ch 14 NCLEX questions

ch 14 NCLEX questions ScienceMedicineNursing joelle_hilton Save Anxiety Disorders Practice Question...24 terms jennibugarinPreview

chapter 18: anxiety

Teacher 20 terms jcpierre1Preview

N6720 GU

102 terms Emily_Tackett5 Preview Anxiety 25 terms Pol The mental health nurse is gathering a health history on a new client. The client is constantly pacing the floor and is concerned only with stating that the client is about to die. The nurse would classify this level of anxiety as what?Mild Euphoria Moderate Severe Moderate Rationale:In moderate anxiety, the client experiences a narrowing of the ability to concentrate. The client paces, has voice tremors, and has an increased rate of speech. During euphoria, the client experiences an exaggerated feeling of well-being that is not directly proportional to a specific circumstance or situation. Mild anxiety causes the client to have an increased alertness to inner feelings or the environment. During severe anxiety, the client is able to focus on only small or scattered details.Which nursing intervention is focused on the primary goal of anxiety management and treatment?helping the client identify ways to eliminate all sources of stress in his or her daily life assessing the client's ability to implement stress management techniques effectively assessing the client for possible symptoms of panic disorder educating the client concerning the use of medications to manage anxiety disorders assessing the client's ability to implement stress management techniques effectively Rationale:For people with anxiety disorders, it is important to emphasize that the goal is effective management of stress and anxiety, not the total elimination of anxiety. Learning anxiety management techniques and effective methods for coping with life and its stresses is essential for overall improvement in life quality. Although medication is important to relieve excessive anxiety, it does not solve or eliminate the problem entirely. While assessment is appropriate, it is not directly associated with the management and treatment of the original disorder.

Which would not be included in the plan of care for a client diagnosed with acute anxiety?Encouraging the client to verbalize feelings and concerns Providing the client with a safe, quiet, and private place Approaching the client in a calm, confident manner Touching the client in an attempt to comfort the client Touching the client in an attempt to comfort the client Rationale:The emergency nurse must establish rapport and trust with the anxious client before using therapeutic touch. Touching an anxious client may actually increase anxiety. Trust can be established by approaching the client in a calm and confident manner; providing a place that is quiet, safe, and private; and encouraging the client to verbalize feelings and concerns.A nurse is preparing a plan of care for a client with anxiety. Which elements would the nurse likely include? Select all that apply.Using appropriate coping skills Providing supportive feedback Using restraint when panic develops Identifying treatment modalities Involving family for support, if appropriate Using appropriate coping skills Providing supportive feedback Identifying treatment modalities Involving family for support, if appropriate Rationale:Appropriate measures to include in the plan of care for a client with anxiety include: introducing appropriate coping skills, identifying alternate treatment modalities, involving family and support persons when appropriate, and providing feedback that is supportive to the client.Restraint is always a last resort.Which level of anxiety helps the client focus the client's attention to learn, problem solve, think, act, feel, and protect himself or herself?Moderate Severe Mild Panic Mild Rationale:In mild anxiety, sensory stimulation increases and helps the client focus the client's attention to learn, solve problems, and think.Moderate anxiety causes the client to have difficulty concentrating independently, but he or she can be redirected to the topic. Severe anxiety causes the client to have a reduced perceptual field and he or she cannot complete tasks. Panic anxiety reduces the perceptual field to focus on the self, and the client cannot process any environmental stimuli.

The nurse is assessing a client who recently experienced their first panic attack while at the grocery store. What question should the nurse ask to identify complications of the disorder?"What do you think is the origin of the panic you felt?" "Are you concerned there will be more panic attacks?" "Can you describe how you felt physically during the attack?" "Do you have any problems going out alone to public places?" "Do you have any problems going out alone to public places?" Rationale:To identify complications of the disorder when assessing a client who recently experienced the client's first panic attack while at a grocery store, the psychiatric nurse asks, "Do you have any problems going out alone to public places?" Which is a cardiovascular response of the sympathetic nervous system?Bradypnea Bradycardia Hypotension Tachycardia Tachycardia Rationale:Tachycardia is a cardiovascular response of the sympathetic nervous system. Bradypnea, hypotension, and bradycardia are responses of the parasympathetic system. Sympathetic cardiovascular responses to stress include increased heart rate, cardiac contractility, and cardiac output; increased blood pressure; and peripheral vasoconstriction.Nearly what percentage of adults are affected by anxiety disorders?

0.1 0.4 0.25 0.5 0.25

Rationale:Nearly 25% of adults are affected by anxiety disorders.

Which should be included in a teaching plan for a client prescribed a benzodiazepine?Rise slowly from a lying or sitting position Stop taking drug if sedation develops Consume caffeine in moderation Maintain a fluid restriction Rise slowly from a lying or sitting position Rationale:Clients taking a benzodiazepine should rise slowly from a lying or sitting position. The client should drink adequate fluids, avoid caffeine, and not stop taking the drug abruptly.

Which term describes feelings of being disconnected from oneself as seen in a panic attack?Derealization Automatisms Agoraphobia Depersonalization Depersonalization Rationale: Depersonalization describes feelings of being disconnected from oneself as seen in a panic attack. Derealization is sensing that things are not real. Automatisms are automatic, unconscious mannerisms. Agoraphobia is a fear of being outside.A nurse determines that a client who is experiencing anxiety is using relief or primitive survival behaviors. The nurse determines that the client is experiencing which degree of anxiety?Panic Severe Mild Moderate Severe Rationale:A client experiencing severe anxiety typically uses relief behaviors. With mild anxiety, the client is easily able to recognize and name anxiety. With moderate anxiety, the client is usually able to state that he or she is anxious. With panic, the client is perplexed and self-absorbed.A patient with anxiety disorder has excessive anxiety and worries about multiple life circumstances. For how long would this patient experience these feelings before the anxiety disorder would be considered chronic and generalized?

• months

12 months

• months
• months
• months

Rationale:For generalized anxiety disorder, the diagnostic criteria listed include unrealistic or excessive anxiety and worry about two or more life circumstances for 6 months or more, during which time these concerns exist for a majority of days.Which medication classification has been found to be effective in reducing or eliminating panic attacks?Antimanics Antipsychotics Anticholinergics Antidepressants Antidepressants Rationale:Tricyclic and monoamine oxidase inhibitor antidepressants have been found to be effective in treating clients with panic attacks. Why these drugs help control panic attacks is not clearly understood. Anticholinergic agents, which are smooth-muscle relaxants, relieve physical symptoms of anxiety but do not relieve the anxiety itself. Antipsychotic drugs are inappropriate because clients who experience panic attacks are not psychotic. Mood stabilizers are not indicated because panic attacks are rarely associated with mood changes.