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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 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.
After teaching a class about the biochemical theories associated with panic disorder, the instructor determines a need for additional teaching when the students identify which neurotransmitter as being implicated?
- A. Dopamine
- B. Serotonin
- C. Norepinephrine
- D. Gamma-aminobutyric acid (GABA)
Correct Answer: A
Rationale: Serotonin (B), norepinephrine (C), and GABA (D) are implicated in panic disorder due to their roles in anxiety regulation. Dopamine (A) is primarily linked to psychosis and reward, not panic, indicating a misunderstanding.
A group of students is reviewing the signs and symptoms associated with anxiety. The students demonstrate an understanding of the information when they identify which of the following as cognitive symptoms? Select all that apply.
- A. Edginess
- B. Feelings of unreality
- C. Difficulty concentrating
- D. Tunnel vision
- E. Apprehensiveness
- F. Speech dysfluency
Correct Answer: B,C,E
Rationale: Cognitive symptoms of anxiety include feelings of unreality (B), difficulty concentrating (C), and apprehensiveness (E), reflecting mental processing disruptions. Edginess (A) is emotional, tunnel vision (D) is perceptual, and speech dysfluency (F) is behavioral.
A nurse is preparing an in-service presentation about panic disorders and associated theories related to the cause. When describing the cognitive-behavioral concepts associated with panic disorders, which of the following would the nurse expect to address?
- A. Personal losses
- B. Conditioned response
- C. Early separation
- D. Dysfunctional family communication
Correct Answer: B
Rationale: Cognitive-behavioral theory links panic disorder to a conditioned response (B), where physical sensations are misinterpreted as catastrophic, triggering panic. Personal losses (A), early separation (C), and dysfunctional communication (D) are more relevant to psychoanalytic theories.
While interviewing a client, the client reports an intense fear of spiders, stating, I can?t be near them. I get so upset. I start to sweat and hyperventilate if I see one. The nurse documents this finding as which of the following?
- A. Algophobia
- B. Entomophobia
- C. Arachnophobia
- D. Cynophobia
Correct Answer: C
Rationale: Arachnophobia (C) is the specific fear of spiders, matching the client?s symptoms of sweating and hyperventilation. Algophobia (A) is fear of pain, entomophobia (B) is a broader fear of insects, and cynophobia (D) is fear of dogs.