoraphobia most commonly occurs in the 20s and 30s and persists for many years.

Question 2

A nursing instructor is teaching about the medications used to treat panic disorder.Which student statement indicates that learning has occurred?

Accepted Answer

Rationale: The student indicates learning has occurred when he or she states that clonazepam is a particularly effective treatment for panic disorder.Clonazepam is a type of benzodiazepine in which the major risk is physical dependence and tolerance,which may encourage abuse.It can be used on an as-needed basis to reduce anxiety and the related symptoms.

Question 3

A nursing instructor is teaching about specific phobias.Which student statement indicates to the instructor that learning has occurred?

Accepted Answer

Rationale: The nursing instructor should evaluate that learning has occurred when the student knows that clients with phobias have a panic level of fear that is overwhelming and unreasonable.Phobia is fear cued by a specific object or situation in which exposure to the stimuli produces an immediate anxiety response.Even though the disorder is relatively common among the general population,people seldom seek treatment unless the phobia interferes with ability to function.

Question 4

A nurse has been caring for a client diagnosed with generalized anxiety disorder (GAD).Which of the following nursing interventions would address this client's symptoms? (Select all that apply.)

Accepted Answer

Rationale: Nursing interventions that address GAD symptoms should include encouraging the client to recognize signs of escalating anxiety,to employ relaxation techniques,to cognitively reframe thoughts about anxiety-provoking situations,and to avoid caffeinated products.Avoiding situations that cause stress is not an appropriate intervention,because avoidance does not help the client overcome anxiety and because not all situations are easily avoidable.

Question 5

A college student has been diagnosed with generalized anxiety disorder (GAD).Which of the following symptoms should a campus nurse expect this client to exhibit? (Select all that apply.)

Accepted Answer

Rationale: The nurse should expect that a client diagnosed with GAD would experience fatigue,insomnia,and irritability.GAD is characterized by chronic,unrealistic,and excessive anxiety and worry.

Question 6

A client living in a beachfront community is seeking help with an extreme fear of bridges,which is interfering with daily functioning.A psychiatric nurse practitioner decides to try systematic desensitization.Which explanation of this treatment should the nurse provide?

Accepted Answer

Rationale: The nurse should explain to the client that when participating in systematic desensitization he or she will go through a series of increasingly anxiety-provoking steps that will gradually increase tolerance.Systematic desensitization was introduced by Joseph Wolpe in 1958 and is based on behavioral conditioning principles.

Question 7

What symptoms should a nurse recognize that differentiate a client diagnosed with panic disorder from a client diagnosed with generalized anxiety disorder (GAD)?

Accepted Answer

Rationale: The nurse should recognize that a client diagnosed with panic disorder experiences depersonalization,whereas a client diagnosed with GAD would not.Depersonalization refers to being detached from oneself when experiencing extreme anxiety.

Question 8

A client diagnosed with an obsessive-compulsive disorder spends hours bathing and grooming.During a one-on-one interaction,the client discusses the rituals in detail but avoids any feelings that the rituals generate.Which defense mechanism should the nurse identify?

Accepted Answer

Rationale: The nurse should identify that the client is using the defense mechanism of intellectualization when discussing the rituals of obsessive-compulsive disorder in detail while avoiding discussion of feelings.Intellectualization is an attempt to avoid expressing emotions associated with a stressful situation by using the intellectual process of logic,reasoning,and analysis.

Question 9

A family member is seeking advice about an older parent who seems to worry unnecessarily about everything.The family member states,"Should I seek psychiatric help for my mother?" Which is an appropriate nursing response?

Accepted Answer

Rationale: The most appropriate response by the nurse is to explain to the family member that anxiety is considered abnormal when it is out of proportion and impairs functioning.Anxiety is a normal reaction to a realistic danger or threat to biological integrity or self-concept.

Question 10

Which symptoms should a nurse recognize that differentiate a client diagnosed with obsessive-compulsive disorder (OCD)from a client diagnosed with obsessive-compulsive personality disorder?

Accepted Answer

Rationale: A client diagnosed with OCD experiences both obsessions and compulsions.Clients with obsessive-compulsive personality disorder exhibit a pervasive pattern of preoccupation with orderliness,perfectionism,mental and interpersonal control,but do not experience obsessions and compulsions.

Question 11

A client is newly diagnosed with obsessive-compulsive disorder and spends 45 minutes folding clothes and rearranging them in drawers.Which nursing intervention would best address this client's problem?

Accepted Answer

Rationale: The nurse should discuss with the client the anxiety-provoking triggers that precipitate the ritualistic behavior.If the client is going to be able to control interrupting anxiety,he or she must first learn to recognize precipitating factors.Attempting to distract the client,seeking medication increase,and locking the client's room are not appropriate interventions,because they do not help the client gain insight.

Question 12

A nurse is discussing treatment options with a client whose life has been negatively impacted by claustrophobia.Which of the following commonly used behavioral therapies for phobias should the nurse explain to the client? (Select all that apply.)

Accepted Answer

Rationale: The nurse should explain to the client that systematic desensitization and imploding are the most common behavioral therapies used for treating phobias.Systematic desensitization involves the gradual exposure of the client to anxiety-provoking stimuli.Imploding is the intervention used in which the client is exposed to extremely frightening stimuli for prolonged periods of time.

Question 13

A client is experiencing a severe panic attack.Which nursing intervention would meet this client's physiological need?

Accepted Answer

Rationale: The nurse can meet this client's physiological need by having the client breathe into a paper bag.Hyperventilation may occur during periods of extreme anxiety.Hyperventilation causes the amount of carbon dioxide (CO₂)in the blood to decrease,possibly resulting in lightheadedness,rapid heart rate,shortness of breath,numbness or tingling in the hands or feet,and syncope.If hyperventilation occurs,assist the client to breathe into a small paper bag held over the mouth and nose.Six to twelve natural breaths should be taken,alternating with short periods of diaphragmatic breathing.

Question 14

Which nursing statement to a client about social anxiety disorder versus schizoid personality disorder (SPD)is most accurate?

Accepted Answer

Rationale: Clients diagnosed with social anxiety disorder avoid interactions only in social settings,whereas clients diagnosed with SPD avoid interactions in all areas of life.Social anxiety disorder is an excessive fear of situations in which a person might do something embarrassing or be evaluated negatively by others.

Question 15

A nursing student questions an instructor regarding the order for fluvoxamine (Luvox)300 mg daily for a client diagnosed with obsessive-compulsive disorder (OCD).Which instructor response is most accurate?

Accepted Answer

Rationale: The most accurate instructor response is that SSRI doses in excess of what is effective for treating depression may be required in the treatment of OCD.SSRIs have been approved by the Food and Drug Administration for the treatment of OCD.Common side effects include headache,sleep disturbances,and restlessness.

Question 16

A cab driver,stuck in traffic,becomes lightheaded,tremulous,diaphoretic,tachycardic and dyspneic.A workup in an emergency department reveals no pathology.Which medical diagnosis should a nurse suspect,and what nursing diagnosis should be the nurse's first priority?

Accepted Answer

Rationale: The nurse should suspect that the client has exhibited signs and symptoms of a panic disorder.The priority nursing diagnosis should be anxiety.Panic disorder is characterized by recurrent,sudden-onset panic attacks in which the person feels intense fear,apprehension,or terror.

Question 17

Which treatment should a nurse identify as most appropriate for clients diagnosed with generalized anxiety disorder (GAD)?

Accepted Answer

Rationale: The nurse should identify that an appropriate treatment for clients diagnosed with GAD is long-term treatment with buspirone.Buspirone is an anxiolytic medication that is effective in 60% to 80% of clients diagnosed with GAD.Buspirone takes 10 to 14 days for alleviation of symptoms but does not have the dependency concerns of other anxiolytics.

Question 18

A client diagnosed with obsessive-compulsive disorder is admitted to a psychiatric unit.The client has an elaborate routine for toileting activities.Which would be an appropriate initial client outcome during the first week of hospitalization?

Accepted Answer

Rationale: An appropriate initial client outcome is for the client to wake early enough to complete rituals prior to breakfast.The nurse should also provide a structured schedule of activities and begin to gradually limit the time allowed for rituals.

Question 19

A client diagnosed with panic disorder states,"When an attack happens,I feel like I am going to die." Which is the most appropriate nursing response?

Accepted Answer

Rationale: The most appropriate nursing response to the client's concerns is to empathize with the client and provide encouragement that panic attacks only last a short period.Panic attacks usually last minutes but can,rarely,last hours.When the nurse states that "Most people who experience panic attacks…" the nurse depersonalizes and belittles the client's feeling.

Question 20

A nurse is providing discharge teaching to a client taking a benzodiazepine.Which client statement would indicate a need for further follow-up instructions?

Accepted Answer

Rationale: The client indicates a need for additional information about taking benzodiazepines when stating the need for blood work to monitor for toxic levels.This intervention is used when taking lithium (Eskalith)for the treatment of bipolar disorder.The client should understand that taking extra doses of a benzodiazepine may result in addiction and that the drug should not be taken in conjunction with alcohol.

Quiz 18: Anxiety,obsessive-Compulsive,and Related Disorders

A nursing instructor is teaching about the symptoms of agoraphobia.Which student statement indicates that learning has occurred?

A nursing instructor is teaching about the medications used to treat panic disorder.Which student statement indicates that learning has occurred?

A nursing instructor is teaching about specific phobias.Which student statement indicates to the instructor that learning has occurred?

A nurse has been caring for a client diagnosed with generalized anxiety disorder (GAD) .Which of the following nursing interventions would address this client's symptoms? (Select all that apply.)

A college student has been diagnosed with generalized anxiety disorder (GAD) .Which of the following symptoms should a campus nurse expect this client to exhibit? (Select all that apply.)

A client living in a beachfront community is seeking help with an extreme fear of bridges,which is interfering with daily functioning.A psychiatric nurse practitioner decides to try systematic desensitization.Which explanation of this treatment should the nurse provide?

What symptoms should a nurse recognize that differentiate a client diagnosed with panic disorder from a client diagnosed with generalized anxiety disorder (GAD) ?

A client diagnosed with an obsessive-compulsive disorder spends hours bathing and grooming.During a one-on-one interaction,the client discusses the rituals in detail but avoids any feelings that the rituals generate.Which defense mechanism should the nurse identify?

A family member is seeking advice about an older parent who seems to worry unnecessarily about everything.The family member states,"Should I seek psychiatric help for my mother?" Which is an appropriate nursing response?

Which symptoms should a nurse recognize that differentiate a client diagnosed with obsessive-compulsive disorder (OCD) from a client diagnosed with obsessive-compulsive personality disorder?