Chapter 27: Anxiety Disorders: Nursing Care of Patients with Anxiety, Phobia, and Panic

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

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

B) People with panic attacks often have fewer attacks if they also have agora phobia.

C) Typically, individuals experience this disorder after the age of 30 years.

D) Persons rarely have an underlying comorbid condition of depression.

A) Individuals may believe they are having a heart attack when a panic attack

A client comes to the emergency department due to symptoms of a potential 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 ask?

A) "Are you feeling much better now that you are lying down?"

B) "What did you experience just before and during the attack?"

C) "Do you think you will be able to drive home?"

D) "What do you think caused you to feel this way?"

B) "What did you experience just before and during the attack?"

A client diagnosed with a panic disorder has been prescribed a benzodiazepine medication. Which risk would the nurse emphasize as associated with using this medication?

A) Dietary restrictions

B) Withdrawal symptoms

C) Agitation

D) Fecal impaction

B) Withdrawal symptoms

A client is diagnosed with panic disorder and hasn't left the house in more than a month because of fears of another attack. Which nursing diagnosis would be a priority for this client?

A) Powerlessness related to symptoms of anxiety

B) Decisional conflict related to fear of leaving the house

C) Ineffective family coping related to symptoms of anxiety

D) Social isolation related to fear of recurrence of anxiety symptoms

D) Social isolation related to fear of recurrence of anxiety symptoms

A nurse has instructed a client diagnosed with panic disorder about how to use the technique of positive self-talk. The nurse determines that the client has understood the instructions when the client verbalizes which statement to use during an impending panic attack?

A) "I am feeling very nervous right now."

B) "I can handle this anxiety; it will be over shortly."

C) "I am taking medication to eliminate these symptoms."

D) "Relax your muscles, relax your muscles."

B) "I can handle this anxiety; it will be over shortly."

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?

A) Stay with the client and remain calm.

B) Move the client to a safe environment.

C) Tell the client that the attack will soon pass.

D) Teach the client deep-breathing techniques to calm the client.

A) Stay with the client and remain calm.

A client diagnosed with generalized anxiety disorder (GAD) is at the outpatient psychiatric clinic for a follow-up appointment. The nurse determines that the client's therapy has been effective when the client makes which statement?

A) "I am still experiencing quite a bit of stress at home and at work; things are different at home than they were in the hospital."

B) "When my mother-in-law comes over now, I go out to my workshop and work on one of my projects."

C) "I'm still drinking coffee; I can't quit after drinking it all these years."

D) "I've learned having a beer after I get home from work helps me relax."

B) "When my mother-in-law comes over now, I go out to my workshop and work on one of my projects."

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?

A) Demonstrate empathy for the client by trying to mimic the client's state of anxiety.

B) Tell the client that you must leave to go report the client's symptoms to the psychiatrist on duty.

C) Tell the client this is an acute exacerbation with a positive prognosis and low morbidity.

D) Stay with the client, emphasizing that the client is safe and that you will remain with the client.

D) Stay with the client, emphasizing that the client is safe and that you will remain with the client.

A nurse determines that a client who is experiencing anxiety is demonstrating relief survival behaviors. The nurse determines that the client is experiencing which degree of anxiety based on this presentation?

A) Mild

B) Moderate

C) Severe

D) Panic

C) Severe

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 make which statement?

A) Anxiety disorders rank second to depression in psychiatric illnesses being treated.

B) Women experience anxiety disorders more often than men.

C) Most anxiety disorders tend to be short term with individuals achieving full recovery.

D) Anxiety disorders are more common among children than among adolescents.

B) Women experience anxiety disorders more often than men.

During an interview, a client reports an intense fear of spiders, stating, "I can't be near them. I get so upset. I start to sweat and hyperventilate if I see one." The nurse documents this finding as which of the following?

A) Algophobia

B) Entomophobia

C) Arachnophobia

D) Cynophobia

C)Arachnophobia

After teaching a class about the biologic theories associated with panic disorder, the group leader determines a need for additional education when the group identifies which neurotransmitter as being implicated?

A) Dopamine

B) Serotonin

C) Norepinephrine

D) Gamma-aminobutyric acid (GABA)

A) Dopamine

A nurse is preparing an in-service presentation about panic disorders and associated theories related to the cause. When describing the cognitive-behavioral concepts associated with panic disorders, which of the following would the nurse expect to address?

A) Personal losses

B) Conditioned response

C) Early separation

D) Dysfunctional family communication

B) Conditioned response

A nurse is developing a plan of care for a client diagnosed with panic disorder that will include pharmacologic therapy. Which would the nurse most likely expect to administer?

A) Benzodiazepine

B) Selective serotonin reuptake inhibitor (SSRI)

C) Monoamine oxidase inhibitor (MAOI)

D) Tricyclic antidepressant (TCA)

B) Selective serotonin reuptake inhibitor (SSRI)

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 a representation of the bases for this disorder?

A) Inaccurate environmental danger assessment

B) Exposure to multiple stressful life events

C) Kindling caused by overstimulation

D) Intense worry and stress about work or simple family life

D) Intense worry and stress about work or simple family life

A client is diagnosed with generalized anxiety disorder (GAD) and is prescribed medication therapy. Which agent would the nurse expect to administer to the client to obtain the quickest relief from anxiety symptoms?

A) Buspirone

B) Venlafaxine

C) Alprazolam

D) Imipramine

C) Alprazolam

A client diagnosed with panic disorder who has been prescribed sertraline in conjunction with alprazolam comes to the clinic for a follow-up. The client states, "I stopped taking the alprazolam about 2 days ago. I was feeling really sleepy and tired." Which manifestations would alert the nurse to suspect possible withdrawal? Select all that apply.

A) Apprehension

B) Irritability

C) Dry, flushed skin

D) Weight gain

E) Muscle flaccidity

A) Apprehension

B) Irritability

A nurse is developing an education plan for a client diagnosed with generalized anxiety disorder (GAD), focusing on nutrition. Which item would the nurse encourage the client to avoid? Select all that apply.

A) Coffee

B) Chocolate

C) Milk products

D) Citrus juices

E) Aged cheese

A) Coffee

B) Chocolate

A group of students is reviewing information about social anxiety disorder in preparation for an oral class presentation. How would the students describe a person with this condition? Select all that apply.

A) Fear that others will judge them negatively

B) Openly speak up in crowds to reduce fear

C) Are insensitive to other's criticism

D) Demonstrate a distorted view of their own strengths

E) Exaggerate personal flaws

A) Fear that others will judge them negatively

D) Demonstrate a distorted view of their own strengths

E) Exaggerate personal flaws