NCLEX Unit 4 Anxiety Disorders

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Unit 4: Aniiety Disorders (35 Questions)source: Psychiatric Mental Health Nursing Success by Curtis et. al.. 20131. From a cognitive theory perspective, which is a possible cause of panic disorder?A. Inability of the ego to intervene when conflict occurs.B. Abnormal elevation of blood lactate and increased lactate sensitivity.C. Increased involvement of the neurochemical norepinephrine.D. Distorted thinking patterns that precede maladaptive behaviors.Rationale:A. Inability- of the ego to intervene when conflict occurs relates to the psychoanalytic. notcognitive, theory of panic disorder developmentB. Abnormal elevations of blood lactate and increased lactate sensitivity relate to thebiological, not cognitive, theory of panic disorder development.C. Increased involvement of the neurochemical norepinephrine relates to the biological, notcognitive, theory of panic disorder development.D. Distorted thinking patterns that precede maladaptive behaviors relate to the cognitivetheory perspective of panic disorder development.2.xAclient diagnosed with posttraumatic stress disorder is close to discharge. Which clientstatement would indicate that teaching about the psychosocial cause of PTSD was effective?A. "My experience, how I dealt with it, and my support system all affect my diseaseprocess."B."I have learned to avoid stressful situations as a way to decrease my emotional pain."C."So, natural opioid release during the trauma caused my body to become addicted."D."Because of the trauma. I have a negative perception of the world and feel hopeless."Rationale:A. When the client verbalizes understanding of how the experienced event, individual traits,and available support systems affect his or her dx. the client demonstrates a goodunderstanding of the psychosocial cause of PTSD.B.voiding situations as a way to decrease emotional pain is an example of a learned, notpsychosocial, cause of PTSD.C. The release of natural opioids during a traumatic event is an example of a biological, notpsychosocial, cause of PTSD.D.Having a negative perception of the world because of a traumatic event is an example ofa cognitive, not psychosocial, cause of PTSD.3. Which statement explains the etiology of OCD from a biological theory perspective?

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A. Individuals diagnosed with OCD have weak and underdeveloped egos.B.Obsessive and compulsive behaviors are a conditioned response to a traumatic event.C. Regression to the pre-Oedipal anal sadistic phase produces the clinical symptoms ofOCD.D. Abnormalities in various regions of the brain been implicated in the cause of OCD.Rationale:A. The belief that individuals diagnosed with OCD have weak and underdeveloped egos isan explanation of OCD etiology, from a psychoanalytic theory not biological.B. The belief that obsessive and compulsive disorders are a conditioned response to atraumatic event is an explanation of OCD etiology from a learning theory not a biologicaltheory.C. The belief that regression to the pre-Oedipal anal sadistic phase produces the clinicalsymptoms of OCD is an explanation of OCD etiology psychoanalytic theory perspectivenot biological.D.The belief that abnormalities in various regionsofthe brain cause OCD is an explanationof OCD etiology from a biological theory perspective.4. A client diagnosed with social phobia has an outcome that states, "Client will voluntarilyparticipate in group activities by day 3." Which would be an appropriate intrapersonal nursingintervention to assist the client in achieving this outcome?A. Offer pm lorazepam (Ativan) 1 hour before group begins.B.Attend group with client to assist in decreasing anxiety.C.Encourage discussion about fears related to socialization.D. Role-play scenarios that may occur in group to decrease anxiety.Rationale:A. Offering lorazepam before group is an example of a biological nursing intervention, notintrapersonal.B. Attempting group uith the client is an exampleofan interpersonal, not intrapersona],nursing intervention.C. Encouraging discussion about fears is an intrapersona! nursing intervention.D. Role-playmg a scenario that may occur is a behavioral, not intrapersonal, nursingintervention.5. Using psychodynamic theory, which intervention would be appropriate for a client diagnosedwith panic disorder?A.Encourage the client to evaluate the power distorted thinking.B. Ask the client to include his or her family in scheduled therapy sessions.C. Discuss the overuse of ego defense mechanisms ami their impact on anxiety,D. Teach the client regarding blood lactate level as it relates to the client's panic attacks.Rationale:

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A. Encouraging the client to evaluate the power of distorted thinking is based on a cognitive,not psyrhodynamin, perspective.B. Asking the client to include his or her family in scheduled therapy sessions is based on aninterpersonal, not psychodynamic, perspective.C. The nurse discussing the overuse of ego defense mechanisms illustrates a psychodynamicapproach to address the client's behaviors related to panic disorder.D. Teaching the client the effects of blood lactate on anxiety is based on the biological, notpsychodynamic, perspective.6.x Aclient with diabetes mellitns demonstrates acute anxiety when admitted to the hospital forthe treatment of htTierglycemia. What is the appropriate intervention to decrease the client'sanxiety?A. -Administer a sedative.B. Convey empathy, trust, and respect toward the client.C. Ignore the signs and symptoms, anticipating they will soon disappear.D. Make sure that the client is familiar with the current medical terms to promoteunderstanding of what is happening.Rationale:A. -Administering a sedative is not the most appropriate intervention and does not addressthe source of the client's anxiey.B. -Anxiety is a subjective feeling of apprehension, uneasiness, or dread. The appropriateintervention is to address the client's feelings related to the anxiety.C. The nurse should not ignore the client's anxious feelings.D. xAnxiety needs to be managed before meaningful client education can occur.Psychiatric. Mental Health Nursing Success 3rd ed.7. In which situation would the nurse suspect a diagnosis of social anxiety disorder?A.xAclient abuses marijuana daily and avoids social situations because of fear ofhumiliation.B.xAn S year old child isolates from adults because of fear of embarrassment but has goodpeer relationships in school.C.x Aclient diagnosed with Parkinson s disease avoids social situations because ofembarrassment regarding tremors and drooling.D. A college student avoids taking classes that include an oral presentation because offear of being scrutinized by others.Rationale:A.x Aclient can not be diagnosed with social anxiety disorder when under the influence ofsubstance such as marijuana. It would be unclear if the client is experiencing the fearbecause of the mood altering substance or a true social phobia.B. Children can be diagnosed with social anxiety disorder. However, in children there mustbe evidence of the capacity for age appropriate social relationships with familiar people,and the anxiety must occur in peer and adult interactions.

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C. If a general medical condition or another mental disorder is present, the social anxietymust be unrelated. If the fear is related to the medical condition, the client can nor bediagnosed with social anxiety disorder.D. A student who avoids classes because of the fear of being scrutinized by others meets thecriteria for a diagnosis of social anxiety disorder.8. Anxiety is a symptom that can result from which of the following physiological conditions?Select all that applyA.ChronicObstructive Pulmonary diseaseB. HyperthyroidismC.HypertensionD. DiverticulosisE. HypoglycemiaRationale:A. Chronic obstructive pulmonary disease causes shortness of breath. Air deprivation causesanxiety. sometimes to the point of panic.B. Hyperthyroidism (Graves disease) involves excess stimulation of the sympatheticnervous system and excessive levels of thyroxine. Anxiety is one of the severalsymptoms brought on by these increases.C. Hypertension is an often asymptomatic disorder characterized by persistently elevatedblood pressure. Hypertension may be caused by anxiety, but normally clients do notexperience anxiety due to hypertension.D. Diverticulosis results from the outpocketing of the colon. Unless these pockets becomeinflamed, diverticulosis is generally asymptomatic.E. Marked irritability and anxiety are some of the many symptoms associated withhypoglycemia.ATI Mental Health Nursing10ed9) A nurse is assessing a client who has generalized anxiety disorder.Whichof the followingfindings should the nurse expect? (select all that apply)A. Excessive worry ford monthsB. Impulsive decision makingC.Delayed reflexesD. RestlessnessE.NeedforreassuranceRationale:A. Generalized anxiety disorder is characterized by uncontrollable. e=excessive worry formore that 3 months.B. Generalized anxiety disorder is characterized by procrastination in decision making.C. Generalized anxiety disorder is characterized by muscle tension.D. Generalized anxiety disorder is characterized by restlessness.E. Generalized anxiety disorder is characterized by the need for repeated reassurance.

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10) A nurse is experiencing a client who is experiencing a panic attack. WHich of the followingactions should thenursetake first?A. Discuss new relaxation techniquesB. Show the client how to change his behaviorC. Distract the client with a television showD. Stay with the dieut aud remain quietRationale:A. During a panic attack, the client is unable to concentrate on learning new information.B. During a panic attack, the client is unable to concentrate on learning new information.C. During a panic attack, the nurse should avoid further stimuli that can increase the client'slevel of anxiety.D. During a panic attack, the nurse should quietly remain with the client. This promotessafety and reassurance without additional stimuli.Alejandra Barragan 11-12ATI mental health10.011. A nurse observesaclient whohas OCD repeatedly applying, removing, and then reapplyingmakeup, the nurse identifies that repetitive behavior in a client who has OCD is duetowhich ofthe following underlying reasons?A.narcissistic behaviorB.Fear of rejection from staffC.AttempttoreduceanxietyD.Adverse effect of antidepressant medicationRationale:A. Clients who have OCD demonstrate repetitive behavior but not out of narcissism, whichmight be associated with personality 'disorders.B. Clients who have OCD demonstrate repetitive behaviorbutnot out of fearofrejection, whichmight be associated with social phobia anxiety disorder.C.CORRECT:Clients who have OCD demonstrate repetitive behavior m an attempttosuppress persistent thoughts or urges that cause anxiety.D. Clients who have OCD might take an antidepressant to help control repetitive behavior.12. A nurse is planning care for a cheat who has body dysmorphic disorder. Which of thefollowing actions should the nurse plan to take first?A. Assessing the client's risk for self-harmB. Instilling hope for positive outcomesC. Encouraging the client to participate in group therapy sessionsD. Encouraging the clienttoparticipate in treatment decisionsRationale:

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A. CORRECT: The greatest risk to a client who has an anxiety or obsessive-compulsivedisorder is self-harm or suicide, therefore, the rst action the nurse should plan to take is to assessthe client's risk for self-harm to ensure that the client is provided with a safe environment.B. The nurse should instill hope for positive outcomes, without providing false reassurance, aspart of milieu therapy; however there is another action that the nurse should take first.C. The nurse should encourage the client to participate in group therapy to assist the client inorder to address social impairments that result from the disorder; however, there is another actionthat the nurse should take rst.D. The nurse should encourage the client to participate in treatment decisions as part of milieutherapy: however, there is another action that the nurse should take first.RN Mental Health Nursing. Psychiatric Mental Health Nursing13. A nursing student diagnosed with acute test anxiety is prescribed propranolol (Inderal). Whatis the rationale for this treatment?A.Propranolol is a mood stabilizer that will decrease situational anxiety.B.Propranolol is an antihypertensive medication. Question this order.C.Propranolol has potent effects on the somatic manifestations of anxiety.D.Propranolol is an anxiolytic used specifically for generalized anxiety.Rationale:A. Propranolol is an antihypertensive beta blocker, not a mood stabilizer, tvhich can beused in the treatment of acute situational anxiety.B. Propranolol is an antihypertensive medication: hoyvever, because it can be effectivein the treatment of the somatic manifestations of acute situational anxiety, there is noneed to question this order.C. Correct. Research studies show7that propranolol is effective in decreasing anxietysymptoms. It has potent effects on the somatic, manifestations of anxiety, such aspalpitations and tremors, but has less dramatic effects on the psychic components ofanxiety. It is most effective in the treatment of acute situational anxiety, such asperformance anxiety and or test anxiety.D. Propranolol is an antihypertensive beta blocker, not an anxiohlic, that can be usedspecifically for acute situational anxiety. not generalized anxiety.14. Which nursing intervention takes priority"for a client experiencing moderate anxiety-?A.Explore the etiology of the anxiety.B.Investigate decompensation behaviors.C.Focusou anxiety reduction.D.Accept the level of anxiety.RationalesA. Exploring the etiology of anxiety is recommended only if the client is experiencingmild or well-controlled anxiety. With moderate anxiety, the client's perceptual field

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