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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.
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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.
A group of students is reviewing information about anxiety disorders in preparation for a class examination. The students demonstrate understanding of the material when they state which of the following?
- A. Anxiety disorders rank second to depression in psychiatric illnesses being treated.
- B. Women experience anxiety disorders more often than do men.
- C. Most anxiety disorders tend to be short term with individuals achieving full recovery.
- D. Anxiety disorders are more common in children than in adolescents.
Correct Answer: B
Rationale: Women experience anxiety disorders more frequently than men (B), likely due to hormonal and social factors. Anxiety disorders are the most common psychiatric conditions (A), many are chronic (C), and prevalence is higher in adolescents than children (D).
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 nurse is developing a teaching plan for a client with generalized anxiety disorder, focusing on nutrition. Which of the following would the nurse encourage the client to avoid? Select all that apply.
- A. Coffee
- B. Ginseng
- C. Milk products
- D. Citrus juices
- E. Aged cheese
Correct Answer: A,B
Rationale: Coffee (A) and ginseng (B) are stimulants that can exacerbate anxiety symptoms in GAD. Milk products (C), citrus juices (D), and aged cheese (E) are not typically contraindicated unless specific sensitivities exist.
A client comes to the emergency department because he thinks he is having a heart attack. Further assessment determines that the client is not having a heart attack but is having a panic attack. When beginning to interview the client, which question would be most appropriate for the nurse to use?
- A. Are you feeling much better now that you are lying down?
- B. What did you experience just before and during the attack?
- C. Do you think you will be able to drive home?
- D. What do you think caused you to feel this way?
Correct Answer: B
Rationale: Asking about the client?s experiences before and during the attack (B) gathers critical information about triggers and symptoms, aiding in confirming the panic attack diagnosis and planning care. Asking about feeling better (A) is premature, driving ability (C) is irrelevant during acute assessment, and causes (D) are less urgent than symptom details.