Nokea
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.
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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.
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.
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.
The nurse has instructed a client with panic disorder about how to use the technique of positive self-talk. The nurse determines that the client has understood the instructions when the client verbalizes which statement to use during an impending panic attack?
- A. I am feeling very nervous right now.
- B. I can handle this anxiety; it will be over shortly.
- C. I am taking medication to eliminate these symptoms.
- D. Relax your muscles, relax your muscles.
Correct Answer: B
Rationale: Positive self-talk (B) involves reassuring statements that empower the client to manage anxiety, such as affirming control and the transient nature of the attack. Stating nervousness (A) reinforces anxiety, medication reliance (C) is not self-talk, and muscle relaxation (D) is a different technique.
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.