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A nurse stops at the scene of an accident and attempts to assist a client who is lying in an overturned vehicle. When the nurse crawls into the vehicle, the client starts screaming 'incoming, incoming' and is violently thrashing and attempting to kick the nurse. Which is the best interpretation by the nurse?
- A. The client is diagnosed with post-traumatic stress disorder.
- B. The accident has triggered a flashback.
- C. The accident is a result from psychic numbing.
- D. Alcohol use disorder caused the accident.
Correct Answer: B
Rationale: The crash situation has brought about a flashback to a previous trauma in the experience of this client. The client is probably dealing with PTSD but this cannot be assumed as a diagnosis by the nurse. Psychic numbing is not indicated. Although it is not unusual for clients who suffer from PTSD to use alcohol or other substances to suppress symptoms, it cannot be assumed that any alcohol was used in this instance or is the root of the accident.
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Clients with obsessive-compulsive disorder (OCD) may exhibit what sign or symptom?
- A. Fear of situations in which they may capture the attention of others
- B. Delayed anxiety response
- C. Psychic numbing
- D. Performing ritualistic behaviors
Correct Answer: D
Rationale: Clients with OCD may feel compelled to perform the same act repeatedly for a specific number of times or in a prescribed sequence and acknowledge performing ritualistic behaviors. Persons with social phobia experience fear of situations in which they may capture the attention of others. Post-traumatic stress disorder (PTSD) is a condition that involves a delayed anxiety response. Initially, the affected person avoids dealing with the tragedy and detaches from others using a technique that is referred to as psychic numbing.
Which type of therapy assists the clients to alter their irrational thinking?
- A. Psychopharmacology
- B. Desensitization
- C. Behavioral Therapy
- D. Cognitive Therapy
Correct Answer: D
Rationale: Cognitive therapy is a type of psychotherapy in which the therapist helps clients alter their irrational thinking, correct their faulty belief systems, and replace negative self-statements with positive ones. Desensitization involves providing emotional support while gradually exposing a person to whatever it is that provokes anxiety. Behavioral therapy attempts to extinguish undesirable responses by learning other adaptive techniques. Psychopharmacology is the use of medications to treat various disorders.
What is another name for the drug classification known as minor tranquilizers?
- A. Beta-blockers
- B. Anxiolytics
- C. Antidepressants
- D. Central-acting sympatholytics
Correct Answer: B
Rationale: Anxiolytics are drugs that relieve the symptoms of anxiety. They are sometimes referred to as minor tranquilizers. The other choices are not alternative names for minor tranquilizers.
A client who is being interviewed by the nurse begins pacing and wringing hands, and repeating, 'I just need to keep moving.' Which statement by the nurse is most appropriate and therapeutic for this client?
- A. Please sit down and relax.
- B. Is something bothering you?
- C. The physician will talk with you next.
- D. Are you feeling anxious?
Correct Answer: D
Rationale: Asking if the client is feeling anxious helps to identify the behavior being presented and provides an opening for the client to express feelings. Asking the client to sit down and relax is not appropriate and may further agitate the client. By stating the physician will speak with the client next, the nurse is dismissing the behavior. Asking if something is bothering the client is a vague question and does not address the expression of anxiety.
A client is scheduled for magnetic resonance imaging (MRI) of the head and neck. Which action by the nurse would be most helpful in calming the anxious client?
- A. Administer antianxiety medication.
- B. Allow the client to express fears and concerns.
- C. Discuss how others have survived the procedure.
- D. Explain how the client can notify staff if anxiety increases.
Correct Answer: B
Rationale: Building trust and restoring comfort can be accomplished when the nurse allows the client to verbalize anxiety. Identifying the problem and exploring possible solutions may be helpful in decreasing anxiety. The physician may prescribe an antianxiety medication to the client prior to testing. Antianxiety drugs work but conversation is more immediate and safer. Knowing the client can call for assistance during the testing may be helpful in decreasing anxiety. But calling for assistance does not help the client in the moment. Discussion of other clients is not helpful in this situation.