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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.
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A client who is a nursing student reports increased anxiety with test iniziative. Which behavioral technique is most appropriate for this client to put into practice?
- A. Write 'I can do this' on an index card and place in view.
- B. Use breathing techniques to reduce anxiety.
- C. Use meditation prior to exams.
- D. Participate in a study group and prepare well before exams.
Correct Answer: B
Rationale: Behavioral therapy is used to coach a client to engage in some form of distraction or perform relaxation or breathing exercises to overcome symptoms. Teaching the student how to use breathing techniques can be helpful during stress-inducing exams. Writing 'I can do this' on a card is a form of cognitive therapy and provides positive thinking. Use of meditation can be helpful in the management of generalized anxiety but is not practical in a classroom setting. Studying and preparing for exams is expected but is not a behavioral technique that is helpful during test-taking events.
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.
Following the death of a spouse, a client is prescribed a short-term use of lorazepam. Which is the best rationale to support taking this medication at bedtime?
- A. Deters the client from driving under the influence
- B. Prevents nightmares and obsessive thoughts
- C. Induces drowsiness and sleep
- D. Causes dizziness and lightheadedness
Correct Answer: C
Rationale: Antianxiety drugs such as lorazepam can cause drowsiness and induce sleep. Because many clients with anxiety disorders also have insomnia, taking the medication at bedtime will promote sleep. Nightmares and obsessive thoughts may be decreased through the induction of sleep. Using the drug at bedtime is not for the purpose of deterring driving. This drug can cause dizziness and light-headedness in some clients.
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.
The nurse is caring for a client diagnosed with PTSD. The client is exhibiting withdrawal and ignoring problems and issues. The nurse recognizes this as which of the following?
- A. Social phobia
- B. Flashback
- C. Psychic numbing
- D. Guilt
Correct Answer: C
Rationale: Initially, a person diagnosed with PTSD avoids dealing with the tragedy and detaches from others using a technique termed psychic numbing. Social phobia is a fear of being in social places. Flashbacks are recurrent nightmares. Guilt may occur from emotional conflicts related to the traumatic experience.