Name That Anxiety Disorder
The client exhibits excessive levels of anxiety and concern when separated from someone to whom they have an emotional attachment, fearing that something tragic will occur resulting in permanent seperation
Separation anxiety disorder
Which of the following are true about busiprone?
a.Its use does not produce sedation or drowsiness
b.It is much less likely to produce dependency
c.It binds serotonin/ dopamine
d.all of the above
Answer: D all of the above
Busiprone binds serotonin and dopamine receptors. It is different from other anxiolytics that have sedative qualities. It is not as likely to produce dependency either.
A nurse observes a client who has OCD repeatedly applying, removing and reapplying makeup. The nurse identifies the repetitive behavior demonstrated as being due to what?
a. narcissistic behavior
b. fear of rejection from staff
c. attempt to reduce anxiety
d. adverse effect of antidepressant medication
Answer: An attempt to reduce anxiety.
C. Clients who have OCD demonstrate repetitive behavior in an attempt to suppress persistent thoughts or urges that cause anxiety.
Which characteristic is considered a risk factor for the development of posttraumatic stress disorder (PTSD)?
A. being male
b. experiencing childhood neglect
c. having a grandmother diagnosed with the disorder
d. Spending 3 or more years in a branch of the military
Answer: B
PTSD risk factors include a history of childhood trauma that includes abuse or neglect, being female, and having a first-degree relative diagnosed with a mental illness. Military service does not always present the intense trauma associated with PTSD.
Which personal factor has the greatest impact on a person's management of stressful events?
a. perception of the event.
b. coping skills
c. life experiences
d. identification of stressors
b: coping skills
The ability to adapt to (cope with) stressors leads to conflict resolution, whereas the inability to adapt effectively might result in physical or mental disorders, or even death.
The client reports a fear of specific objects such as spiders, snakes, or strangers.
Specific Phobias
What is the first line of treatment for anxiety and obsessive compulsive disorders?
a. SSRI's
b. SNRI'S
c. Anti-anxiety medication such as benzodiazipines
d. Busiprone
A. SSRI atidepressants such as sertraline or paroxetine are the first line of treatment for anxiety and obsessive compulsive disorders.
Which of the following is not recognized as being an obsessive-compulsive disorder?
a. OCD
b. hoarding disorder
c. body dysmorphic disorder
d. Obsessive-compulsive personality disorder
D: Obsessive-compulsive personality disorder
Obsessive-compulsive personality disorder is a personality disorder and does not belong to the obsessive compulsive disorders according to the DSM-5
Which of the following are criterion in the DSM V for PTSD? (select all that apply)
a. stressor
b. persistent recollection
c. avoidance
d. negative alterations in cognition and mood
e. alterations in arousal and reactivity
answer: abcde
a. Person was exposed to death, threatened death, or actual threatened serious injury, or actual or threatened sexual violence.
b. The traumatic event is persistently re-experienced in the following ways
c. Persistent effortful avoidance of distressing trauma-related stimuli after the event
d. Inability to recall key features of the traumatic event (usually dissociative amnesia)
e.
1. Irritable or aggressive behavior
2. Self-destructive or reckless behavior
3. Hypervigilance
4. Exaggerated startle response
5. Problems in concentration
6. Sleep disturbance
When a patient enters into the exhaustion stage of anxiety, the nurse is aware that the most serious outcome to the patient is:
a. death
b. psychosis
c.disorganized personality
d. aggressive behavior
b: coping skills
The ability to adapt to (cope with) stressors leads to conflict resolution, whereas the inability to adapt effectively might result in physical or mental disorders, or even death.
The client avoids certain places or situations that cause anxiety. This avoidance might disrupt the client's ability to maintain employment or participate in routine activities of daily life.
Agoraphobia
A patient is prescribed Klonopin for panic disorder. Which additional medical condition would also benefit from this medication?
a.Lower back spasms
b.alcohol withdrawal
c. convulsions
d.nausea/vom
C. Convolsuions
Clonazepam is most often used as an anticonvulsant but also has use in the treatment of panic disorder.
A nurse is planning care for a client who has body dysmorphic disorder. Which of the following actions should the nurse plan to take first?
A. Assessing the client's risk for self-harm.
B. Instilling hope for positive outcomes
C. Encouraging the client to participate in group therapy sessions
D. Encouraging the client to participate in treatment decisions.
A: Assessing the client for risk of self-harm
The greatest risk to a client who has an anxiety or obsessive compulsive disorder is self-harm or suicide. Therefore, the first action the nurse should plan to take is to assess the client's risk for self-harm to ensure that the client is provided with a safe environment.
A nurse working on an acute mental health unit is caring for a client who has posttraumatic stress disorder. Which of the following findings should the nurse expect?
a. difficulty concentrating
b. obsessive need to talk about the traumatic event
c. negative self image
d. recurring nightmares
e. diminished reflexes
Answer:
a. difficulty concentrating
c. Negative self image
D. recurring nightmares
(not B because clients with PTSD are reluctant to talk about the traumatic event that triggered the disorder. Ando not E because a client who has PTSD has an increased startle reflex and hypervigilance.)
A patient is having a panic attack. The nurse responds by touching the patient lightly on the arm and saying "What's the matter?". Why is this not a therapeutic approach?
A panic attack requires that the nurse provide simple, brief explanations while not leaving the patient alone. Too many words and too much information for a +4 level of anxiety is nontherapeutic. The nurse should avoid touching a patient experiencing panic-level anxiety; the question, "What's the matter?" is counterproductive and ill-timed.
The client reports difficulty performing or speaking in front of others or participating in social situations due to an excessive fear of embarrassment or poor performance.
Agoraphobia
What is the most serious symptom of benzodiazepine withdrawal?
a. visual hallucinations
b. convulsions
c. cardiac arrest
d. respiratory arrest
B: convulsions
When a benzodiazepine is withdrawn from the dependent person, symptoms such as agitation, tremor, irritability, insomnia, vomiting, sweating, and even convulsions might be experienced.
The nurse is caring for a client with obsessive-compulsive disorder (OCD) . Which clinical manifestations would the nurse expect to see in this client? Select all that apply
a Intrusive thoughts
b Physical complaints such as irritated skin
c Happy and overly excited affect
d Signs of distress and increased anxiety
e Repetitive actions or motions
a.b.d.e
(Rationale:
Repetitive behaviors are a hallmark sign of OCD. Physical complaints can be seen in patients who perform repetitive activities such as hand washing. Signs of distress or increased anxiety can be seen in clients when they feel compelled to complete rituals. The ritual is the client's way of resolving the anxiety. A happy and overly excited affect is not a clinical manifestation associated with OCD.)
You are a nurse working at a primary care clinic. Today, a patient named John walked in complaining of headaches from "stress". You talk to him about this stress and are concerned that he may be experiencing PTSD after being exposed to the death of his brother. Which of the following are expected assessments that may be administered to John?
a. Primary Care PTSD Screen
b. PTSD check list
c. Asking about suicidal ideation
d. CAGE AID
e. Mental status exam
a. Primary Care PTSD Screen
b. PTSD check list
c. Asking about suicidal ideation
e. Mental status exam
NOT D. CAGE is used as a 5-question tool to assess for drug and alcohol dependence. While the patient may present with commorbidities that warrant this assessment, it is not a traditionally administered screening tool for this condition.
A nurse is involved in a serious and prolonged mass casualty incident in the emergency department. Which of the following strategies should the nurse use to help prevent developing a trauma related disorder? (select all that apply)
a. avoid thinking about the incident when it is over.
b. take breaks during the incident for food and water.
c. debrief with others following the incident
d. hold emotions in check in the days following the incident
e. take advantage of offered counseling
answer:
b. taking breaks and remembering to drink water
c. debriefing with others following a traumatic incident
e. taking advantage of counseling offered by an employer
The client demonstrates persistent and excessive worry about a number of things for more than six months. They also demonstrate significant impairment in one or more areas of functioning.
Generalized Anxiety Disorder
When prescribed a benzodiazepine, a patient is considered to be at risk for falls mostly because of what common medication-related side effect?
a.ataxia
b.dysarythia
c.lassitude
d.retrograde amnesia
a. ataxia
Commonly, central nervous system side effects such as ataxia (decreased motor coordination) are exhibited and increase the patient's risk for falls.
The nurse is providing care to a client with obsessive-compulsive disorder (OCD). Which interventions are appropriate for this client?
Select all that apply.
a Encourage the client to verbalize his or her feelings.
b Assist the client with developing new coping mechanisms.
c Interrupt the ritual, using distraction.
d Establish a loud and fun environment for the client.
e Include time in the daily routine to perform the ritual.
a,b,e
a: encourage the client to verbalize his or her feelings.
b: assist the client with developing new coping mechanisms
e: include time in daily routine to perform the ritual
(Rationale
Verbalization of feelings will assist the client with reducing stress and anxiety. The client with OCD needs to learn new coping skills to manage the intrusive thoughts that lead to the performance of rituals. Allowing time in a client's daily schedule to perform the ritual will allow the client to complete the ritual and still manage daily activities. A loud environment is not recommended. Interrupting a client's ritual may lead to increased anxiety and is not recommended, unless it is harmful to the client.)
Identify this symptom commonly seen in PTSD:
Dissociative reactions where the client feels the traumatic event is recurring in the present, such as when a military veteran feels that he or she is reliving a comabt situation after hearing a harmless loud noise.
Flashback
A nurse is caring for a cllient who has acute stress disorder and is experiencing severe anxiety. Which of the following statements actions should the nurse make?
a. " tell me about ho you are feeling right now?"
b. " you should focus on the positive things in your life to decrease our anxiety"
c. "why do you believe you are experiencing this anxiety"?
d. "let's discuss the medications your provider is prescribing to decrease your anxiety"
Answer: A
Asking an open-ended question is therapuectic and assists the client in identifying teh anxiety.
b. offering advice is nontherapeutic and can further hinder communicatinon
c. asking the client a why question is nontherapeutic and can promote a defensive client response
d. postpone health teaching until after the acute anxiety subsides. Clients experiencing anxiety are unable to concentrate or learn.