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A client with panic disorder who has been prescribed sertraline in conjunction with alprazolam comes to the clinic for a follow-up. The client states, I stopped taking the alprazolam about 2 days ago. I was feeling really sleepy and tired. Which of the following would alert the nurse to suspect possible withdrawal? Select all that apply.
- A. Metallic taste
- B. Irritability
- C. Dry, flushed skin
- D. Tremor
- E. Muscle flaccidity
Correct Answer: B,D
Rationale: Abrupt cessation of alprazolam, a benzodiazepine, can cause withdrawal symptoms like irritability (B) and tremor (D) due to central nervous system rebound. Metallic taste (A), dry skin (C), and muscle flaccidity (E) are not typical withdrawal symptoms.
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A nurse is developing a teaching plan for a client with generalized anxiety disorder, focusing on nutrition. Which of the following would the nurse encourage the client to avoid? Select all that apply.
- A. Coffee
- B. Ginseng
- C. Milk products
- D. Citrus juices
- E. Aged cheese
Correct Answer: A,B
Rationale: Coffee (A) and ginseng (B) are stimulants that can exacerbate anxiety symptoms in GAD. Milk products (C), citrus juices (D), and aged cheese (E) are not typically contraindicated unless specific sensitivities exist.
A nurse determines that a client who is experiencing anxiety is using relief behaviors. The nurse determines that the client is experiencing which degree of anxiety?
- A. Mild
- B. Moderate
- C. Severe
- D. Panic
Correct Answer: C
Rationale: Relief behaviors, such as avoidance or rituals, are typically used in severe anxiety (C) to reduce overwhelming distress. Mild anxiety (A) enhances alertness, moderate (B) involves manageable distress, and panic (D) involves disorganized behavior, not specific relief behaviors.
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 nurse who has worked with a client diagnosed with generalized anxiety disorder (GAD) when he was an inpatient on the psychiatric unit sees the client in the waiting room of the outpatient psychiatric clinic. The client motions to the nurse to come over so he can tell the nurse how things have been going since he was discharged. While talking with the client, the nurse determines that the client?s therapy has been effective when the client states which of the following?
- A. I am still experiencing quite a bit of stress at home and at work; things are different at home than they were in the hospital.
- B. When my mother-in-law comes over now, I go out to my workshop and work on one of my projects.
- C. I?m still drinking coffee; I can?t quit after drinking it all these years.
- D. I?ve learned having a beer after I get home from work helps me relax.
Correct Answer: B
Rationale: Going to the workshop (B) indicates effective coping by using a constructive activity to manage stress from a trigger (mother-in-law?s visits). Persistent stress (A) suggests ineffective therapy, coffee (C) can worsen anxiety, and alcohol use (D) is an unhealthy coping mechanism.
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.