Question 1

A psychiatric patient is experiencing panic-level anxiety.The initial intervention of highest priority is:

Accepted Answer

Safety is of highest priority because the patient in panic is at high risk for self-injury related to increased non-goal-directed motor activity,distorted perceptions,and disordered thoughts.The remaining options are to be considered only after the patient is safe.

Question 2

A patient is very anxious and can only follow simple directions with great difficulty.The patient tells a nurse about a fear of keeping clean in such a public place and is observed repeatedly dusting the furniture.The nurse should assess the patient's level of anxiety as:

Accepted Answer

Severe anxiety is characterized by a reduced perceptual field as evidenced by inability to follow directions.All behavior is aimed at relieving anxiety as evidenced by the rituals the patient performs.

Question 3

A patient has significant non-goal-directed motor activity,seems terror stricken,and experiences both distorted perceptions and disordered thoughts.When the nurse attempts to calm the patient,the patient does not respond.The level of patient anxiety can be assessed as:

Accepted Answer

Panic-level anxiety is associated with awe,dread,and terror.The person is disorganized,is unable to relate to others,and experiences distorted perceptions and loss of rational thought.The person is unable to do things even with direction.

Question 4

After hitting a playmate,a child untruthfully states,"The other kid hit me first!" This is an example of:

Accepted Answer

Projection is the attributing of one's thoughts or impulses to another person.

Question 5

Which nursing intervention would be most therapeutic for a newly admitted patient diagnosed with obsessive-compulsive disorder (OCD) who is busily cleaning and straightening a bedroom?

Accepted Answer

This remark acknowledges the patient's feelings but addresses the newly admitted patient's need to know important areas of the unit.

Question 6

Defense mechanisms:

Accepted Answer

Ego defense mechanisms operate unconsciously and usually involve some degree of self-deception and reality distortion.The remaining options are not true statements regarding defense mechanisms.

Question 7

When assessing a patient who gives the impression of being anxious,a nurse seeks to validate this impression because anxiety is:

Accepted Answer

Anxiety is a subjective human experience.The nurse can infer that a patient is anxious based on selected behaviors but must validate this with the patient.

Question 8

A nurse determines that a patient is able to follow directions but appears to experience a narrowed perceptual field and focus on immediate concerns.The nurse determines that the patient is experiencing anxiety at which level?

Accepted Answer

Moderate anxiety is characterized by a focus on only immediate concerns and by the demonstration of a narrowed perceptual field as the person sees,hears,and grasps less.The person blocks out selected areas but can attend to more if directed to do so.

Question 9

A patient whose current behavior includes pacing and cursing tells a nurse,"I'm feeling edgy and can't concentrate." The nurse can assess the patient's level of anxiety as:

Accepted Answer

Restlessness is a behavioral symptom of mild anxiety,whereas edginess is an affective symptom,and inability to concentrate is a cognitive symptom.

Question 10

A patient calls the community mental health center and shares,"For the past 6 months,whenever I even think about leaving my house,my heart pounds,my body shakes,and I cry and feel dizzy.There's no reason for me to feel this way,but I do." These symptoms can be assessed as being most consistent with:

Accepted Answer

The patient has a persistent fear of open places.The extreme physical and emotional reaction is consistent with panic-level anxiety experienced when the feared situation is imminent.

Question 11

A person who was raped several years ago denies having any memory of the event.The defense mechanism in use is:

Accepted Answer

Repression is the involuntary exclusion of a painful or conflicting thought,impulse,or memory from awareness.

Question 12

A patient tends to use the defense mechanism of displacement.When the patient's spouse accuses the patient of being disorganized and flighty,the patient is most likely to react by:

Accepted Answer

Displacement is defined as the shifting of an emotion from its original source to a person or object that is less threatening.The remaining options do not reflect a shifting of emotion onto a less-threatening person or object.

Question 13

A patient admitted to the psychiatric unit with a diagnosis of obsessive-compulsive disorder (OCD) tells a nurse of a need to perform oral hygiene at least 15 times each day while sleeping only 1 hour each night for the last 5 days.Within the next 48 hours,which outcome would best indicate that nursing interventions to relieve anxiety had been successful?

Accepted Answer

Patients with obsessive-compulsive disorder may be so consumed by rituals that they are not able to stop long enough to eat,go to the bathroom,or sleep.Sleeping 6 hours per night in comparison with sleeping only 1 hour indicates improvement.

Question 14

A nurse explains a patient's behavior by stating,"The patient's anxiety stemmed from being unable to attain a desired goal." Which theory is the nurse basing the response upon?

Accepted Answer

Behaviorist theory proposes that anxiety is a product of frustration caused by anything that interferes with attaining a desired goal.This is not the theory proposed by the other options.

Question 15

If a penny-pinching patient rationalizes personal behavior,a nurse will expect that the patient is most likely to:

Accepted Answer

Rationalization is the offering of a socially acceptable or apparently logical reason as a justification for an unacceptable impulse,feeling,behavior,or motive.

Question 16

During a staff conflict,one of your nursing peers defends her actions and asserts her own rights among the professional staff.Defending one's actions and asserting one's rights typify the coping mechanism of:

Accepted Answer

Task-oriented reactions are thoughtful,deliberate attempts to solve problems,resolve conflicts,and gratify needs.They are consciously directed and action oriented and can include attack,withdrawal,and compromise.

Question 17

A police officer who uses reaction formation to deal with fears of acting cowardly is most likely to:

Accepted Answer

Reaction formation is the development of behavior patterns or conscious attitudes that are the opposite of what one really feels or would like to do.

Question 18

A patient is experiencing panic-level anxiety.Of these medications listed on the patient's prn medication administration record,which should be given?

Accepted Answer

Lorazepam (Ativan) is a benzodiazepine used to treat anxiety.It may be given as a prn medication.The remaining options are either not ordered for anxiety or as prn medication.

Question 19

Several months after being trapped in a collapsed building for several hours before being rescued,a patient admits to currently feeling "numb" and being unable to relate well with people.The patient sometimes re-experiences the terror associated with being trapped.The data collected about the patient are consistent with the symptoms of which problem?

Accepted Answer

Posttraumatic stress disorder (PTSD) follows exposure to a traumatic event.Symptoms include a tendency to relive the experience,a feeling of emotional "numbness," inability to relate,and persistent symptoms of arousal.

Question 20

Physiological responses associated with anxiety are modulated by the brain through which system?

Accepted Answer

The autonomic nervous system,which comprises parasympathetic and sympathetic systems,is responsible for the individual's physiological responses to anxiety.The parasympathetic system conserves body responses,and the sympathetic system activates body responses.Sympathetic reactions predominate in anxiety.

Quiz 15: Anxiety Responses and Anxiety Disorders