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A client who has an intense fear of flying has elected to participate in a therapy that culminates in a short air flight. This is an example of which type of therapy?
- A. Psychotherapy
- B. Cognitive therapy
- C. Behavioral therapy
- D. Alternative therapy
Correct Answer: C
Rationale: Desensitization is a form of behavioral therapy and attempts to extinguish undesirable responses by learning adaptive techniques. Emotional support is provided while the client is gradually coached through experiences that provoke anxiety. Eventually, the client will be able to tolerate the anxiety-provoking experience independently. Psychotherapy involves talking with a psychiatrist, psychologist, or other clinical specialist. Cognitive therapy is a form of psychotherapy in which the therapist assists the client in correcting faulty belief systems. Alternative therapy is the use of techniques to manage anxiety through relaxation techniques and physical exercise.
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A client is scheduled for magnetic resonance imaging (MRI) of the head and neck. Which action by the nurse would be most helpful in calming the anxious client?
- A. Administer antianxiety medication.
- B. Allow the client to express fears and concerns.
- C. Discuss how others have survived the procedure.
- D. Explain how the client can notify staff if anxiety increases.
Correct Answer: B
Rationale: Building trust and restoring comfort can be accomplished when the nurse allows the client to verbalize anxiety. Identifying the problem and exploring possible solutions may be helpful in decreasing anxiety. The physician may prescribe an antianxiety medication to the client prior to testing. Antianxiety drugs work but conversation is more immediate and safer. Knowing the client can call for assistance during the testing may be helpful in decreasing anxiety. But calling for assistance does not help the client in the moment. Discussion of other clients is not helpful in this situation.
A client who is being interviewed by the nurse begins pacing and wringing hands, and repeating, 'I just need to keep moving.' Which statement by the nurse is most appropriate and therapeutic for this client?
- A. Please sit down and relax.
- B. Is something bothering you?
- C. The physician will talk with you next.
- D. Are you feeling anxious?
Correct Answer: D
Rationale: Asking if the client is feeling anxious helps to identify the behavior being presented and provides an opening for the client to express feelings. Asking the client to sit down and relax is not appropriate and may further agitate the client. By stating the physician will speak with the client next, the nurse is dismissing the behavior. Asking if something is bothering the client is a vague question and does not address the expression of anxiety.
The Beer's List is helpful in providing the nurse with a quick reference on potential risks and benefits for which likely group of clients?
- A. Infants and children
- B. Older adults
- C. Chemically dependent
- D. Complex medical problem clients
Correct Answer: B
Rationale: Beer's criterion has been used to identify drugs that may be inappropriately prescribed, ineffective, or cause adverse drug reactions in older adult clients. The Beer's criteria are very useful and help determine risk-associated situations for older adults and specific drugs that may be problematic. Chemical dependency and complex medical problems are not a consideration.
One week ago, the client was prescribed Buspirone (Buspar) for anxiety. The client phones the office and reports the medication has not eliminated the symptoms. Which is the best response by the nurse?
- A. It may take up to 4 weeks for full therapeutic response.
- B. There are many other medications that can be offered.
- C. Buspar will not eliminate all symptoms associated with anxiety.
- D. Call back in one week if the symptoms continue.
Correct Answer: A
Rationale: Buspirone (Buspar) may take 2 to 4 weeks to produce desired effects. Clients should be provided this information at the time of initial administration. Changing to another medication would not be indicated at this time. Suggesting that the symptoms may not be eliminated is not indicated and should be avoided. Listening to and validating the client's concerns is a therapeutic measure.
The nurse is evaluating an older adult client who, for the past year, has been constantly fretful and worries about finances, living alone, and being lonely. The nurse understands these are symptoms of which type of anxiety disorder?
- A. Generalized anxiety disorder
- B. Phobic disorder
- C. Posttraumatic stress disorder
- D. Obsessive-compulsive disorder
Correct Answer: A
Rationale: Generalized anxiety disorder is characterized by chronic, daily worrying for 6 months or more. Phobic disorder is characterized by an exaggerated and irrational fear, such as the fear of insects, animals, or various life experiences such as riding on a roller coaster or flying on an airplane, some of which are potentially dangerous. Posttraumatic stress disorder is a condition that involves a delayed anxiety response 3 or more months after an emotionally traumatic experience. Obsessive-compulsive disorder is manifested by the performance of an anxiety-relieving ritual to terminate a disturbing, persistent, and recurring thought.