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A client comes to the emergency department because he thinks he is having a 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 use?
- 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?
Correct Answer: B
Rationale: Asking about the client?s experiences before and during the attack (B) gathers critical information about triggers and symptoms, aiding in confirming the panic attack diagnosis and planning care. Asking about feeling better (A) is premature, driving ability (C) is irrelevant during acute assessment, and causes (D) are less urgent than symptom details.
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The nurse is planning a presentation to a group of nursing students on the topic of anxiety disorders. Which of the following 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 agoraphobia.
- C. Typically, individuals experience this disorder after the age of 30 years.
- D. Persons rarely have an underlying comorbid condition of depression.
Correct Answer: A
Rationale: Panic disorder (A) is characterized by sudden, intense fear often mistaken for a heart attack due to symptoms like chest pain and palpitations. Agoraphobia (B) typically increases attack frequency due to fear of public spaces, onset is often earlier than 30 (C), and depression is a common comorbidity (D), making these options incorrect.
A client is diagnosed with generalized anxiety disorder 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
Correct Answer: C
Rationale: Alprazolam (C), a benzodiazepine, provides the fastest relief from anxiety symptoms due to its rapid onset. Buspirone (A) and venlafaxine (B) take weeks to be effective, and imipramine (D), a TCA, is slower and less used for GAD.
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 of the following as representing the psychoanalytic theory for this disorder?
- A. Inaccurate environmental danger assessment
- B. Exposure to multiple stressful life events
- C. Kindling caused by overstimulation
- D. Unresolved unconscious conflicts
Correct Answer: D
Rationale: Psychoanalytic theory attributes GAD to unresolved unconscious conflicts (D), such as repressed emotions from early experiences. Inaccurate danger assessment (A) is cognitive, stressful events (B) are environmental, and kindling (C) is a neurobiological concept.
A female client is diagnosed with panic disorder. The client tells the nurse that she hasn?t left her house in more than a month because she was afraid of another attack. She visited the mental health clinic today only because her son brought her. 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
Correct Answer: D
Rationale: Social Isolation (D) is the priority, as the client?s fear of panic attacks has led to avoiding leaving home, significantly impacting social functioning. Powerlessness (A) and decisional conflict (B) are relevant but less immediate, and ineffective family coping (C) is not supported by the scenario.
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. Which of the following would the nurse do first?
- A. Stay with the client while remaining 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 her.
Correct Answer: A
Rationale: Staying with the client while remaining calm (A) is the first priority during a panic attack to provide reassurance and safety, reducing fear. Moving to a safe environment (B) is secondary, reassuring about duration (C) is less immediate, and teaching breathing (D) requires the client to be calmer first.