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PrepU Chapter 14, PrepU Chapter 14 combo

question

The nurse is assessing a client and finds two enlarged supraclavicular lymph nodes. The nurse asks the client how long these enlarged nodes have been there. The client states, “I can’t remember. A long time I think. Do I have cancer?” The nurse is aware that that body responds to stress. Which is an immediate physiologic response to stress the nurse would expect to see in this client? Vasodilation of peripheral blood vessels Increased blood pressure Decrease in blood glucose levels Pupil constriction
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Increased blood pressure
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A nursing instructor is describing the care of a client with acute anxiety to a class of nursing students. The instructor determines that more education is necessary when the students identify which intervention as appropriate? Providing the client with a comforting touch Providing the client with a safe, quiet, and private place Encouraging the client to verbalize feelings and concerns Approaching the client in a calm, confident manner
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Providing the client with a comforting touch
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A nurse is preparing a plan of care for a client with anxiety. Which would the nurse likely include? Select all that apply. Using appropriate coping skill Identifying treatment modalities Involving family for support, if appropriate Providing supportive feedback Using restraint when panic develops
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Using appropriate coping skill Identifying treatment modalities Involving family for support, if appropriate Providing supportive feedback
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Which nursing intervention is focused on the primary goal of anxiety management and treatment? assessing the client’s ability to implement stress management techniques effectively helping the client identify ways to eliminate all sources of stress in his or her daily life educating the client concerning the use of medications to manage anxiety disorders assessing the client for possible symptoms of panic disorder
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assessing the client’s ability to implement stress management techniques effectively
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A school health nurse is meeting with the parents of a 6-year-old child who has been selectively mute. The nurse is offering the parents education regarding this problem. The nurse can tell the parents that what is true about selective mutism? selective mutism is associated with social anxiety parenting does not play a role in selective mutism selective mutism arises from child abuse children with selective mutism should be home-schooled.
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selective mutism is associated with social anxiety
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A client comes in for a therapy session and begins to have a panic attack. The therapist asks the client to relax in the chair and then gently asks the client to imagine the client in a very safe and calm place. This technique, often useful in anxiety disorders, is called what? Cognitive therapy Deep breathing Desensitization Problem-solving
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Deep breathing
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The client reports that the client feels anxious when interacting socially with others and “never seems to know what to say.” Which question indicates the nurse has a sound understanding of interpersonal theory as it relates to anxiety? “What kind of relationship do you have with your parents?” “Do other members of your family have similar problems?” “How long have you experienced these problems?” “What have you tried to help manage your feelings and discomfort?”
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“What kind of relationship do you have with your parents?”
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A client spends hours stacking and unstacking towels. The client is repeatedly checking to make sure that the towels are in order of color. What term is used to identify this behavior? Compulsion Phobia Obsession Derealization
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Compulsion
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The nurse walks into the client’s room and finds the client sobbing uncontrollably. When the nurse asks what the problem is, the client responds, “I am so scared. I have never known anyone who goes into a hospital and comes out alive.” On this client’s care plan the nurse notes a nursing diagnosis of ineffective coping related to stress. What is the best outcome to be expected for this client? Client will adapt relaxation techniques to reduce stress. Client will be stress free. Client will avoid stressful situations. Client will start antianxiety agent.
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Client will adapt relaxation techniques to reduce stress.
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Which statement by the nurse demonstrates an understanding of the role automatisms have in a panic attack? “The client taps her fingers very rapidly when she is feeling anxious.” “I discourage her finger tapping since it serves to increase her anxiety level.” “She knows that if she taps her fingers she will be able to lessen her anxiety.” “I can tell that the more she taps, the less anxiety she is actually feeling.”
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“The client taps her fingers very rapidly when she is feeling anxious.”
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Anxiety disorder is considered chronic and generalized when excessive anxiety and worry about two or more life circumstances exist for at least … 6 months 2 months 12 months 4 months
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6 months
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The nurse is caring for a client who is being treated in the emergency department for a panic attack. Which nursing intervention would be most appropriate? Demonstrate empathy for the client by trying to mimic the client’s state of anxiety. Tell the client that the nurse must leave to go report the client’s symptoms to the psychiatrist on duty. Tell the client this is an acute exacerbation with a positive prognosis and low morbidity. Stay with the client, emphasizing that the client is safe and that the nurse will remain with the client.
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Stay with the client, emphasizing that the client is safe and that the nurse will remain with the client.
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The nurse at the student health center is seeing a group of nursing students who are interested in reducing their stress level. The nurse identifies guided imagery as an appropriate intervention. What does guided imagery involve? The use of progressive tensing and relaxing of muscles to release tension in each muscle group Using a positive self-image to increase and intensify physical workouts in the gym, which decreases stress The mindful use of a word, phrase, or visual image, which allows oneself to be distracted and temporarily escape from stressful situations The use of music and humor to create a calm and relaxed demeanor, which allows escape from stressful situations
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The mindful use of a word, phrase, or visual image, which allows oneself to be distracted and temporarily escape from stressful situations
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A nurse is caring for a client who has panic attack. The nurse takes the client in a small, isolated room. How would this intervention benefit the client? Choose the best answer. The client would return to rational thought. The client would have an enhanced sense of security. The client would be able to demonstrate relaxation techniques. The client would be able to understand what the nurse is saying.
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The client would have an enhanced sense of security.
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Which would be an appropriate intervention of a client experiencing a panic attack? Staying with the client and speaking in short sentences Turning on the lights and opening the windows so that the client does not feel crowded Leaving the client alone Turning on stereo music loudly
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Staying with the client and speaking in short sentences
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A client with generalized anxiety disorder states that the client is worried about the client’s job. The client never feels like the client has control over the client’s responsibilities, even though the client puts in extra hours. The client adds that the client is afraid the client will be fired. Which response by the nurse is most therapeutic? “It sounds to me like you’re doing a good job.” “Your worries are a feature of your anxiety disorder. Tell yourself that you have nothing to worry about.” “Has something changed at work that is causing you to worry?” “Why do you think you’ll be fired?”
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“Has something changed at work that is causing you to worry?”
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Which assessment question is most likely to allow the nurse to differentiate between anxiety disorder due to a general medical condition and psychological factors affecting a medical condition? Reviewing the client’s previous medication administration record and the client’s current list of medications Questioning the client about the clinician who first diagnosed the medical problem Asking the client to provide a detailed explanation of his or her medical problem to determine if the presentation is typical of the problem Establishing whether the client’s anxiety preceded the medical problem or whether the medical problem appeared first
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Establishing whether the client’s anxiety preceded the medical problem or whether the medical problem appeared first
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A hospitalized client states that the client is having difficulty resting. Which intervention would help promote rest? Leaving the client’s door open so the client can see into the hallway Assisting the client with deep-breathing exercises Offering the client a cup of tea Encouraging the client to take prescribed sedatives daily
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Assisting the client with deep-breathing exercises
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What is the term for the change that takes place in response to a stressor? Rehabilitation Adaptation Positive movement Negative movement
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Adaptation
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Which condition involves a persistent, irrational fear attached to an object or situation that objectively does not pose a significant danger? Specific phobia Posttraumatic stress disorder Obsessive-compulsive disorder Generalized anxiety disorder
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Specific phobia
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Clients taking benzodiazepines need education about what? Avoiding cheeses and smoked meats Interactions with monoamine oxidase inhibitors (MAOIs) Avoiding spending too much time in the sun Concomitant use of alcohol
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Concomitant use of alcohol
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A client who has been diagnosed with panic disorder visits the clinic and experiences a panic attack. The client tells the nurse, “I’m so nervous. My hands are shaking, and I’m sweating. I feel as if I’m having a stroke right now.” What would be the priority intervention at this time? Stay with the client while remaining calm. Move the client to a safe environment. Tell the client that the attack will soon pass. Teach the client deep breathing techniques to calm the client.
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Stay with the client while remaining calm.
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The nurse is assessing a client with anxiety. Which behavior might indicate that the client has moderate anxiety? The client is focused in an activity. The client is nervous and agitated. The client has impaired cognitive skills. The client is unable to communicate verbally.
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The client is nervous and agitated.
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A nurse is seeing a client who is having severe to panic level anxiety after a physical assault months previously. The client tells the nurse, “When the panic starts I feel like I am watching myself through a window.” The nurse can most accurately describe this experience as: depersonalization. derealization. decatastrophizing. demonstrating automatisms.
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depersonalization.
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The nurse is providing care for a psychiatric-mental health client who has a diagnosis of anxiety. Which statement by the nurse is likely the most therapeutic intervention? “Anxiety is a feeling that is experienced by everyone at some point and it can never be completely removed from one’s life.” “With the development of more life skills and a demonstration of continued success in life, your anxiety will shrink and eventually disappear.” “Every time you feel anxious, try to focus on how much easier your life would be if you didn’t experience anxiety so often.” “If you address the causes of your anxiety head-on, you will find that you can recover from it without medications or therapy.”
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“Anxiety is a feeling that is experienced by everyone at some point and it can never be completely removed from one’s life.”
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The nurse has read in a client’s admission record that the client has been taking propranolol for psychiatric, rather than medical, reasons. The nurse should recognize that the client likely has a history of which mental health condition? Obsessive-compulsive disorder (OCD) Panic disorder Acute stress disorder Nightmares
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Panic disorder
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Which statement, made by a client diagnosed with an anxiety disorder, should trigger the nurse’s concern about the client’s understanding of the use of defense mechanisms? “I’m thankful that I have a way to manage my problems.” “Defense mechanisms provide a sense of control over the uncontrollable.” “I’m not sure when I’m actually using a defense mechanism.” “When I have a problem, I just deny it until it goes away.”
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“When I have a problem, I just deny it until it goes away.”
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The nurse can document correctly that a client diagnosed with an anxiety disorder is experiencing moderate anxiety when the nurse observes the client doing what? Pacing and repeatedly asking staff what time the “doctor will be here.” Reporting, “I just can’t relax; I’ve got things to do.” Telling another client that “there is nothing they can do for me; I just know it’s really bad.” Demonstrating difficulty actually verbalizing anxious feelings
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Pacing and repeatedly asking staff what time the “doctor will be here.”
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All except which are considered clinical symptoms of anxiety? Palpitations Extreme restlessness Motor excitement Tearfulness and sadness
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Tearfulness and sadness
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Which medication classification has been used to treat social phobia? Selective serotonin reuptake inhibitors (SSRIs) Monoamine oxidase inhibitors (MAOIs) Tricyclic antidepressants (TCAs) Nonbenzodiazepines
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Selective serotonin reuptake inhibitors (SSRIs)
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In speaking with a client with moderate anxiety, the client becomes tangential discussing unrelated topics. To help the client’s attention from wandering, which is an effective intervention? The nurse should speak in short and simple sentences. The nurse should remain with the client until the anxiety is reduced. The nurse should speak in a soft and calm voice. The nurse should take the client to a nonstimulating environment.
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The nurse should speak in short and simple sentences.
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A client is currently experiencing panic. Which acation would be most appropriate for the nurse to do? Allow the client to pace Ask the client repeated questions about feelings Employ the use of negative self-talk Urge the client to engage in vigorous exercise
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Allow the client to pace
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When assessing an elderly client who has newly been diagnosed with an anxiety disorder, the mental health nurse’s priority is to carry out which task? Determine the client’s risk for self-harm or harm to others Obtain a thorough history, focusing on the client’s physiologic functioning Assess for physical conditions that may affect anxiety Determine the effects that culture has had on the client’s anxiety issues
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Determine the client’s risk for self-harm or harm to others
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A client reports the client is beginning a new job and is feeling anxious about the client’s performance. The nurse can explain which type of anxiety can actually improve functioning? Mild Moderate Severe All anxiety decreases functioning
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Mild
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A client has sought treatment because of the overwhelming anxiety the client experiences regarding the safety of the client’s young children. The client admits that the client will not normally let the client’s children leave the client’s sight for fear that they will be abducted, abused, or injured. The client is unable to function at work as a result of this anxiety. The nurse would recognize that this client experiences which condition? Signal anxiety Fear Derealization Anticipatory anxiety
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Anticipatory anxiety
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During which type of anxiety does a person’s perceptual field actually increase? Mild Moderate Severe Panic
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Mild
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Nursing interventions for physical stress related illness should include what? Assessing the need for increased dose of benzodiazepines Attending group therapy Establishing daily routines of meals and sleeping Fostering use of a social support system
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Establishing daily routines of meals and sleeping
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The nurse recognizes that who is the client most likely experiencing generalized anxiety disorder (GAD)? 40-year-old who has reported numerous absences from work, muscle aches, and difficulty falling asleep for the last 8 months 22-year-old soldier who served in the Middle East who “cannot sleep” and is facing criminal charges for hurting someone in a barroom brawl 70-year-old whose spouse died 1 year ago who has “no desire to leave my house” and reports severe fatigue 30-year-old business executive who reports being anxious about attending the meetings and social events that are the executive’s job responsibilities
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40-year-old who has reported numerous absences from work, muscle aches, and difficulty falling asleep for the last 8 months
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Which medication classification has been found to be effective in reducing or eliminating panic attacks? Antidepressants Anticholinergics Antipsychotics Antimanics
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Antidepressants
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Which factor has the least influence on achieving mental health for the client who has anxiety disorder? The client’s mother also suffered from an anxiety disorder. The client was raised in a household with high stress and frequent geographic moves. The client’s mother often related to the client in ways that reflected the mother’s high level of anxiety. The client is often late to school and makes poor grades in most of the client’s subjects.
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The client is often late to school and makes poor grades in most of the client’s subjects.
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A group of nursing students are reviewing signs and symptoms of anxiety. The students demonstrate a need for additional review when they identify what? Palpitations Extreme restlessness Motor excitement Tearfulness
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Tearfulness
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A group of students is reviewing information about anxiety disorders in preparation for a class examination. The students demonstrate understanding of the material when they state what? Anxiety disorders rank second to depression in psychiatric illnesses being treated. Women experience anxiety disorders more often than do men. Most anxiety disorders tend to be short term with individuals achieving full recovery. Anxiety disorders are more common among children than among adolescents.
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Women experience anxiety disorders more often than do men.
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A client diagnosed with anxiety disorder has been prescribed benzodiazepine drugs. The nurse is explaining the possible side effects of the medications. Which side effects of the drug explained by the nurse is correct? Select all that apply. Agitation Dry mouth Blurred vision Constipation Vomiting
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Dry mouth Blurred vision Constipation
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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? Moderate Euphoria Mild Severe
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Moderate
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Humans are able to adapt to physiological and psychological threats. Which is key to a person’s adaptation to these situations? Coping mechanisms Ability to ignore symptoms Previous experience Communication skills
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Coping mechanisms
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Which level of anxiety helps the client focus the client’s attention to learn, problem solve, think, act, feel, and protect himself or herself? Mild Moderate Severe Panic
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Mild
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A group of students is reviewing information about the etiology of generalized anxiety disorder (GAD). The students demonstrate understanding of this information when they identify which as representing the bases for this disorder? Inaccurate environmental danger assessment Exposure to multiple stressful life events Kindling caused by overstimulation Intense worry and stress about work or simple family life
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Intense worry and stress about work or simple family life
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A nurse assesses a client and determines that the client is experiencing mild anxiety based on what? The client is selectively inattentive The client is aware and alert The client has focused attention on a small area The client voices feelings of unreality
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The client is aware and alert
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Which is one characteristic that differentiates generalized anxiety disorder (GAD) and panic disorder? In panic disorder, the person suffers from a chronic state of elevated anxiety. Panic disorders are more easily treated than GAD. In GAD, the person usually does not experience eruptions of acute anxiety. GAD is characterized by occasional, unexpected panic attacks.
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In GAD, the person usually does not experience eruptions of acute anxiety.
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An adolescent client reveals that she is about to take a math test from her tutor. Nursing assessment reveals mild anxiety. The nurse explains that this level of anxiety does what? Will interfere with her cognitive abilities Is conducive to concentration and problem solving May be transferred to her tutor and result in test anxiety Is pathologic and warrants postponing the test
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Is conducive to concentration and problem solving
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A 21-year-old client has been recently diagnosed with agoraphobia. Which situation is most likely to cause the client anxiety? Having a blood sample drawn and experiencing mild pain Going to a crowded, outdoor market independently Having the client’s work performance closely scrutinized by a supervisor Gaining 5 pounds and being unable to exercise vigorously
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Going to a crowded, outdoor market independently
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A biologic theory explains anxiety disorders in which way? Based in genetics with clinical symptoms being a result of chromosomal influence Rooted in episodes of physical or psychological abuse that occurred at times of developmental growth Originated from disappointments resulting from an exaggerated sense of self-worth Caused by substance abuse, particularly narcotics, resulting in damage to the brain’s receptors
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Based in genetics with clinical symptoms being a result of chromosomal influence
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Which is considered a tricyclic antidepressant (TCA) used in the treatment of clients with panic disorder? Imipramine Fluoxetine Sertraline Lorazepam
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Imipramine
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When a parent observes the parent’s young child heading toward a busy road the parent becomes stressed, feeling the parent’s heart pounding, breathing heavily, and hands becoming wet with perspiration. Which physiological system is activated with the parent’s “fight or flight” reaction to this danger? Parasympathetic nervous system Sympathetic nervous system Motherly response system Central nervous system
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Sympathetic nervous system
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The nurse is assessing a client with anxiety. What symptom indicates that the the client has adopted a maladaptive behavior in response to stress? Tachycardia Dyspnea Headache Pedal edema
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Headache
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The nurse is planning a presentation to a group of nursing students on the topic of anxiety disorders. Which would the nurse include when describing panic disorder? Individuals may believe they are having a heart attack when a panic attack occurs. People with panic attacks often have fewer attacks if they also have agoraphobia. Typically, individuals experience this disorder after the age of 30 years. Persons rarely have an underlying comorbid condition of depression.
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Individuals may believe they are having a heart attack when a panic attack occurs.
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The nurse can be confident that the admitted client diagnosed with an anxiety disorder will respond well to treatment when the client which of the following conditions are present? The client states, “I understand what I need to do, and I’m ready to do it so I’m back to normal.” The client has a family that is truly willing and capable of supporting him during the treatment The client readily agrees to immediately notify the mental health care team if symptoms reoccur after discharge The client has a no history of other psychiatric disorders
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The client states, “I understand what I need to do, and I’m ready to do it so I’m back to normal.”
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Which client, presenting with a report of vague physical symptoms, should be assessed for possible anxiety by the nurse? a Native American client a African American client an Asian American client an Arab American client
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an Asian American client
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Nearly what percentage of adults are affected by anxiety disorders? 10% 25% 40% 55%
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25%
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Panic disorder is treated with cognitive-behavioral techniques, deep breathing, and relaxation, in addition to what? Antidepressants Anticonvulsants Antipsychotics Central nervous system depressants
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Antidepressants
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The nurse is assessing a client who recently experienced the client’s first panic attack while at the grocery store. To identify complications of the disorder, the nurse should ask: “Do you have any problems going out alone to public places?” “What do you think is the origin of the panic you felt?” “Can you describe how you felt physically during the attack?” “Are you concerned there will be more panic attacks?”
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“Do you have any problems going out alone to public places?”
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When explaining the difference between anxiety and fear, the mental health nurse shares what? Select all that apply. Anxiety involves experiencing subjective, uncomfortable feelings resulting from unknown causes Fear results in objective, physical responses caused by real danger Anxiety is likely to result from an attempt to overcome stress People who experience anxiety tend to use maladaptive coping mechanisms Obsessive-compulsive behavior is often the result of abandonment
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Anxiety involves experiencing subjective, uncomfortable feelings resulting from unknown causes Fear results in objective, physical responses caused by real danger Anxiety is likely to result from an attempt to overcome stress
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A client who experiences panic anxiety around dogs is sitting in a room with a dog and the client’s nurse therapist. The nurse therapist is using which behavioral intervention for this type of anxiety? Systematic desensitization Implosion therapy Relaxation exercise Biofeedback
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Systematic desensitization
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Which is the primary concern for a client with panic-level anxiety? Safety Emotional needs Physiologic needs Social support
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Safety
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A client spends hours stacking and unstacking towels. The client is repeatedly checking to make sure that the towels are in order of color. What term is used to identify this behavior? Compulsion Phobia Obsession Derealization
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Compulsion
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A 25-year-old client tells the nurse that the client has been worried and tearful lately because of pressures at work. The client states, “My partner tells me that it’s ‘stress’ and ‘anxiety,’ but doesn’t everyone have that? What is anxiety anyway?” Which response would be most appropriate for the nurse to provide about the nature of anxiety? “Anxiety is an abnormal response to everyday stress.” “Anxiety is a sense of psychological distress.” “Anxiety is a physiologic response to stress.” “Anxiety is a normal response to everyday stress.”
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“Anxiety is a sense of psychological distress.”
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Clients taking benzodiazepines need education about what? Avoiding cheeses and smoked meats Interactions with monoamine oxidase inhibitors (MAOIs) Avoiding spending too much time in the sun Concomitant use of alcohol
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Concomitant use of alcohol
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What does desensitization refer to? A systematic way to replace a panic response with a relaxation response A cognitive technique for replacing a worry with a positive statement Exposing the client to an anxiety-producing stimulus for 1 to 2 hours (flooding) Teaching the client to ignore or become immune to anxiety-producing situations
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A systematic way to replace a panic response with a relaxation response
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When assessing a client with anxiety, the nurse should recognize that anxiety may often be a result of what? Cognitive deficits Organic brain changes Medications Fluid and electrolyte imbalances
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Medications
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During the admission assessment of a 27-year-old client who has been diagnosed with an anxiety disorder, the nurse observes that the client is becoming increasingly restless and agitated. How should the nurse respond to this development? Inform the client that the assessment can be postponed if the client is finding it overwhelming. Increase the speed of the assessment in order to ensure that it is completed sooner and inform the client that the nurse is doing so. Provide education regarding the level of anxiety that the client may be experiencing. Explain to the client that the client’s current feelings of anxiety have the potential to foster better coping skills in the future.
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Inform the client that the assessment can be postponed if the client is finding it overwhelming.
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The most important factor in the person’s stress response is what? Strength of the immune system Supportive friends Relaxation techniques Adaptive coping strategies
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Adaptive coping strategies
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The nurse is teaching shoulder exercises to a client recovering from a mastectomy. The nurse might view the client’s mild anxiety during the session positively, because mild anxiety helps what? Select all that apply. To focus attention to learn To feel and think To motivate to make a change To engage in goal-directed activity To calm restlessness
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To focus attention to learn To feel and think To motivate to make a change To engage in goal-directed activity
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A nurse is talking with a client who has experienced panic attacks. The client asks the nurse, “What causes these attacks?” Which information would the nurse most likely integrate into the response about the etiology of panic disorders? There is evidence of a substantial familial predisposition to panic disorder Neurologic abnormalities are a rare occurrence with panic disorder The link between panic disorders and neurotransmitters is lacking There is a strong evidence supporting a psychodynamic influence
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There is evidence of a substantial familial predisposition to panic disorder
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Which nursing assessment is most appropriate for an older client presenting with reports of generalized anxiety? assess for depression assess for panic attacks assess for elder abuse assess for dementia
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assess for depression
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Which nursing intervention is focused on the primary goal of anxiety management and treatment? assessing the client’s ability to implement stress management techniques effectively helping the client identify ways to eliminate all sources of stress in his or her daily life educating the client concerning the use of medications to manage anxiety disorders assessing the client for possible symptoms of panic disorder
answer

assessing the client’s ability to implement stress management techniques effectively
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A nurse is seeing a client prior to discharge after being admitted to hospital for suicidal ideation. As the nurse begins the discharge process, the client closes the eyes and begins rapid, shallow breathing. The client also begins to shake and perspire profusely. Which actions should the nurse take? Select all that apply. Talk to the client in a comforting manner. Take the client to a quiet space. Reassure the client of being safe. Ask the client to spend some time alone. Assess the client for suicidal ideation.
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Talk to the client in a comforting manner. Take the client to a quiet space. Reassure the client of being safe.
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A nursing role in providing client education regarding panic disorder includes which of the following? (Select all that apply.) Introduction of appropriate coping skills Identification of alternate treatment modalities Involving family and support persons when appropriate Providing feedback to support the client Adjustment of treatment plan when indicated
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Introduction of appropriate coping skills Identification of alternate treatment modalities Involving family and support persons when appropriate Providing feedback to support the client
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Generalized anxiety disorder (GAD) is characterized by what criteria? Excessive worry or anxiety lasting more than 6 months Flashbacks and feelings of unreality Fear of going outdoors Behavioral changes in response to panic attacks
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Excessive worry or anxiety lasting more than 6 months
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A client reports the client has been experiencing increased stress at work. The client has been managing the stress by drinking 2-3 glasses of wine per evening. Despite the nurse recommending that drinking alcohol is not an effective way to manage the stress, the client reports it is unlikely that the client will be able to stop. Which statement explains why this will be difficult for the client? The client is probably physically dependent on alcohol. Drinking alcohol is more socially acceptable than taking medications. The client has no adaptive coping mechanisms. A few glasses of wine each night is not necessarily a problem.
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The client has no adaptive coping mechanisms.
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Which medication classifications used in the treatment of panic disorder can cause physical dependence? Benzodiazepines Selective serotonin reuptake inhibitors (SSRIs) Tricyclic antidepressants (TCAs) Serotonin-norepinephrine reuptake inhibitors (SNRIs)
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Benzodiazepines
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The nurse understands that a certain level of anxiety is required in a client for effective learning. Which anxiety-related symptom indicates the client may be able to learn effectively? The client is trembling. The client is speaking in a high-pitch voice. The client has heightened awareness. The client has increased muscle tension.
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The client has heightened awareness.
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A client experiencing stress has tachycardia and tachypnea. On the basis of the physiological model of the general adaptation syndrome, in which stage is this client? Stress Alarm reaction Resistance Exhaustion
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Resistance
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After teaching a group of mental health nursing students about the care of a client experiencing a panic attack, the instructor determines that additional education is required when the students identify which as an appropriate intervention? Touching the client in an attempt to comfort the client Providing the client with a safe, quiet, and private place Encouraging the client to verbalize feelings and concerns Approaching the client in a calm, confident manner
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Touching the client in an attempt to comfort the client
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A 30-year-old client who has been unemployed secondary to the client’s anxiety disorder states that the client would like to have a job where the client is alone and no one needs to evaluate the client’s work. The nurse interprets these comments as an indicator of what? Social anxiety disorder Agoraphobia Obsessive-compulsive disorder Panic disorder
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Social anxiety disorder
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A nurse is assessing a client with anxiety. Which signs and symptoms would the nurse attribute to sympathetic nervous stimulation? Select all that apply. Pressure to urinate Fainting Heart racing Hypertension Bradycardia
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Heart racing Hypertension
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A client approaches the nurse on an inpatient psychiatric hospital unit crying, trembling, and feeling nauseous. The client states, “I’ve tried everything, I still feel so anxious.” Which action by the nurse would be most appropriate? Direct the client to continue deep breathing. Take the client on a walk around the unit. Take the client to the dayroom as a distraction. Administer the prescribed PRN anxiolytic medication.
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Administer the prescribed PRN anxiolytic medication.
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A client with a specific phobia of spiders is seeing a therapist for the first session of treatment. The therapist hands the client a clear container with a large house spider inside. This activity is repeated continuously until the client’s fear subsides. Which strategy is being used to treat the client’s specific phobia? systematic desensitization flooding decatastrophizing assertiveness training
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flooding
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Which would be an appropriate intervention for a client experiencing an anxiety attack? Staying with the client and speaking in short sentences Turning on the lights and opening the windows so that the client does not feel crowded Leaving the client alone Turning on stereo music
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Staying with the client and speaking in short sentences
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Which would not be an initial intervention for the client with acute anxiety? Touching the client in an attempt to comfort the client Use of open-ended communication techniques Encouraging the client to verbalize feelings and concerns Maintaining a nonstimulating environment
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Touching the client in an attempt to comfort the client
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Which condition involves a persistent, irrational fear attached to an object or situation that objectively does not pose a significant danger? Phobic disorders Posttraumatic stress disorder Obsessive-compulsive disorder Stress disorders
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Phobic disorders
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A young parent tells the nurse, “I can’t stop smoking. That is what I do to make myself feel better.” What is the term used to describe this behavior? Defense mechanism Coping mechanism Caregiver burden Crisis
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Coping mechanism
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A nurse is seeing a client who is experiencing symptoms of moderate anxiety. She tells the nurse she and her parents disagree over her sexual orientation. Which theory would best explain the course of the client’s anxiety? interpersonal behavioral neurochemical genetic
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interpersonal
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While conducting a class on anxiety and stress reduction, a nurse describes the symptoms of anxiety (including panic), informing the class that the physical symptoms of a panic attack can mimic what? Stroke Gastrointestinal flu Heart attack Appendicitis
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Heart attack
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When a client is experiencing panic, which is the priority intervention? Give the client medication immediately. Move the client to a quiet environment. Offer the client therapy to calm down. Physically restrain the client.
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Move the client to a quiet environment.
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A client is experiencing moderate anxiety. Which manifestation would the nurse most likely observe? Select all that apply. The client can sustain attention on a particular focus. The client verbally states, “For some reason, I am feeling anxious now.” The client has flights of ideas and confusion. The client makes distorted inferences because of inadequacy of observed data. The client may pace, run, or fight violently if asked to perform a task the client does not want to perform.
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The client can sustain attention on a particular focus. The client verbally states, “For some reason, I am feeling anxious now.”
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An adolescent who is seeing the school health nurse states, “I won’t be able to hang out with my friends on Friday night because I have two essays due Monday.” What level of anxiety is the adolescent experiencing? mild moderate severe panic
answer

mild
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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? Mild Moderate Severe Panic
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Severe
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A nurse is seeing a client in the emergency department who repeatedly presents with gastrointestinal discomfort. Despite exhaustive medical investigations, there are no significant medical findings to explain the discomfort. The nurse should suspect: endocrine dysfunction. chronic obstructive pulmonary disease. heart disease. somatic symptoms.
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somatic symptoms.
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A nurse is giving a presentation on mental health promotion to college students. One student asks the nurse to explain the difference between normal anxiety and an anxiety disorder. Which response is best? “People with anxiety disorders experience a fight-or-flight response when threatened.” “People with anxiety disorders generally find that the anxiety interferes with daily activities.” “Normal anxiety does not result in feelings of dread or restlessness.” “Normal anxiety occurs in response to everyday stressors.”
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“People with anxiety disorders generally find that the anxiety interferes with daily activities.”
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The nurse is assessing a client suffering from stress and anxiety. The most common physiologic response to stress and anxiety is: gastrointestinal upset. sedation. vertigo. skin rash.
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gastrointestinal upset.
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A nurse is developing a plan of care for a client with panic disorder that will include pharmacologic therapy. Which would the nurse most likely expect to administer? Benzodiazepine Selective serotonin reuptake inhibitor (SSRI) Monoamine oxidase inhibitor (MAOI) Tricyclic antidepressant (TCA)
answer

Selective serotonin reuptake inhibitor (SSRI)
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Which is a cardiovascular response of the sympathetic nervous system? Tachycardia Bradypnea Hypotension Bradycardia
answer

Tachycardia
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A client states that the client has just had an argument with the client’s spouse over the phone. What can the nurse expect that the client’s sympathetic nervous system has stimulated the client’s adrenal gland to release? Endorphins Dopamine Epinephrine Testosterone
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Epinephrine
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A client diagnosed with panic disorder has been receiving medication therapy, which is being discontinued. A nurse would be alert for possible withdrawal symptoms if the client was receiving what? Lorazepam Duloxetine Escitalopram Fluvoxamine
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Lorazepam
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Which question in the assessment of a client with anxiety is most clinically appropriate? “What can I give you to make you feel less anxious right now?” “Does your anxiety make you feel less valuable and competent as a person?” “Do you think that you’re justified in feeling anxious right now?” “How do you feel about everything that is happening in your life right now?”
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“How do you feel about everything that is happening in your life right now?”
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A client responds to bad news regarding test results by crying uncontrollably. What is the term for this response to a stressor? Adaptation Homeostasis Coping mechanism Defense mechanism
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Coping mechanism
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A client comes in for a therapy session and begins to have a panic attack. The therapist asks the client to relax in the chair and then gently asks the client to imagine the client in a very safe and calm place. This technique, often useful in anxiety disorders, is called what?
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Deep breathing
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Which would not be an initial intervention for the client with acute anxiety?
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Touching the client in an attempt to comfort the client
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A 30-year-old client who has been unemployed secondary to anxiety disorder states that the client would like to have a job where the client is alone and no one needs to evaluate the client’s work. The nurse interprets these comments as an indicator of what?
answer

Social phobia
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A client with generalized anxiety disorder states that the client is worried about the client’s job. The client never feels like the client has control over the client’s responsibilities, even though the client puts in extra hours. The client adds that the client is afraid the client will be fired. Which response by the nurse is most therapeutic?
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“Has something changed at work that is causing you to worry?”
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Relaxation techniques help clients with anxiety disorders because they can promote what?
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Reduction of autonomic arousal
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An adolescent client reveals that she is about to take a math test from her tutor. Nursing assessment reveals mild anxiety. The nurse explains that this level of anxiety does what?
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Is conducive to concentration and problem solving
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In teaching a client who has been prescribed a benzodiazepine for panic disorder, the nurse must be certain to do what?
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Educate the client that this medication has a high risk for withdrawal symptoms, and the client should not discontinue without a doctor’s supervision.
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Which question in the assessment of a client with anxiety is most clinically appropriate?
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“How do you feel about everything that is happening in your life right now?”
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Which assessment question is most likely to allow the nurse to differentiate between anxiety disorder due to a general medical condition and psychological factors affecting a medical condition?
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Establishing whether the client’s anxiety preceded the medical problem or whether the medical problem appeared first
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Which medication classifications used in the treatment of panic disorder can cause physical dependence?
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Benzodiazepines
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The nurse at the student health center is seeing a group of nursing students who are interested in reducing their stress level. The nurse identifies guided imagery as an appropriate intervention. What does guided imagery involve?
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The mindful use of a word, phrase, or visual image, which allows oneself to be distracted and temporarily escape from stressful situations
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A young parent tells the nurse, “I can’t stop smoking. That is what I do to make myself feel better.” What is the term used to describe this behavior?
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Coping mechanism
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In speaking with a client with moderate anxiety, the client becomes tangential discussing unrelated topics. To help the client’s attention from wandering, which is an effective intervention?
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The nurse should speak in short and simple sentences.
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Which would be an appropriate intervention of a client experiencing a panic attack?
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Staying with the client and speaking in short sentences
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After teaching a group of mental health nursing students about the care of a client experiencing a panic attack, the instructor determines that additional education is required when the students identify which as an appropriate intervention?
answer

Touching the client in an attempt to comfort the client
question

A 30-year-old client who has been unemployed secondary to the client’s anxiety disorder states that the client would like to have a job where the client is alone and no one needs to evaluate the client’s work. The nurse interprets these comments as an indicator of what?
answer

Social anxiety disorder
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A nursing instructor is describing the care of a client with acute anxiety to a class of nursing students. The instructor determines that more education is necessary when the students identify which intervention as appropriate?
answer

Providing the client with a comforting touch
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Which condition involves a persistent, irrational fear attached to an object or situation that objectively does not pose a significant danger?
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Specific phobia
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An adolescent who is seeing the school health nurse states, “I won’t be able to hang out with my friends on Friday night because I have two essays due Monday.” What level of anxiety is the adolescent experiencing?
answer

mild
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A client with a specific phobia of spiders is seeing a therapist for the first session of treatment. The therapist hands the client a clear container with a large house spider inside. Which strategy is being used to treat the client’s specific phobia?
answer

flooding
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A client spends hours stacking and unstacking towels. The client is repeatedly checking to make sure that the towels are in order of color. What term is used to identify this behavior?
answer

Compulsion
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A nurse is giving a presentation on mental health promotion to college students. One student asks the nurse to explain the difference between normal anxiety and an anxiety disorder. Which response is best?
answer

“People with anxiety disorders generally find that the anxiety interferes with daily activities.”
question

A client reports the client has been experiencing increased stress at work. The client has been managing the stress by drinking 2-3 glasses of wine per evening. Despite the nurse recommending that drinking alcohol is not an effective way to manage the stress, the client reports it is unlikely that the client will be able to stop. Which statement explains why this will be difficult for the client?
answer

The client has no adaptive coping mechanisms.
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Which client is most likely to be at risk for drug dependence and difficulties with withdrawal?
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A woman who has been taking lorazepam for several months after witnessing a traumatic motor vehicle accident
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A client comes to the emergency department because the client thinks the client is having a heart attack. Further assessment determines that the client is not having a heart attack but is having a panic attack. When beginning to interview the client, which question would be most appropriate for the nurse to use?
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“What did you experience just before and during the attack?”
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A nurse is developing a plan of care for a client with panic disorder that will include pharmacologic therapy. Which would the nurse most likely expect to administer?
answer

Selective serotonin reuptake inhibitor (SSRI)
question

The nurse is assessing a client and finds two enlarged supraclavicular lymph nodes. The nurse asks the client how long these enlarged nodes have been there. The client states, “I can’t remember. A long time I think. Do I have cancer?” The nurse is aware that that body responds to stress. Which is an immediate physiologic response to stress the nurse would expect to see in this client?
answer

Increased blood pressure
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A client states that the client has just had an argument with the client’s spouse over the phone. What can the nurse expect that the client’s sympathetic nervous system has stimulated the client’s adrenal gland to release?
answer

Epinephrine
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The nurse walks into the client’s room and finds the client sobbing uncontrollably. When the nurse asks what the problem is, the client responds, “I am so scared. I have never known anyone who goes into a hospital and comes out alive.” On this client’s care plan the nurse notes a nursing diagnosis of ineffective coping related to stress. What is the best outcome to be expected for this client?
answer

Client will adapt relaxation techniques to reduce stress.
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A hospitalized client states that the client is having difficulty resting. Which intervention would help promote rest?
answer

Assisting the client with deep-breathing exercises
question

When a parent observes the parent’s young child heading toward a busy road the parent becomes stressed, feeling the parent’s heart pounding, breathing heavily, and hands becoming wet with perspiration. Which physiological system is activated with the parent’s “fight or flight” reaction to this danger?
answer

Sympathetic nervous system
question

A client responds to bad news regarding test results by crying uncontrollably. What is the term for this response to a stressor?
answer

Coping mechanism
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The most important factor in the person’s stress response is what?
answer

Adaptive coping strategies
question

A client diagnosed with panic disorder has been receiving medication therapy, which is being discontinued. A nurse would be alert for possible withdrawal symptoms if the client was receiving what?
answer

Lorazepam
question

When a client is experiencing panic, which is the priority intervention?
answer

Move the client to a quiet environment.
question

A nurse is preparing a plan of care for a client with anxiety. Which would the nurse likely include? Select all that apply.
answer

Using appropriate coping skill Identifying treatment modalities Involving family for support, if appropriate Providing supportive feedback
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Panic disorder is treated with cognitive-behavioral techniques, deep breathing, and relaxation, in addition to what?
answer

Antidepressants
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Which statement, made by a client diagnosed with an anxiety disorder, should trigger the nurse’s concern about the client’s understanding of the use of defense mechanisms?
answer

“When I have a problem, I just deny it until it goes away.”
question

A nurse is seeing a client who is experiencing symptoms of moderate anxiety. She tells the nurse she and her parents disagree over her sexual orientation. Which theory would best explain the course of the client’s anxiety?
answer

interpersonal
question

A nurse is seeing a client who is having severe to panic level anxiety after a physical assault months previously. The client tells the nurse, “When the panic starts I feel like I am watching myself through a window.” The nurse can most accurately describe this experience as:
answer

depersonalization.
question

Which is one characteristic that differentiates generalized anxiety disorder (GAD) and panic disorder?
answer

In GAD, the person usually does not experience eruptions of acute anxiety.
question

A biologic theory explains anxiety disorders in which way?
answer

Based in genetics with clinical symptoms being a result of chromosomal influence
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Which level of anxiety helps the client focus the client’s attention to learn, problem solve, think, act, feel, and protect himself or herself?
answer

Mild
question

Which medication classification has been found to be effective in reducing or eliminating panic attacks?
answer

Antidepressants
question

Which is a cardiovascular response of the sympathetic nervous system?
answer

Tachycardia
question

A 25-year-old client tells the nurse that the client has been worried and tearful lately because of pressures at work. The client states, “My partner tells me that it’s ‘stress’ and ‘anxiety,’ but doesn’t everyone have that? What is anxiety anyway?” Which response gives the best information about the nature of anxiety?
answer

“Anxiety is a sense of psychological distress.”
question

Clients taking benzodiazepines need education about what?
answer

Concomitant use of alcohol
question

Which factor has the least influence on achieving mental health for the client who has anxiety disorder?
answer

The client is often late to school and makes poor grades in most of the client’s subjects.
question

When discussing various types of anxiolytic medications with a client, the nurse recognizes that which medication has the lowest potential for abuse?
answer

Buspirone
question

The nurse is planning a presentation to a group of nursing students on the topic of anxiety disorders. Which would the nurse include when describing panic disorder?
answer

Individuals may believe they are having a heart attack when a panic attack occurs.
question

Humans are able to adapt to physiological and psychological threats. Which is key to a person’s adaptation to these situations?
answer

Coping mechanisms
question

The overall goals of care for individuals experiencing a stress response are to focus on interventions to develop …
answer

positive coping skills.
question

The nurse is assessing a client with anxiety. Which behavior might indicate that the client has moderate anxiety?
answer

The client is nervous and agitated.
question

A nurse is caring for a client who has panic attack. The nurse takes the client in a small, isolated room. How would this intervention benefit the client? Choose the best answer.
answer

The client would have an enhanced sense of security.
question

The nurse is teaching shoulder exercises to a client recovering from a mastectomy. The nurse might view the client’s mild anxiety during the session positively, because mild anxiety helps what? Select all that apply.
answer

To focus attention to learn To feel and think To motivate to make a change To engage in goal-directed activity
question

A group of nursing students are reviewing signs and symptoms of anxiety. The students demonstrate a need for additional review when they identify what?
answer

Tearfulness
question

Which nursing intervention is focused on the primary goal of anxiety management and treatment?
answer

assessing the client’s ability to implement stress management techniques effectively
question

Which statement by the nurse demonstrates an understanding of the role automatisms have in a panic attack?
answer

“The client taps her fingers very rapidly when she is feeling anxious.”
question

A nurse is assessing the vital signs of a client in the cardiac clinic. The nurse observes the client’s blood pressure and heart rate are higher than what is normally expected for this client. The client tells the nurse, “It makes me nervous to come into the clinic.” What is the most likely explanation for the unexpected change in the client’s vital signs.
answer

Self-preservation
question

A school health nurse is seeing a 7-year-old child. The mother of the child describes the child holding on to her leg and crying loudly when she attempts to leave the child at school each morning. The nurse should explain that the child is experiencing:
answer

separation anxiety disorder.
question

What does desensitization refer to?
answer

A systematic way to replace a panic response with a relaxation response
question

All except which are considered clinical symptoms of anxiety?
answer

Tearfulness and sadness
question

The nurse is providing care for a psychiatric-mental health client who has a diagnosis of anxiety. Which statement by the nurse is likely the most therapeutic intervention?
answer

“Anxiety is a feeling that is experienced by everyone at some point and it can never be completely removed from one’s life.”
question

The causes of anxiety disorders can be best explained by what?
answer

Neurobiologic vulnerabilities and perception of psychosocial stress
question

A client diagnosed with anxiety disorder has been prescribed benzodiazepine drugs. The nurse is explaining the possible side effects of the medications. Which side effects of the drug explained by the nurse is correct? Select all that apply.
answer

Dry mouth Blurred vision Constipation
question

A nurse assesses a client and determines that the client is experiencing mild anxiety based on what?
answer

The client is aware and alert
question

Nearly what percentage of adults are affected by anxiety disorders?
answer

25%