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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 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.
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.
A client who has been diagnosed with panic disorder visits the clinic and experiences a panic attack. The client tells the nurse, I?m so nervous. My hands are shaking, and I?m sweating. I feel as if I?m having a stroke right now. Which of the following would the nurse do first?
- A. Stay with the client while remaining calm.
- B. Move the client to a safe environment.
- C. Tell the client that the attack will soon pass.
- D. Teach the client deep breathing techniques to calm her.
Correct Answer: A
Rationale: Staying with the client while remaining calm (A) is the first priority during a panic attack to provide reassurance and safety, reducing fear. Moving to a safe environment (B) is secondary, reassuring about duration (C) is less immediate, and teaching breathing (D) requires the client to be calmer first.
A client with a panic disorder has been prescribed a benzodiazepine medication. Which of the following would the nurse emphasize as a risk associated with using this medication?
- A. Dietary restrictions
- B. Withdrawal symptoms
- C. Agitation
- D. Fecal impaction
Correct Answer: B
Rationale: Benzodiazepines (B) carry a significant risk of withdrawal symptoms, including anxiety and seizures, if stopped abruptly, necessitating careful tapering. Dietary restrictions (A) apply to MAOIs, agitation (C) is a symptom not a risk, and fecal impaction (D) is unrelated.