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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.
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A nurse is developing the plan of care for a client with panic disorder that will include pharmacologic therapy. Which of the following would the nurse most likely expect to administer?
- A. Benzodiazepine
- B. Selective serotonin reuptake inhibitor (SSRI)
- C. Monoamine oxidase inhibitor (MAOI)
- D. Tricyclic antidepressant (TCA)
Correct Answer: B
Rationale: SSRIs (B) are the first-line treatment for panic disorder due to their efficacy and safety profile for long-term management. Benzodiazepines (A) are used short-term, MAOIs (C) and TCAs (D) are less preferred due to side effects and dietary restrictions.
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.
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.
The nurse is caring for a client who is being treated in the emergency department for a panic attack. Which of the following nursing interventions would be most appropriate?
- A. Demonstrate empathy for the client by trying to mimic the client?s state of anxiety.
- B. Tell the client that you must leave to go report his symptoms to the psychiatrist on duty.
- C. Tell the client this is an acute exacerbation with a positive prognosis and low morbidity.
- D. Stay with the client, emphasizing that he is safe and that you will remain with him.
Correct Answer: D
Rationale: Staying with the client and emphasizing safety (D) provides reassurance and reduces fear during a panic attack. Mimicking anxiety (A) is inappropriate, leaving the client (B) increases distress, and discussing prognosis (C) is less urgent than providing immediate support.
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.