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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.
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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.
The nurse is planning a presentation to a group of nursing students on the topic of anxiety disorders. Which of the following would the nurse include when describing panic disorder?
- A. Individuals may believe they are having a heart attack when a panic attack occurs.
- B. People with panic attacks often have fewer attacks if they also have agoraphobia.
- C. Typically, individuals experience this disorder after the age of 30 years.
- D. Persons rarely have an underlying comorbid condition of depression.
Correct Answer: A
Rationale: Panic disorder (A) is characterized by sudden, intense fear often mistaken for a heart attack due to symptoms like chest pain and palpitations. Agoraphobia (B) typically increases attack frequency due to fear of public spaces, onset is often earlier than 30 (C), and depression is a common comorbidity (D), making these options incorrect.
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 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 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.