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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.
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A nurse determines that a client who is experiencing anxiety is using relief behaviors. The nurse determines that the client is experiencing which degree of anxiety?
- A. Mild
- B. Moderate
- C. Severe
- D. Panic
Correct Answer: C
Rationale: Relief behaviors, such as avoidance or rituals, are typically used in severe anxiety (C) to reduce overwhelming distress. Mild anxiety (A) enhances alertness, moderate (B) involves manageable distress, and panic (D) involves disorganized behavior, not specific relief behaviors.
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.
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 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.
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.