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The nurse has instructed a client with panic disorder about how to use the technique of positive self-talk. The nurse determines that the client has understood the instructions when the client verbalizes which statement to use during an impending panic attack?
- A. I am feeling very nervous right now.
- B. I can handle this anxiety; it will be over shortly.
- C. I am taking medication to eliminate these symptoms.
- D. Relax your muscles, relax your muscles.
Correct Answer: B
Rationale: Positive self-talk (B) involves reassuring statements that empower the client to manage anxiety, such as affirming control and the transient nature of the attack. Stating nervousness (A) reinforces anxiety, medication reliance (C) is not self-talk, and muscle relaxation (D) is a different technique.
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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 client is diagnosed with generalized anxiety disorder and is prescribed medication therapy. Which agent would the nurse expect to administer to the client to obtain the quickest relief from anxiety symptoms?
- A. Buspirone
- B. Venlafaxine
- C. Alprazolam
- D. Imipramine
Correct Answer: C
Rationale: Alprazolam (C), a benzodiazepine, provides the fastest relief from anxiety symptoms due to its rapid onset. Buspirone (A) and venlafaxine (B) take weeks to be effective, and imipramine (D), a TCA, is slower and less used for GAD.
A group of students is reviewing the signs and symptoms associated with anxiety. The students demonstrate an understanding of the information when they identify which of the following as cognitive symptoms? Select all that apply.
- A. Edginess
- B. Feelings of unreality
- C. Difficulty concentrating
- D. Tunnel vision
- E. Apprehensiveness
- F. Speech dysfluency
Correct Answer: B,C,E
Rationale: Cognitive symptoms of anxiety include feelings of unreality (B), difficulty concentrating (C), and apprehensiveness (E), reflecting mental processing disruptions. Edginess (A) is emotional, tunnel vision (D) is perceptual, and speech dysfluency (F) is behavioral.
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.
The nurse is caring for a client who is being treated in the emergency department for a panic attack. Which of the following nursing interventions would be most appropriate?
- A. Demonstrate empathy for the client by trying to mimic the client?s state of anxiety.
- B. Tell the client that you must leave to go report his symptoms to the psychiatrist on duty.
- C. Tell the client this is an acute exacerbation with a positive prognosis and low morbidity.
- D. Stay with the client, emphasizing that he is safe and that you will remain with him.
Correct Answer: D
Rationale: Staying with the client and emphasizing safety (D) provides reassurance and reduces fear during a panic attack. Mimicking anxiety (A) is inappropriate, leaving the client (B) increases distress, and discussing prognosis (C) is less urgent than providing immediate support.