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The client recounts to the nurse an instance of jumping onto the hood of a car to avoid an approaching dog, and reports feeling embarrassed by this reaction. The client discloses suffering from a severe dog bite in childhood. The nurse classifies this symptom as which of the following?
- A. Generalized anxiety
- B. Panic disorder
- C. Phobic disorder
- D. Post-traumatic stress disorder
Correct Answer: C
Rationale: Phobic disorders are those conditions in which a person manifests an exaggerated fear. When a person with a phobic disorder is exposed to the fear-causing stimuli, the symptom of anxiety can reach panic levels. Generalized anxiety is related to chronic worrying. Panic disorder can lead to intense fear that precipitates escaping to a safer place but is less specific to phobic disorder in this case. PTSD is not indicated.
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To develop a therapeutic relationship with an anxious client, the nurse looks for ways to build trust. What nursing intervention is most likely to help the nurse gain the client's trust?
- A. Leaving the client alone during a new experience.
- B. Giving support in nonverbal ways.
- C. Being available and attentive to the client's requirements.
- D. Giving detailed explanations and do not repeat them frequently.
Correct Answer: C
Rationale: Building trust is especially critical to developing a therapeutic relationship with an anxious client. Being available and attentive to the client's requirements contributes to this trust. The nurse should not leave an anxious client alone, especially during a new or potentially frightening experience. To manage an anxious client's restricted attention and concentration, directions or explanations must be simple, brief, and repeated frequently to implement adjusting teaching.
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.
The Beer's List is helpful in providing the nurse with a quick reference on potential risks and benefits for which likely group of clients?
- A. Infants and children
- B. Older adults
- C. Chemically dependent
- D. Complex medical problem clients
Correct Answer: B
Rationale: Beer's criterion has been used to identify drugs that may be inappropriately prescribed, ineffective, or cause adverse drug reactions in older adult clients. The Beer's criteria are very useful and help determine risk-associated situations for older adults and specific drugs that may be problematic. Chemical dependency and complex medical problems are not a consideration.
Which provides the best data to support the diagnosis of anxiety disorder in clients of any age? Select all that apply.
- A. Magnetic resonance imaging (MRI)
- B. Computed tomography (CT scan)
- C. Presenting symptoms
- D. Client history
- E. Prescription list
- F. Over-the-counter medications
Correct Answer: C,D
Rationale: Diagnosing of most clients with anxiety disorders is based on presenting symptoms and client history. MRI and CT scans can be done to rule out brain pathology and other physiologic causes. Alcohol, prescription drugs, as well as over-the-counter drugs can alter findings or contribute to symptoms presented but are not the best data to base a diagnosis of anxiety disorder.
The nurse is evaluating an older adult client who, for the past year, has been constantly fretful and worries about finances, living alone, and being lonely. The nurse understands these are symptoms of which type of anxiety disorder?
- A. Generalized anxiety disorder
- B. Phobic disorder
- C. Posttraumatic stress disorder
- D. Obsessive-compulsive disorder
Correct Answer: A
Rationale: Generalized anxiety disorder is characterized by chronic, daily worrying for 6 months or more. Phobic disorder is characterized by an exaggerated and irrational fear, such as the fear of insects, animals, or various life experiences such as riding on a roller coaster or flying on an airplane, some of which are potentially dangerous. Posttraumatic stress disorder is a condition that involves a delayed anxiety response 3 or more months after an emotionally traumatic experience. Obsessive-compulsive disorder is manifested by the performance of an anxiety-relieving ritual to terminate a disturbing, persistent, and recurring thought.