Question 1

Antianxiety drugs are also called ______________________ and minor tranquilizers.

Accepted Answer

anxiolytics

Question 2

A client is newly diagnosed with obsessive-compulsive disorder and spends 45 minutes folding clothes and rearranging them in drawers. Which nursing intervention would best address this client's problem?

Accepted Answer

A)  Distract the client with other activities whenever ritual behaviors begin. 
B)  Report the behavior to the psychiatrist to obtain an order for medication dosage increase. 
C)  Lock the room to discourage ritualistic behavior. 
D)  Discuss the anxiety-provoking triggers that precipitate the ritualistic behaviors. 
A)  Distract the client with other activities whenever ritual behaviors begin. 
B)  Report the behavior to the psychiatrist to obtain an order for medication dosage increase. 
C)  Lock the room to discourage ritualistic behavior. 
D)  Discuss the anxiety-provoking triggers that precipitate the ritualistic behaviors. D

Question 3

Which nursing statement to a client about social anxiety disorder versus schizoid personality disorder (SPD) is most accurate?

Accepted Answer

A)  "Clients diagnosed with social anxiety disorder can manage anxiety without medications, whereas clients diagnosed with SPD can only manage anxiety with medications." 
B)  "Clients diagnosed with SPD are distressed by the symptoms experienced in social settings, whereas clients diagnosed with social anxiety disorder are not." 
C)  "Clients diagnosed with social anxiety disorder avoid interactions only in social settings, whereas clients diagnosed with SPD avoid interactions in all areas of life." 
D)  "Clients diagnosed with SPD avoid interactions only in social settings, whereas clients diagnosed with social anxiety disorder tend to avoid interactions in all areas of life." 
A)  "Clients diagnosed with social anxiety disorder can manage anxiety without medications, whereas clients diagnosed with SPD can only manage anxiety with medications." 
B)  "Clients diagnosed with SPD are distressed by the symptoms experienced in social settings, whereas clients diagnosed with social anxiety disorder are not." 
C)  "Clients diagnosed with social anxiety disorder avoid interactions only in social settings, whereas clients diagnosed with SPD avoid interactions in all areas of life." 
D)  "Clients diagnosed with SPD avoid interactions only in social settings, whereas clients diagnosed with social anxiety disorder tend to avoid interactions in all areas of life." C

Question 4

A cab driver, stuck in traffic, becomes lightheaded, tremulous, diaphoretic, tachycardic, and dyspneic. A work-up in an emergency department reveals no pathology. Which medical diagnosis should the nurse suspect, and what nursing diagnosis should be the nurse's first priority?

Accepted Answer

A)  Generalized anxiety disorder and a nursing diagnosis of fear 
B)  Mild anxiety disorder and a nursing diagnosis of anxiety 
C)  Pain disorder and a nursing diagnosis of altered role performance 
D)  Panic disorder and a nursing diagnosis of anxiety 
A)  Generalized anxiety disorder and a nursing diagnosis of fear 
B)  Mild anxiety disorder and a nursing diagnosis of anxiety 
C)  Pain disorder and a nursing diagnosis of altered role performance 
D)  Panic disorder and a nursing diagnosis of anxiety

Question 5

A client diagnosed with obsessive-compulsive disorder is admitted to a psychiatric unit. The client has an elaborate routine for toileting activities. Which would be an appropriate initial client outcome during the first week of hospitalization?

Accepted Answer

A)  The client will refrain from ritualistic behaviors during daylight hours. 
B)  The client will wake early enough to complete rituals prior to breakfast. 
C)  The client will participate in three unit activities by day three. 
D)  The client will substitute a productive activity for rituals by day one. 
A)  The client will refrain from ritualistic behaviors during daylight hours. 
B)  The client will wake early enough to complete rituals prior to breakfast. 
C)  The client will participate in three unit activities by day three. 
D)  The client will substitute a productive activity for rituals by day one.

Question 6

An attractive female client presents with high anxiety levels because of her belief that her facial features are large and grotesque. Body dysmorphic disorder (BDD) is suspected. Which of the following additional symptoms would support this diagnosis?

Accepted Answer

A)  Mirror checking 
B)  Excessive grooming 
C)  History of an eating disorder 
D)  History of delusional thinking 
E)  Skin picking 
A)  Mirror checking 
B)  Excessive grooming 
C)  History of an eating disorder 
D)  History of delusional thinking 
E)  Skin picking

Question 7

Which treatment should the nurse identify as most appropriate for clients diagnosed with generalized anxiety disorder?

Accepted Answer

A)  Long-term treatment with diazepam (Valium) 
B)  Acute symptom control with citalopram (Celexa) 
C)  Long-term treatment with buspirone (BuSpar) 
D)  Acute symptom control with ziprasidone (Geodon) 
A)  Long-term treatment with diazepam (Valium) 
B)  Acute symptom control with citalopram (Celexa) 
C)  Long-term treatment with buspirone (BuSpar) 
D)  Acute symptom control with ziprasidone (Geodon)

Question 8

Traits associated with schizoid, obsessive-compulsive, and _____________________ personality disorders are commonly seen in clients with the diagnosis of BDD.

Accepted Answer

The answer of Traits associated with schizoid, obsessive-compulsive, and _____________________...

Question 9

Which symptoms should the nurse recognize that differentiate a client diagnosed with obsessive-compulsive disorder (OCD) from a client diagnosed with obsessive-compulsive personality disorder?

Accepted Answer

A)  Clients diagnosed with OCD experience both obsessions and compulsions, and clients diagnosed with obsessive-compulsive personality disorder do not. 
B)  Clients diagnosed with obsessive-compulsive personality disorder experience both obsessions and compulsions, and clients diagnosed with OCD do not. 
C)  Clients diagnosed with obsessive-compulsive personality disorder experience only obsessions, and clients diagnosed with OCD experience only compulsions. 
D)  Clients diagnosed with OCD experience only obsessions, and clients diagnosed with obsessive-compulsive personality disorder experience only compulsions. 
A)  Clients diagnosed with OCD experience both obsessions and compulsions, and clients diagnosed with obsessive-compulsive personality disorder do not. 
B)  Clients diagnosed with obsessive-compulsive personality disorder experience both obsessions and compulsions, and clients diagnosed with OCD do not. 
C)  Clients diagnosed with obsessive-compulsive personality disorder experience only obsessions, and clients diagnosed with OCD experience only compulsions. 
D)  Clients diagnosed with OCD experience only obsessions, and clients diagnosed with obsessive-compulsive personality disorder experience only compulsions.

Question 10

A nursing student questions an instructor regarding the order for fluvoxamine (Luvox) 300 mg daily for a client diagnosed with obsessive-compulsive disorder. Which instructor response is most accurate?

Accepted Answer

A)  High doses of tricyclic medications will be required for effective treatment of OCD. 
B)  Selective serotonin reuptake inhibitor (SSRI) doses, in excess of what is effective for treating depression, may be required for OCD. 
C)  The dose of Luvox is low because of the side effect of daytime drowsiness. 
D)  The dose of this SSRI is outside the therapeutic range and needs to be questioned. 
A)  High doses of tricyclic medications will be required for effective treatment of OCD. 
B)  Selective serotonin reuptake inhibitor (SSRI) doses, in excess of what is effective for treating depression, may be required for OCD. 
C)  The dose of Luvox is low because of the side effect of daytime drowsiness. 
D)  The dose of this SSRI is outside the therapeutic range and needs to be questioned.

Question 11

A college student is unable to take a final exam due to severe test anxiety. Instead of studying, the student relieves stress by attending a movie. Which priority nursing diagnosis should the campus nurse assign for this client?

Accepted Answer

A)  Non-adherence R/T test taking 
B)  Ineffective role performance R/T helplessness 
C)  Altered coping R/T anxiety 
D)  Powerlessness R/T fear 
A)  Non-adherence R/T test taking 
B)  Ineffective role performance R/T helplessness 
C)  Altered coping R/T anxiety 
D)  Powerlessness R/T fear

Question 12

A college student has been diagnosed with generalized anxiety disorder. Which of the following symptoms should the campus nurse expect this client to exhibit?

Accepted Answer

A)  Fatigue 
B)  Anorexia 
C)  Hyperventilation 
D)  Insomnia 
E)  Irritability 
A)  Fatigue 
B)  Anorexia 
C)  Hyperventilation 
D)  Insomnia 
E)  Irritability

Question 13

A nursing instructor is teaching about the symptoms of agoraphobia. Which student statement indicates that teaching has been effective?

Accepted Answer

A)  Onset of symptoms most commonly occurs in early adolescence and persists until midlife. 
B)  Onset of symptoms most commonly occurs in the 20s and 30s and persists for many years. 
C)  Onset of symptoms most commonly occurs in the 40s and 50s and persists until death. 
D)  Onset of symptoms most commonly occurs after the age of 60 and persists for at least 6 years. 
A)  Onset of symptoms most commonly occurs in early adolescence and persists until midlife. 
B)  Onset of symptoms most commonly occurs in the 20s and 30s and persists for many years. 
C)  Onset of symptoms most commonly occurs in the 40s and 50s and persists until death. 
D)  Onset of symptoms most commonly occurs after the age of 60 and persists for at least 6 years.

Question 14

A nursing instructor is teaching about specific phobias. Which student statement indicates to the instructor that teaching has been effective?

Accepted Answer

A)  "These clients recognize their fear as excessive and frequently seek treatment." 
B)  "These clients have a panic level of fear that is overwhelming and unreasonable." 
C)  "These clients experience symptoms that mirror a cerebrovascular accident." 
D)  "These clients experience the symptoms of tachycardia, dysphagia, and diaphoresis." 
A)  "These clients recognize their fear as excessive and frequently seek treatment." 
B)  "These clients have a panic level of fear that is overwhelming and unreasonable." 
C)  "These clients experience symptoms that mirror a cerebrovascular accident." 
D)  "These clients experience the symptoms of tachycardia, dysphagia, and diaphoresis."

Question 15

A nursing instructor is teaching about the medications used to treat panic disorder. Which student statement indicates that teaching has been effective?

Accepted Answer

A)  "Clonazepam (Klonopin) is particularly effective in the treatment of panic disorder." 
B)  "Clozapine (Clozaril) is used off-label in long-term treatment of panic disorder." 
C)  "Doxepin (Sinequan) can be used in low doses to relieve symptoms of panic attacks." 
D)  "Buspirone (BuSpar) is used for its immediate effect to lower anxiety during panic attacks." 
A)  "Clonazepam (Klonopin) is particularly effective in the treatment of panic disorder." 
B)  "Clozapine (Clozaril) is used off-label in long-term treatment of panic disorder." 
C)  "Doxepin (Sinequan) can be used in low doses to relieve symptoms of panic attacks." 
D)  "Buspirone (BuSpar) is used for its immediate effect to lower anxiety during panic attacks."

Question 16

The nurse is providing education to a client diagnosed with anxiety. Which statement by the client indicates that teaching has been effective?

Accepted Answer

A)  "There is nothing that I can do to that will reduce anxiety." 
B)  "Medication is available, but only for those who have had anxiety for a year or more." 
C)  "If I ignore the symptoms of anxiety, it will go away." 
D)  "Practicing yoga or meditation may help reduce my anxiety." 
A)  "There is nothing that I can do to that will reduce anxiety." 
B)  "Medication is available, but only for those who have had anxiety for a year or more." 
C)  "If I ignore the symptoms of anxiety, it will go away." 
D)  "Practicing yoga or meditation may help reduce my anxiety."

Question 17

A client living in a beachfront community is seeking help with an extreme fear of bridges, which is interfering with daily functioning. The psychiatric nurse practitioner decides to try systematic desensitization. Which explanation of this treatment should the nurse provide?

Accepted Answer

A)  "Using your imagination, we will attempt to achieve a state of relaxation." 
B)  "Because anxiety and relaxation are mutually exclusive states, we can attempt to substitute a relaxation response for the anxiety response." 
C)  "Through a series of increasingly anxiety-provoking steps, we will gradually increase your tolerance to anxiety." 
D)  "In one intense session, you will be exposed to a maximum level of anxiety that you will learn to tolerate." 
A)  "Using your imagination, we will attempt to achieve a state of relaxation." 
B)  "Because anxiety and relaxation are mutually exclusive states, we can attempt to substitute a relaxation response for the anxiety response." 
C)  "Through a series of increasingly anxiety-provoking steps, we will gradually increase your tolerance to anxiety." 
D)  "In one intense session, you will be exposed to a maximum level of anxiety that you will learn to tolerate."

Question 18

What symptoms should the nurse recognize that differentiate a client diagnosed with panic disorder from a client diagnosed with generalized anxiety disorder (GAD)?

Accepted Answer

A)  GAD is acute in nature, and panic disorder is chronic. 
B)  Chest pain is a common GAD symptom, whereas this symptom is absent in panic disorders. 
C)  Hyperventilation is a common symptom in GAD and rare in panic disorder. 
D)  Depersonalization is commonly seen in panic disorder and absent in GAD. 
A)  GAD is acute in nature, and panic disorder is chronic. 
B)  Chest pain is a common GAD symptom, whereas this symptom is absent in panic disorders. 
C)  Hyperventilation is a common symptom in GAD and rare in panic disorder. 
D)  Depersonalization is commonly seen in panic disorder and absent in GAD.

Question 19

A client is prescribed alprazolam (Xanax) for acute anxiety. What client history should cause a nurse to question this order?

Accepted Answer

A)  History of alcohol use disorder 
B)  History of personality disorder 
C)  History of schizophrenia 
D)  History of hypertension 
A)  History of alcohol use disorder 
B)  History of personality disorder 
C)  History of schizophrenia 
D)  History of hypertension

Question 20

A client is experiencing a severe panic attack. Which nursing intervention would meet this client's physiological need?

Accepted Answer

A)  Teach deep breathing relaxation exercises. 
B)  Place the client in a Trendelenburg position. 
C)  Have the client breathe into a paper bag. 
D)  Administer the ordered prn buspirone (BuSpar). 
A)  Teach deep breathing relaxation exercises. 
B)  Place the client in a Trendelenburg position. 
C)  Have the client breathe into a paper bag. 
D)  Administer the ordered prn buspirone (BuSpar).

Exam 18: Anxiety, Obsessive-Compulsive, and Related Disorders

Antianxiety drugs are also called ______________________ and minor tranquilizers.

A client is newly diagnosed with obsessive-compulsive disorder and spends 45 minutes folding clothes and rearranging them in drawers. Which nursing intervention would best address this client's problem?

Which nursing statement to a client about social anxiety disorder versus schizoid personality disorder (SPD) is most accurate?

A cab driver, stuck in traffic, becomes lightheaded, tremulous, diaphoretic, tachycardic, and dyspneic. A work-up in an emergency department reveals no pathology. Which medical diagnosis should the nurse suspect, and what nursing diagnosis should be the nurse's first priority?

A client diagnosed with obsessive-compulsive disorder is admitted to a psychiatric unit. The client has an elaborate routine for toileting activities. Which would be an appropriate initial client outcome during the first week of hospitalization?

An attractive female client presents with high anxiety levels because of her belief that her facial features are large and grotesque. Body dysmorphic disorder (BDD) is suspected. Which of the following additional symptoms would support this diagnosis?

Which treatment should the nurse identify as most appropriate for clients diagnosed with generalized anxiety disorder?

Traits associated with schizoid, obsessive-compulsive, and _____________________ personality disorders are commonly seen in clients with the diagnosis of BDD.

Which symptoms should the nurse recognize that differentiate a client diagnosed with obsessive-compulsive disorder (OCD) from a client diagnosed with obsessive-compulsive personality disorder?

A nursing student questions an instructor regarding the order for fluvoxamine (Luvox) 300 mg daily for a client diagnosed with obsessive-compulsive disorder. Which instructor response is most accurate?

A college student is unable to take a final exam due to severe test anxiety. Instead of studying, the student relieves stress by attending a movie. Which priority nursing diagnosis should the campus nurse assign for this client?

A college student has been diagnosed with generalized anxiety disorder. Which of the following symptoms should the campus nurse expect this client to exhibit?

A nursing instructor is teaching about the symptoms of agoraphobia. Which student statement indicates that teaching has been effective?

A nursing instructor is teaching about specific phobias. Which student statement indicates to the instructor that teaching has been effective?

A nursing instructor is teaching about the medications used to treat panic disorder. Which student statement indicates that teaching has been effective?

The nurse is providing education to a client diagnosed with anxiety. Which statement by the client indicates that teaching has been effective?

A client living in a beachfront community is seeking help with an extreme fear of bridges, which is interfering with daily functioning. The psychiatric nurse practitioner decides to try systematic desensitization. Which explanation of this treatment should the nurse provide?

What symptoms should the nurse recognize that differentiate a client diagnosed with panic disorder from a client diagnosed with generalized anxiety disorder (GAD)?

A client is prescribed alprazolam (Xanax) for acute anxiety. What client history should cause a nurse to question this order?

A client is experiencing a severe panic attack. Which nursing intervention would meet this client's physiological need?

Mental Health and Mental Illness

Biological Implications

Ethical and Legal Issues

Psychopharmacology

Cultural and Spiritual Concepts Relevant to Psychiatricmental Health Nursing

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The Nursing Process in Psychiatricmental Health Nursing

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