Question 1

The nurse enters the client's room and finds the client anxiously pacing the floor. The client begins shouting at the nurse, Get out of my room! The best intervention by the nurse would be to

Accepted Answer

Staying with the client while allowing personal space is an important and safe intervention; this therapeutic communication technique is designed to get the client to communicate feelings. It may not be safe for the nurse to approach the client. Help is not needed at this time, and saying, Calm down, is not effective. Turning and walking away from the client may seem like rejection and may worsen the client's anxiety as well as damage the nurseñclient relationship.

Question 2

Which of the following are cognitiveñbehavioral therapy techniques that may be used effectively with anxious clients? Select all that apply.

Accepted Answer

Positive reframing means turning negative messages into positive messages. Decatastrophizing involves the therapist's use of questions to more realistically appraise the situation. Assertiveness training helps the person take more control over life situations. Positive reframing, decatastrophizing, and assertiveness training are cognitiveñbehavioral therapy techniques. Humor is not a cognitiveñbehavioral therapy technique. Unlearning is the theory underlying behavioral therapy.

Question 3

The nurse is teaching about postoperative wound care. As the wound is uncovered, the client begins mumbling, breathing rapidly, and trying to get out of bed, and the client does not respond when the nurse calls his name. Which of the following should be the nurse's first action?

Accepted Answer

The client has severe anxiety; the priority is to lower the client's anxiety level. The first action should be to replace the dressing on the wound to decrease the client's level of anxiety and to prevent contamination of the wound before a new dressing can be applied. The other choices could be done after replacing the dressing on the wound.

Question 4

The nursing student understands correctly when identifying which objective is appropriate for all clients with anxiety disorders?

Accepted Answer

A primary client outcome is improved adaptive coping skills.

Question 5

When a client is experiencing a panic attack while in the recreation room, what interventions are the nurse's first priorities? Select all that apply.

Accepted Answer

During a panic attack, the nurse's first concern is to provide a safe environment and to ensure the client's privacy. If the environment is overstimulating, the client should move to a less stimulating place. Decreasing external stimuli will help lower the client's anxiety level. The client's safety is priority. Anxious behavior can be escalated by external stimuli. In a large area, the client can feel lost and panicked, but a smaller room can enhance a sense of security. An antianxiety agent may be helpful, but it is not the priority. It would likely be stimulating to engage the client in recreational activities.

Question 6

A client is learning to cope with anxiety and stress. The expected outcome is that the client will

Accepted Answer

Stress and anxiety in life are unavoidable; managing the effects of stress is a reasonable goal for treatment. It is not possible or desirable to avoid anxiety at all costs as anxiety is a warning that the client is not dealing with stress effectively. Learning to heed this warning and to make needed changes is a healthy way to deal with the stress of daily events.

Question 7

A client asks the nurse, Why do I have to go to counseling? Why can't I just take medications? The best response by the nurse would be,

Accepted Answer

Treatment for anxiety disorders usually involves medication and therapy. This combination produces better results than either one alone.

Question 8

A client asks how his prescribed alprazolam (Xanax) helps his anxiety disorder. The nurse explains that antianxiety medications such as alprazolam affect the function of which neurotransmitter that is believed to be dysfunctional in anxiety disorders?

Accepted Answer

Gamma-aminobutyric acid (GABA) is the amino acid neurotransmitter believed to be dysfunctional in anxiety disorders. GABA reduces anxiety, and norepinephrine increases it; researchers believe that a problem with the regulation of these neurotransmitters occurs in anxiety disorders. Serotonin is usually implicated in psychosis and mood disorders. Dopamine is indicated in psychosis.

Question 9

The nurse is teaching a client with an anxiety disorder ways to manage anxiety. The nurse suggests which of the following schedules for practicing stress management techniques?

Accepted Answer

The nurse can teach the client relaxation techniques to use when he or she is experiencing stress or anxiety, including deep breathing, guided imagery and progressive relaxation, and cognitive restructuring techniques. For any of these techniques, it is important for the client to learn and to practice them when he or she is relatively calm.

Question 10

The nurse is educating a client and family about managing panic attacks after discharge from treatment. The nurse includes which of the following in the discharge teaching? Select all that apply.

Accepted Answer

Client/family education for panic disorder includes reviewing breathing control and relaxation techniques, discussing positive coping strategies, encouraging regular exercise, emphasizing the importance of maintaining prescribed medication regimen and regular follow-up, describing time management techniques such as creating to do lists with realistic estimated deadlines for each activity, crossing off completed items for a sense of accomplishment, saying no, and stressing the importance of maintaining contact with community and participating in supportive organizations. Medication should be adhered to as prescribed. Daily responsibilities cannot be avoided, rather should be successfully accomplished.

Question 11

When teaching a client with generalized anxiety disorder, which is the highest priority for the nurse to teach the client to avoid?

Accepted Answer

The effects of caffeine are similar to some anxiety symptoms, and, therefore, caffeine ingestion will worsen anxiety. The other types of foods are also potentially harmful to physical as well as psychological health, but the worst offender is caffeine.

Question 12

An anxiolytic agent, lorazepam (Ativan), has been prescribed for the client. Which of the following statements by the client would indicate to the nurse that client education about this medication has been effective?

Accepted Answer

Anxiolytics are designed for short-term use to relieve anxiety. These drugs are designed to relieve anxiety so that the person can deal more effectively with whatever crisis or situation is causing stress. Benzodiazepines have a tendency to cause dependence.
Clients need to know that antianxiety agents are aimed at relieving symptoms such as anxiety but do not treat the underlying problems that cause the anxiety.

Question 13

Which of the following would be key points for the nurse to remember when working with persons who are suffering from anxiety disorders?

Accepted Answer

It is critical for the nurse to remember to practice techniques to manage stress and anxiety in his or her own life. Remember that everyone occasionally suffers from stress and anxiety that can interfere with daily life and work. It is important for the nurse to avoid falling into the pitfall of trying to fix the client's problems. It is important that the nurse should discuss any uncomfortable feelings with a more experienced nurse for suggestions on how to deal with his or her feelings toward these clients.

Question 14

Which of the following are reasons that the nurse must understand why and how anxiety behaviors work? Select all that apply.

Accepted Answer

Nurses must understand why and how anxiety behaviors work, not just for client care but to help understand the role anxiety plays in performing nursing responsibilities. Nurses are expected to function at a high level and to avoid allowing their own feelings and needs to hinder the care of their clients, but as emotional beings, nurses are just as vulnerable to stress and anxiety as others, and they have needs of their own.

Quiz 14: Anxiety and Anxiety Disorders