Anxiety Disorders Practice Questions NCLEX

Anxiety Disorders Practice Questions NCLEX ScienceMedicineNursing jennibugarin Save

Psychiatric Nursing - Ch 29: Somatic...

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30 terms hawkinsr10Preview Anxiety Disorders NCLEX style ques...25 terms PollyCxPreview Eating 21 terms sjbr A client is experiencing a severe panic attack. Which nursing intervention would meet this client's immediate need?

• Teach deep breathing relaxation exercises
• Place the client in a Trendelenburg position
• Stay with the client and offer reassurance of safety
• Administer the ordered PRN buspirone (BuSpar)

ANS: C

The nurse can meet this client's immediate need by staying with the client and offering reassurance of safety and security. The client may fear for his or her life and the presence of a trusted individual provides assurance of personal safety.A nurse has been caring for a client diagnosed with post-traumatic stress disorder. What short-term, realistic, correctly written outcome should be included in this client's plan of care?

• The client will have no flashbacks.
• The client will be able to feel a full range of emotions by discharge.
• The client will not require zolpidem (Ambien) to obtain adequate sleep by discharge.
• The client will refrain from discussing the traumatic event.

ANS: C

The nurse should include obtaining adequate sleep without zolpidem (Ambien) by discharge as a realistic outcome for this client. Having no flashbacks and experiencing a full range of emotions are long-term not short-term outcomes for this client. Clients are encouraged to discuss the traumatic event.

A client is prescribed alprazolam (Xanax) for acute anxiety. What client history should cause a nurse to question this order?

• History of alcohol dependence
• History of personality disorder
• History of schizophrenia
• History of hypertension

ANS: A

The nurse should question a prescription of alprazolam (Xanax) for acute anxiety if the client has a history of alcohol dependence. Alprazolam is a benzodiazepine used in the treatment of anxiety and has an increased risk for physiological dependence and tolerance. A client with a history of substance abuse may be more likely to abuse other addictive substances and/or combine this drug with alcohol.Which nursing diagnosis would best describe the problems evidenced by the following client symptoms: avoidance, poor concentration, nightmares, hypervigilance, exaggerated startle response, detachment, emotional numbing, and flashbacks?

• Ineffective coping
• Post-trauma syndrome
• Complicated grieving
• Panic anxiety

ANS: B

Post-trauma syndrome is defined as a sustained maladaptive response to a traumatic, overwhelming event. This nursing diagnosis addresses the problems experienced by clients diagnosed with post-traumatic stress disorder.How should a nurse best describe the major maladaptive client response to panic disorder?

• Clients overuse medical care due to physical symptoms.
• Clients use illegal drugs to ease symptoms.
• Clients perceive having no control over life situations.
• Clients develop compulsions to deal with anxiety.

ANS: C

The major maladaptive client response to panic disorder is the perception of having no control over life situations which leads to nonparticipation in decision making and doubts regarding role performance.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.)

• Fatigue
• Anorexia
• Hyperventilation
• Insomnia
• Irritability

ANS: A, D, E

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.

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.)

• Encourage the client to recognize the signs of escalating anxiety.
• Encourage the client to avoid any situation that causes stress.
• Encourage the client to employ newly learned relaxation techniques.
• Encourage the client to cognitively reframe thoughts about situations that generate anxiety.
• Encourage the client to avoid caffeinated products.

ANS: A, C, D, E

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. Stress is a component of life and is not easily evaded.A client who is a veteran of the Gulf War is being assessed by a nurse for post-traumatic stress disorder (PTSD). Which of the following client symptoms would support this diagnosis? (Select all that apply.)

• The client has experienced symptoms of the disorder for 2 weeks.
• The client fears a physical integrity threat to self.
• The client feels detached and estranged from others.
• The client experiences fear and helplessness.
• The client is lethargic and somnolent.

ANS: B, C, D

Clients diagnosed with PTSD can experience the following symptoms: fear of a physical integrity threat to self, detachment and estrangement from others, and intense fear and helplessness. Characteristic symptoms of PTSD include re-living the traumatic event, a sustained high level of arousal, and a general numbing of responsiveness.Which of the following symptoms are seen when a client abruptly stops taking diazepam (Valium)? Select all that apply.

• Insomnia.
• Tremor.
• Delirium.
• Dry mouth.
• Lethargy.

Diazepam (Valium) is a benzodiazepine. Benzodiazepines are physiologically and psychologically addictive. If a benzodiazepine is stopped abruptly, a rebound stimulation of the central nervous system occurs, and the client may experience insomnia, increased anxiety, abdominal and muscle cramps, tremors, vomiting, sweating, convulsions, and delirium.

• Insomnia is correct.
• Tremor is correct.
• Delirium is correct.
• Dry mouth is a side effect of taking benzodiazepines and is not related to stopping the medication abruptly.
• Lethargy is a side effect of taking benzodiazepines and is not related to stopping the medication abruptly.

TEST-TAKING HINT: The test taker must

distinguish between benzodiazepine side effectsand symptoms of withdrawal to answer this question correctly.

Which of the following would the nurse expect to assess in a client diagnosed with posttraumatic stress disorder? Select all that apply.

• Dissociative events.
• Intense fear and helplessness.
• Excessive attachment and dependence toward others.
• Full range of affect.
• Avoidance of activities that are associated with the trauma.
• A client diagnosed with posttraumatic

stress disorder (PTSD) may have dissociative events in which the client feels detached from the situation or feelings.

• A client diagnosed with PTSD may have

intense fear and feelings of helplessness.

• A client diagnosed with PTSD avoids activities associated with the traumatic event.

TEST-TAKING HINT: To answer this question correctly, the test taker must be aware of the different symptoms associated with the diagnosis of PTSD.A newly admitted client is diagnosed with posttraumatic stress disorder. Which behavioral symptom would the nurse expect to assess?

• Recurrent, distressing flashbacks.
• Intense fear, helplessness, and horror.
• Diminished participation in significant activities.
• Detachment or estrangement from others.
• Diminished participation in significant

activities is a behavioral symptom of PTSD.TEST-TAKING HINT: To answer this question correctly, the test taker should take note of the keyword "behavioral," which determines the correct answer. All symptoms may be exhibited in PTSD, but only answer choice "3" is a behavioral symptom.A client with a history of generalized anxiety disorder enters the emergency department complaining of restlessness, irritability, and exhaustion.Vital signs are blood pressure 140/90 mm Hg, pulse 96, and respirations 20. Based on this assessed information, which assumption would be correct?

• The client is exhibiting signs and symptoms of an exacerbation of generalized anxiety

disorder.

• The client's signs and symptoms are due to an underlying medical condition.
• A physical examination is needed to determine the etiology of the client's problem.
• The client's anxiolytic dosage needs to be increased.
• Physical problems should be ruled out

before determining a psychological cause for this client's symptoms.TEST-TAKING HINT: The test taker needs to remember that although a client may have a history of a psychiatric illness, a complete, thorough evaluation must be done before assuming exhibited symptoms are related to the psychiatric diagnosis. Many medical conditions generate anxiety as a symptom.