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Following a severe automobile accident, the client reports insomnia and terrifying nightmares. The symptoms persist for months. Diagnostic testing reveals no physical basis for these recurrent symptoms. These symptoms suggest the client is experiencing which of the following?
- A. Exaggerated fear
- B. Panic attack
- C. Phobic disorder
- D. Post-traumatic stress disorder
Correct Answer: D
Rationale: Post-traumatic stress disorder (PTSD) is a condition of delayed anxiety response that can occur after an emotionally traumatic event. The circumstances of the event can be an actual or threatened injury to self or others. Exaggerated fear, panic attack, and phobic disorder are not indicated with insomnia and/or nightmares following a traumatic event.
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A client who caused a house fire by leaving a pot on the stove often returns home to recheck the burners. The nurse understands this action is performed for which main purpose?
- A. To eliminate guilty feelings
- B. To alleviate anxiety
- C. To compensate for forgetfulness
- D. To avoid a tragedy
Correct Answer: B
Rationale: This is a symptom of OCD, and the tension-relieving act is performed to reduce anxiety. Guilt feelings are more associated with PTSD or for surviving an event when others died. Although turning off burners may help to avoid another tragedy, the repetition is done to help terminate the persistent thoughts and decrease the anxiety. Repetition is not indicated for forgetfulness.
Which level of anxiety is constructive and prepares a person to take action in appropriate situations?
- A. Moderate
- B. Severe
- C. Mild
- D. Panic
Correct Answer: C
Rationale: Mild anxiety is constructive and prepares a person to take action in appropriate situations. In moderate anxiety, the person is more easily distracted. The attention span decreases in severe anxiety. In panic anxiety, the person exaggerates details.
What is a true statement regarding a panic disorder?
- A. Slow onset of physical symptoms
- B. Lasts several minutes
- C. The first instinct is to escape to a safer place.
- D. Marked by hypotension and bradycardia
Correct Answer: C
Rationale: In panic disorder, the first instinct is to escape to a safer place. Episodes of panic may last minutes to less than 1 hour and then spontaneously subside. People who are affected experience an abrupt onset of physical symptoms and terror that include intense apprehension.
The client is brought to the emergency department with complaint of chest pain, rapid breathing, and palpitations. Cardiovascular event is ruled out, and the client is diagnosed with acute panic attack. The client seems embarrassed and states, 'I thought I was going to die.' Which is the best response from the nurse?
- A. It must have been frightening for you.
- B. Chest pain should always be evaluated.
- C. We would not let you die.
- D. But you are okay now.
Correct Answer: A
Rationale: It must have been frightening' is an empathetic statement that validates the feelings of the client and acknowledges the symptoms experienced. This is a therapeutic response and conveys respect, self-worth, and caring. Chest pain should always be evaluated, but this comment is factual not emotionally supportive. Other statements are not indicated as therapeutic or caring.
The nurse is caring for a client with an anxiety disorder who is prescribed an antianxiety drug. Which response by the client indicates a need for more teaching regarding the use of this group of medications?
- A. I can now make decisions.
- B. The stress is more manageable.
- C. The cause of my stress is gone.
- D. My chest tightness is gone.
Correct Answer: C
Rationale: The use of drug therapy in the management of anxiety disorders is intended to eliminate or decrease the symptoms of anxiety. The stress becomes more manageable and allows the client to better deal with issues of daily living. Drug therapy does not eliminate the causative factors.