Exam 12: Anxiety and Anxiety Disorders

A man checks that his doors are locked two or more times each time he leaves home.The door is always found to be locked.Which of the following initial interventions would most likely be useful to this patient?

An insurance agent who is sitting in his office after returning from a cardiovascular examination in which he was pronounced "in good health" suddenly experiences a feeling of terror.His heart pounds,he feels as though he cannot breathe,and he cannot focus on what is being said to him.Several earlier episodes (for which he was seen in the emergency room,without any findings of cardiovascular disease)and the fear of their repetition had prompted the visit to the doctor for a more thorough evaluation.This experience should be assessed as a possible:

A nursing student asks to be excused from a required group presentation.He reveals that he is afraid that he will "mess up" and that others will laugh at him.He reports significant dread at the thought of any public presentation,accompanied often by nausea and vomiting when such situations occurred in the past.He reports he was unable to go to prom because he cannot dance well and feared he would be teased or become physically ill.This history suggests the presence of a:

A patient who has been unable to leave his home for more than a month because of symptoms of severe anxiety tells the nurse: "I feel really stupid,a grown man not being able to leave his house." The most therapeutic reply is:

A Hispanic woman is recovering from surgery on an inpatient unit when she receives word that her mother has passed away unexpectedly.She begins to shout unintelligibly and then complains of palpitations and a sense of heat in her chest and head.She suddenly begins to tremble and exhibit seizure-like motor behavior.Which of the following would be the most appropriate nursing response?

A patient reports that nothing is wrong with him except a chest cold he's had for a couple weeks and "hasn't been able to shake off." His wife is very worried and says he smokes,coughs a lot,has lost 15 pounds,and is easily fatigued.Which of the following statements best describes this situation?

Two staff nurses were considered for promotion.The promotion was announced by a memo on the unit bulletin board.When the nurse who was not promoted first read the memo and learned that the other nurse had received the promotion,she left the room in tears.This behavior is an example of:

A patient tells the nurse,"My new friend is the most perfect person one could imagine! I can't find a single flaw.He is kind,considerate,handsome-and he puts me before anyone or anything else." The nurse should hypothesize that this patient may be demonstrating:

A patient with moderate to severe anxiety associated with generalized anxiety disorder can be assessed as successfully lowering her anxiety level to mild when she:

A patient who has been pacing actively approaches the nurse and blurts out,"You've got to help me! Something terrible is happening.I'm falling apart.I can't think.I can't get my breath;I feel like I'm dying.What's happening to me?!" Which of the following nursing responses would be appropriate? Select all that apply.

A patient who is a university student states that before taking an examination he feels a heightened sense of awareness and a sense of restlessness.The nurse should assess the patient's situation as:

The care plan for an engineer with agoraphobia includes increasing self-esteem with cognitive restructuring.When the patient tells the nurse,"I'm not smart enough to get that job," the nurse should say:

A patient who has been unable to leave his home for more than a month because of symptoms of severe anxiety tells the nurse,"I know it's probably crazy,but I just can't bring myself to leave my apartment alone." An appropriate nursing intervention for the nurse to include in the initial nursing care plan is:

A patient with obsessive-compulsive disorder spends 2 hours each morning checking and rechecking her home before leaving for work then comes home on the lunch hour and spends more than an hour rechecking faucets,stove burners,appliances,window and door locks,and so forth.The checking continues after work and during the evening.The patient spends so much time in ritualistic behavior that grooming is poor and social activities are nonexistent.Which indicators for measuring progress would be appropriate for this patient? Select all that apply.

A patient tells the nurse that she wants her physician to prescribe diazepam (Valium)for anxiety reduction.The physician has prescribed buspirone (BuSpar).The nurse's reply should be based on the knowledge that buspirone:

The nurse wishes to teach an alternative coping strategy to a patient who is currently experiencing severe anxiety.The nurse will first need to:

The nurse interviewing a patient with suspected posttraumatic stress disorder should be alert to findings indicating the patient: Select all that apply.

For the patient whose nursing diagnosis is Powerlessness related to an inability to control compulsive cleaning,the nurse must understand that the patient uses the cleaning to:

When a patient asks what causes his panic attacks,the nurse should reply that research gives evidence to support the theory that panic disorders have their etiology in:

A patient accompanied her boyfriend to the emergency department after the two had been in a motorcycle accident.The boyfriend was badly hurt,but the patient had only minor cuts and bruises and was discharged.She mentioned to the nurse that since she was driving,she should have been the one to be injured.Twenty-four hours later,while visiting her boyfriend,the patient reported that she was unable to move from her chair and unable to walk.Diagnostic workup revealed no physical reason for the problem.The anxiety relief behavior the patient is demonstrating is: