Question 1

The nurse is caring for a patient with moderate anxiety.Which activity should the nurse encourage to best manage the patient's anxiety?

Accepted Answer

To best manage moderate level anxiety,the nurse should help provide outlets for tension.These activities include walking,crying,and working at simple,concrete tasks.Learning something new,watching an intense TV show,or reading information about the negative effects of anxiety are activities that may exacerbate anxiety rather than relieve it.

Question 2

Which signs and symptoms are consistent with general anxiety disorder (GAD)?

Accepted Answer

A person who experiences persistent,unrealistic,or excessive worry about two or more life circumstances for 6 months or longer is exhibiting symptoms associated with GAD.GAD usually develops slowly and is chronic in nature.Dieresis rather than urinary retention is a commonly seen with GAD.All other options listed are characteristics of GAD.

Question 3

The nurse explains that anxiety disorders differ from normal anxiety.Which statement accurately describes anxiety disorders?

Accepted Answer

Anxiety disorders interrupt normal day-to-day functioning in the workplace and in family settings.

Question 4

A resident in a long-term care facility has been in a manic stage for 2 days.He has not slept and cannot focus long enough to eat a meal.How should the nurse best enhance the resident's nutrition?

Accepted Answer

The patient displays an inability to concentrate and a decreased need for sleep or nutrients.Offering a small amount of high-energy foods and drinks every hour will support nutrition until the manic behavior is under control.Because of the manic patient's abbreviated focus,eating an entire meal may not be possible.The nurse should not force the patient to sit and eat,demean him by spoon-feeding,or challenge him to process a new activity.

Question 5

The nurse is educating a patient with a new prescription for lithium carbonate.Which information is most important for the nurse to include in the teaching plan?

Accepted Answer

Lithium may take 7-14 days to reach therapeutic level in the body.Diuretics should be avoided while on Lithium therapy.Patients should not restrict sodium intake since low sodium levels could cause Lithium toxicity.Medication should be taken with meals to decrease gastric distress.

Question 6

The nurse is caring for a patient who was admitted with fractures sustained during an MVC (motor vehicle collision).The patient tearfully confesses that she relives the accident in her dreams and is afraid to sleep.The nurse recognizes that this scenario is consistent with which disorder?

Accepted Answer

Individuals with PTSD have endured one or more extreme life-threatening events,and the remembrance of these events now produces feelings of intense horror,with recurrent symptoms of anxiety and nightmares or flashbacks.

Question 7

A patient has been taking lithium for 5 days.The nurse notes his gait is a little unsteady with a walker,and he complains of thirst and insomnia.Which finding is most important for the nurse to report?

Accepted Answer

While all findings should be reported,uncoordinated movement is a sign of lithium toxicity and the priority finding.The patient is likely taking lithium to treat manic behavior.Thirst and insomnia are expected side effects of lithium and not indicative of toxicity.

Question 8

After having refused lunch and dinner because her "regular" chair was occupied at breakfast,the resident in a long-term care facility asks for a snack.How should the nurse respond?

Accepted Answer

After acute anxiety passes,the nurse should focus on helping the resident recognize the behavior that was exhibited and how to deal more effectively with the anxiety.Scolding the patient,attempting to induce guilt,or causing the patient to dwell on the trigger do not redirect the patient to consider different behaviors.

Question 9

The nurse is caring for a patient admitted with a diagnosis of serotonin syndrome.Which type of medication will most likely be included in the plan of treatment?

Accepted Answer

Serotonin syndrome is a potential life-threatening condition that could start 30 minutes to 48 hours after taking the medication.Symptoms include change of mental status,increase in pulse and fluctuation in blood pressure,loss of muscular coordination,and hyperthermia.Treatment includes stopping medication,administering IV fluids,and decreasing temperature.

Question 10

A long-term care facility resident with generalized anxiety disorder (GAD)enters the dining room and discovers that a visitor is sitting in her regular seat.The resident becomes agitated and insists that she cannot eat unless she sits in her chair.Which response is most appropriate?

Accepted Answer

A calm approach and reassurance will help the anxious patient to mimic the nurse's behavior.Asking the visitor to move,telling the resident that she will go hungry,or insisting that the resident eat are not therapeutic and will not help in reducing the patient's anxiety.

Question 11

An older adult resident in a long-term care facility expresses multiple minor complaints at the nurse's station and wanders about aimlessly in the hallway.The nurse examines the patient's chart.Which newly prescribed drug may explain his behavior?

Accepted Answer

The drug theophylline may make patients feel anxious and restless.Tylenol,bisacodyl,and lisinopril do not typically have this effect.

Question 12

The nurse is caring for a suicidal patient who has been treated effectively with antidepressant therapy.The patient verbalizes that he feels better.The nurse is alert that the patient is most at risk for which potential complication?

Accepted Answer

The risk of suicide is greater now that the patient has increased energy to plan and complete the suicide.Effective antidepressant therapy should not cause an increase in emotional fragility,weight gain,or activity intolerance.

Question 13

The nurse is educating a patient who has just been prescribed diazepam (Valium).The nurse cautions the patient that diazepam (Valium)may cause which problem?

Accepted Answer

Valium can cause a physiologic and a psychological dependence.Valium should not cause urinary retention,severe dehydration,or hallucinations.

Question 14

The nurse observes a coworker who is always behind because he checks and rechecks the accuracy of his medication dosages.Even after being reassured his dosages are correct,he checks them again.The nurse suspects her coworker suffers from which disorder?

Accepted Answer

When a person has an OCD,he experiences an obsession,recurrent,or intrusive thoughts that he cannot stop thinking about,and these thoughts create anxiety.A compulsive act is an act that the person feels compelled to perform.For example,a person may experience anxiety and so performs repetitive handwashing in an attempt to reduce that anxiety.Time spent in these thoughts and rituals can become overwhelming to the point of interfering with normal life.

Question 15

The nurse is helping a patient get dressed to go to her dialysis treatment.The patient bursts into tears and says,"I can't go! I can't stand another day in that awful place.I will die if I have to go!" Which intervention is best?

Accepted Answer

A calm and supportive attitude will help the patient identify feelings.The nurse should put the dressing process on hold so that the nurse can focus attention on a therapeutic response to the patient's concerns.The nurse should then ask an open-ended question to give the patient freedom to express her concerns.Making a threatening statement about consequences of missed treatments only exacerbates the patient's concern.Continuing to dress the patient while offering empty reassurance or changing the subject ignores the problem at hand.

Question 16

The depressed patient who has been taking amitriptyline (Elavil)for the past 2 weeks complains of still feeling depressed and wants to abandon the drug.How should the nurse respond?

Accepted Answer

Tricyclics may take up to 4 weeks before patients experience symptom relief.The patient has not been taking the medication long enough to request a new order.The nurse should not encourage the patient to discontinue the medication.This medication should not be combined with alcohol.

Question 17

The nurse is educating a patient with generalized anxiety disorder (GAD)who has a new prescription for buspirone (BuSpar).Which information is most important for the nurse to include in the teaching plan?

Accepted Answer

Patients should not stop taking BuSpar abruptly,but should taper this medication according to health care provider instructions.BuSpar is always given as a scheduled drug (never on an as-needed basis).The patient should allow 7 to 10 days for symptoms to subside.No evidence exists that BuSpar causes tolerance or physical dependence

Question 18

Which classic behavior characterizes bulimia?

Accepted Answer

Patients with bulimia nervosa induce vomiting after consuming large quantities of food.This binge eating occurs in a frenzied state and usually in secrecy; afterward,the patient experiences feelings of shame and self-criticism.Laxatives may be taken to purge the system after the binge.Ninety percent of patients with bulimia are young women.

Question 19

The nurse is caring for an older adult patient with a history of anxiety.Which complaint could indicate that the patient may actually be experiencing emotional distress?

Accepted Answer

The older adult population often expresses somatic complaints rather than openly verbalizing emotional distress.You may observe the anxious older adult complaining of an upset stomach,inability to sleep,fatigue,or increased need to urinate.

Question 20

What thought process underscores a patient's anorexia nervosa?

Accepted Answer

Anorexia nervosa is characterized by the patient's refusal to maintain minimal body weight or eat adequate quantities of food.There is a disturbance in the perception of body shape and size and an extreme fear of becoming fat.The patient strives for perfection and control by controlling caloric intake.The person with anorexia nervosa gains a sense of control by limiting food intake.

Quiz 45: Care of Patients with Anxiety, Mood, and Eating Disorders