ANXIETY DISORDER

Student Name: Malinda Sirue

Question 1:

Juostien was diagnosed with social phobia asks the nurse about the livelihood of children inheriting
this disorder from their parents. Which of the following is the most appropriate response by Nurse
Gein?

a. “It is only inherited if the child’s father carries the trait.”

b. “There is no research supporting the heritability of social phobia.”

c. “The child of a parent with a social phobia has a 25% chance of inheriting it.”

d. “The chances of developing social phobia increase about 10% if a parent has the disorder.”

Question 2:

Which of the following should be the priority consideration for the nurse caring for a client performing
overt rituals?

a. The ritual should be interrupted every time it is observed

b. The client should be asked what the rationale is for performing the ritual

c. Performing the ritual serves to decrease the client’s anxiety

d. A less disruptive ritual should be substituted

Question 3:

Which of the following instructions should the nurse give a client about relaxation techniques?

a. Relaxation techniques are most effective when practiced regularly

b. Heart rate should be carefully monitored when relaxing

c. Avoid teaching these techniques to children under 12

d. To avoid dependence, these techniques should be used only when really needed
Question 4:

While educating a client who has a social phobia about the use of a selective serotonin reuptake
inhibitor (SSRI), the nurse assesses the client’s knowledge about the drug. The client tells the nurse
the physician explained that the drug will correct a “chemical imbalance” but states being unsure
about what that means.

Which of the following is the appropriate response by the nurse?

a. “You should ask the physician to explain the purpose of your medication again.”

b. “Sometimes the brain produces too little of a chemical called serotonin and the SSRI corrects this.”

c. “What do you think chemical imbalance means?”

d. “I’m also unsure what chemical imbalance means.”

Question 5:

A client with a dog phobia has undergone desensitization to this stimulus. The nurse evaluates which
of the following client behaviors that indicates the treatment was successful?

a. The client recounts how the fear of dogs began, stating this fear is both unreasonable and excessive

b. The client visits caged dogs in the pet shelter for 10 minutes three times a week

c. The client states the fear of dogs is greatly diminished

d. The client can pet the neighbor’s dog without undue anxiety

Question 6:

Which of the following characteristics should the nurse include when teaching a class on the
developmental theory of anxiety?

Select all that apply:

a. Individuals respond physiologically when anxious

b. Anxiety disorder often evolves gradually when anxious temperament and normal childhood fears
interact with other predisposing factors

c. Excessive reliance on coping responses involving cognitive or behavioral avoidance

d. Interpret ambiguous stimuli or situations as threatening

f. Incompetence with regard to social and emotional regulation and academic skills

Question 7:

While preparing a client for surgery the next day, the nurse observes that the client is having trouble
paying attention to instructions, is trembling, and has sweaty palms, a rapid heart rate, and rapid
respirations. The client states, “All I can think about is this surgery tomorrow, and whether everything
will go all right. The nurse notifies the physician that the client’s level of anxiety is

a. mild.

b. moderate.

c. severe.

d. panic.

Question 8

Which of the following client assessments on the use of a benzodiazepine would be a priority concern
to the nurse?

a. A history of alcohol or substance abuse

b. A lack of adequate coping skills

c. A history of closed head injury

d. A diet high in tyramine-rich foods

Question 9

Which of the following would be the most appropriate statement for the nurse to make to a client
found pacing in the hall?

a. “The ballgame is on in the dayroom. Perhaps you’d like to watch it.”

b. “I noticed you’ve been pacing. Can you tell me how you’re feeling?”

c. “I think you’d be much more comfortable in your room.”

d. “I can tell something is wrong. What is it?”

When a client has panic-level anxiety, plans for nursing intervention should include:

a. darkening the room and offering warm

blankets.

b. having the client describe how he or she

usually copes with anxiety.

c. staying with the client.

d. alerting security to the situation.

Question 11

The nurse caring for a client with a somatic panic disorder includes which of the following
manifestations?

S elect all that apply:

a. Fear of dying

b. Palpitations

c. Sense of impending doom and helplessness

d. Sensation of choking

e. Takes safety precautions such as being with

a “safe” person or avoiding places and situations associated with panic attacks

f. Numbness or tingling

Question 12

A client diagnosed with generalized anxiety disorder reports feeling increasingly ineffective at work
and at home states, “I’m letting everyone down. I don’t know what to do anymore.” Which of the
following diagnoses should the nurse select as most appropriate?

a. Thought processes, disturbed

b. Conflict, decisional
c. Adjustment, impaired

d. Role performance, ineffective

Question 13

While assessing a new client, the nurse asks the client about any fears. The client states, “Well, I’ve
been afraid to go up and down the basement steps since my hip replacement last fall. I let my children
do the laundry.” The nurse should evaluate this response as:

a. manipulative behavior.

b. normal anxiety.

c. a phobic reaction.

d. chronic anxiety.

Question 14

A client being assessed for anxiety disorder to the nurse a concern with many physical clinical
manifestations. The client states, “My heart races, my chest gets tight, and I can’t breathe. I must be
having a heart attack.” Which of the following is the nurse’s most appropriate response?

a. “Those clinical manifestations, although frightening, are very common with anxiety.”

b. “Has anyone in your family had a heart attack?”

c. “Maybe we should ask the doctor to run some tests on your heart.”

d. “Those are the clinical manifestations I get when I too am anxious.”

Question 15

The nurse is reviewing the care plan for a client diagnosed with generalized anxiety disorder. Which of
the following is an appropriate client goal? The client will:

a. describe the traumatic event in detail.

b. report no dissociative episodes.

c. be able to confront the phobic stimulus if accompanied.

d. report tolerating the presence of mild anxiety during activities.

A new client in a mental health center program asks the nurse about the purpose of an assigned
cognitive reframing group. Which of the following explanations should the nurse give?

a. “This group will help you with your short term memory.”

b. “This group will help you socialize more effectively with others.”

c. “All new clients are assigned to this group for assessment.”

d. “This group will help you change your faulty beliefs.”

Question 17

The nurse is assessing an obviously anxious client. Which of the following approaches should the
nurse use?

a.. Avoid any questioning about the anxiety until it has subsided

b. Ask specific, direct questions about the anxiety

c. Don’t mention the anxiety unless the client does

d. Teach the client a relaxation exercise

Question 18

A client reports having stopped the buspirone (BuSpar) prescribed for generalized anxiety disorder
because, after taking it for a week, it did not seem to be helping. Which of the following explanations
should the nurse give?

a. Buspirone is not indicated for anxiety disorder

b. It is likely that the dosage is too low

c. Buspirone takes 2 to 3 weeks to become effective

d. Buspirone must be taken on an empty stomach

The nurse evaluates a client to have which of the following characteristics of severe anxiety?

Select all that apply:

a. Prompted by the ordinary tensions experienced in daily life

b. Produces what is commonly labeled the “fight-or-flight” response

c. B ecomes aware of some motor tension

d. S ensory input begins to disorganize

e. S enses are heightened, and individuals are alert, focused, and able to both learn new information
and problem solve

f. E motional distress is verbalized

Question 20

A client with agoraphobia tells the nurse in the outpatient clinic, “Now that my medication is working,
I don’t think I need to come here for therapy anymore.” The most therapeutic response by the nurse
is which of the following?

a. “Your medicine will only work if you continue with therapy.”

b. “You need to tell the doctor you want to quit therapy.”

c. “You made a commitment to stay in therapy for at least six sessions.”

d. “Combining medicine and therapy gives better, more lasting results.”

Question 21

The spouse of a client with a phobia of water has planned a sailing vacation to the islands and says to
the nurse, “I think the best way to overcome these silly fears is to confront them head on.” The
nurse’s most helpful response is which of the following?

a. “That kind of exposure may well do more harm than good.”

b. “I agree. I think a vacation would be a good idea.”

c. “For a plan like that to work, I think it would have to be a surprise.”

d. “Have you discussed this plan with other family members?”

During an assessment interview, a client replies to the nurse’s question about work relationships, “Oh
no. I don’t go to lunch with anyone at work. I’ve never been able to eat in front of other people.”
Which of the following disorders should the nurse consider?

a. Generalized anxiety disorder

b. Obsessive-compulsive disorder

c. Social phobia

d. Xenophobia

Question 23

A client recently diagnosed with obsessive compulsive disorder says to the nurse, “I know the doctor
said this was just an anxiety problem, but I think I must really be crazy. I keep thinking that people are
mad at me, and then I have to keep telling them I’m sorry.” Which of the following is the most
appropriate response by the nurse?

a. “Be careful. You might offend someone by using the word ‘crazy.’

b. “Very often, people’s obsessive ideas seem rather bizarre to them.”

c. “This is serious. We must let the doctor know.”

d. “What makes you think someone is angry with you?”

Question 24

The registered nurse is preparing to delegate clinical assignments for a psychiatric unit. Which of the
following assignments should the nurse delegate to a licensed practical nurse?

a. Encourage a client with a generalized anxiety disorder to verbalize personal feelings

b. Develop a plan of care for a client with obsessive-compulsive disorder

c. Monitor the laboratory tests of a client admitted to a psychiatric unit

d. Take a detailed social history from a client admitted with a social phobia

Question 25

A client approaches the nurse and says, “I don’t know what’s going on, but I have this terrible feeling
that something awful is going to happen.” The nurse’s best response is which of the following?

a. “Don’t worry, you’re very safe here.”

c. “It sounds like you’re having some anxiety.”

d. “Would you like some anxiety medication?”

Question 26.

An inpatient behavioral health unit employs some unlicensed assistive personnel. Which of the
following activities may the nurse appropriately delegate to unlicensed assistive personnel?

Select all that apply:

a. Document the response of a client with social phobia to a cinema field trip

b. Evaluate the effect of a client’s relaxation practice on the level of anxiety reported

c. Monitor a client’s blood pressure after a new drug is given

d. Plan the weekly current events for a client discussion group

e. Teach the client about dietary restrictions

f. Inform the client on the visiting hours